Psychopathology : Treating OCD Flashcards
What is the main drug therapy for OCD?
> SSRIs (selective serotonin reuptake inhibitors) are a class of medication commonly used to treat OCD. The most popular SSRI is Fluoxetine (also called Prozac).
They are the first line treatment for OCD (meaning they are the first treatment psychiatrists will prescribe).
How do SSRIs work?
> SSRIs work by blocking the reuptake of serotonin. Reuptake is the process through which a presynaptic neuron reabsorbs neurotransmitters it has releases, effectively ending the process of synaptic transmission.
In a patient taking SSRI, the serotonergic neurons (meaning neurons that communicate using serotonin) are prevented from engaging in reuptake, meaning they continue to release serotonin into the synapse, where it can bind with serotonin receptors.
How do SSRIs treat OCD?
> By inhibiting reuptake, SSRIs lead to an increase in levels of serotonin within the synapses. Since people with OCD have abnormally low levels of serotonin, SSRIs can work against this by increasing their serotonin levels .
Serotonin plays a role in inihibiting neural activity within the prefrontal cortex. Since hyperactivity of the prefrontal cortex plays a role in the compulsive behaviours associated with OCD, then increasing serotonin levels in this brain region by inhibiting reuptake may help treat the behavioural characteristics of OCD.
Sine serotonin helps regulate mood, this can have beneficial effects on the anxiety experienced by people with OCD.
What other treatments for OCD are available?
> Some patients receive little to no benefit with SSRIs. For these patients, psychiatrists may consider also treating the patient with an antipsychotic medication. Antipsychotics are not a first line treatment (meaning they would only be used after first trying SSRIs).
How do antipsychotics work?
> They are dopamine antagonists, meaning they work by binding with but not activating dopamine receptors.
Essentially they block dopamine receptors, and therefore prevent dopamine binding with and activating dopamine receptor.
How do antipsychotics treated OCD?
Antipsychotics are effective in treating ICD as they reduce the activity of dopaminergic neurons (meaning neurons that communicate using dopamine). This is important as people with OCD are known to have abnormally high levels of dopamine, and this had been seen as a cause of their hyperactive prefrontal cortex, which has been linked to the symptoms of compulsions.
What side effects are a limitation of the biological treatment for OCD?
All drug treatements have side effects. Common side effects for SSRIs include loss of sex drive and indigestion. Users of SSRIs can also experience withdrawal effects if they stop taking the medications suddenly. Other medications used to treat OCD have even more severe side effects. For example, antipsychotics can lead to significant weight gain and problems controlling the body. The negative consequences of taking medications, such as SSRIs, are not only unpleasant in themselves, but they also present a problem for the ability of these drug therapies to treat OCD. If patients find the side effects unpleasant enough, then they may stop taking the
medication. This means that drug therapies may be unable to treat OCD as people are unwilling
to take the medication
What research support for the effectiveness of the biological treatment of OCD?
For example, Soomro (2008) reviewed the findings of 17 studies that investigated the effectiveness of SSRIs as a treatment for OCD. This shows that SSRIs were significantly better at treating OCD than placebo. This proves the value of biological treatments of OCD. The fact that SSRIs were more effective than a placebo illustrates that the drug treats the symptoms, rather than the benefits being entirely a product of the patients expectations. Moreover, this study’s findings are strengthened by it being a review. Reviews consider multiple studies. Consequently, they consider a large sample size thus have greater external validity than a single study.
What is a limitation of the biological treatment of OCD?
That the supporting research may be vulnerable to publication bias. Publication bias/the file drawer problem, refers to the tendency to favour the publication of studies which show a positive result over studies which give negative results. According to Taylor (2008), in biomedical research there is a strong preference for the publication of studies which show the positive benefits of medication, whereas research which does not support a drug’s effectiveness tends to filed away. A possible motivation for this is financial rewards associated with the discovery of a viable drug treatment. As a consequence of publication bias, the research support for biological treatments of OCD may not be as strong as it appears.
