Psychopathology: The biological approach to treating OCD Flashcards
What is the biological approach to treating OCD?
Drug therapy.
What is the aim of drug therapy?
- To increase or decrease levels of neurotransmitters in the brain or to increase or lower their activity.
- antidepressants: SSRIs
- antidepressants: tricyclics
- anti anxiety drugs
- other drugs
- Easy and accessible currently, drug therapy is the most commonly used treatment for OCD
What is SSRI?
The most commonly used drugs for OCD are antidepressants. Low levels of the neurotransmitter serotonin are associated with OCD, so antidepressants increase the level of serotonin in the body. They also reduce the anxiety associated with OCD and normalise the worry circuit.
They increase serotonin levels, which regulate mood and anxiety — serotonin is implicated in behaviours such as aggression, eating, sleep and depression.
They do this by blocking the repute of serotonin at the pre-synaptic membrane, thus increasing serotonin concentration at receptor sites on the postsynaptic membrane.
What are tricyclics?
Antidepressants are used to treat OCD.
They block the transporter mechanism that reabsorbs both serotonin and noradrenaline into the pre-synaptic cell.
Noradrenaline is found in areas of the brain involved in governing ANS activity such as blood pressure and heart rate.
As a result, more serotonin and noradrenaline are left in the synapse which prolongs their activity and eases transmission of the next impulse.
They target more than one neurotransmitter but have greater side effects so are used as a second resort when SSRIs are not effective.
What are anti-anxiety drugs?
BZs (benzodiazepines) such as Xanax are commonly used to reduce anxiety.
They slow down the activity of the CNS by enhancing the activity of the neurotransmitter GABA (gamma-aminobutyric acid) which has a quietening effect on many of the neurons in the brain.
It reacts with GABA receptors on the outside of the receiving neurons lock onto them and opens a channel that increases the flow of chloride ions into the neuron.
These make it harder for the neuron to be stimulated by other neurotransmitters, thus slowing down its activity and making the person feel more relaxed.
What is GABA?
- Gamma-aminobutyric acid
- A neurotransmitter that regulates excitement in the nervous system and reduces anxiety.
What is noradrenaline?
A neurotransmitter found in areas is the brain involved in governing autonomic nervous system activity.
Such as blood pressure or heart rate.
What is serotonin?
A neurotransmitter implicated in behaviours such as aggression, eating behaviour, sleep and depression.
What are other drugs?
- D-Cycloserine has an effect on reducing anxiety and may be an effective treatment for OCD, particularly when used in conjunction with psychotherapy.
- It is an antibiotic used in the treatment of tuberculosis.
- Appears to enhance the transmission of GABA, thus reducing the anxiety associated with OCD.
A03: Treating OCD
+ Evidence for the effectiveness
- Side effects
- Preferred to other therapies
- Criticised for treating symptoms not the cause
A03: Evidence for effectiveness
There is considerable evidence to show that drug treatments for OCD are effective. For example, Soomro et al (2008) reviewed 17 studies of the use of SSRIs with OCD patients and found them to be more effective than placebos in reducing the symptoms of OCD up to three months after receiving treatment. A strength of this research is the fact that it was scientific and involved the objective measurement of the effectiveness of SSRIs on a number of patients over a period of time. This is positive because the research is valid and shows that SSRIs are an effective way of managing OCD in the short term.
A03: Side effects
Drugs used to treat OCD can have negative and potentially harmful side effects. For example, the side effects of anti-depressant drugs such as Prozac include nausea, insomnia, sexual dysfunction and suicidal morbidity, the side effects of anti-anxieties include dependency and overdose can lead to death. This is a weakness because drug therapies could replace a mental illness such as OCD with other issues for an individual to cope with and so the safety of these drugs should be questioned and patients made fully aware of the potential side effects.
A03: preferred to other therapies
Drug therapy is often preferred to other treatments because it requires little effort from the patient and little input in terms of time. All the patient has to do is take their prescribed pills, whereas other therapies such as CBT require much more dedication as clients need to attend regular meetings and put considerable thought into tackling their problems. This makes it much easier and suitable for those who struggle talking through their problems or who don’t have a lot of time for therapy — e.g. men, people with learning difficulties.
A03: Criticised for treating symptoms not the cause
Drug treatments are criticised for treating the symptoms of the disorder and not the cause. Although SSRIs work by increasing the levels of serotonin in the brain, which reduces anxiety and alleviates the symptoms of OCD, it does not treat the underlying cause of OCD. Furthermore, once a patient stops taking the drug, they are prone to relapse, suggesting that psychological treatments may be more effective, as a long-term solution.
