The biological approach to: treating OCD Flashcards
What does drug therapy for mental disorders aim to do?
Increase or decrease the levels of neurotransmitters in the brain or increase/decrease their activity
High/low levels of serotonin are associated with OCD
Low
Drugs to treat OCD work in various ways to…
increase the level of serotonin within the brain
The standard medical treatment used to tackle the symptoms of OCD involves…
a particular type of antidepressant drug called selective serotonin reuptake inhibitors
What do SSRIs stand for?
Selective serotonin reuptake inhibitors
Which system in the brain do SSRIs work on?
The serotonin system
Serotonin is released by ___________ neurons in the brain
presynaptic
Serotonin is released by presynaptic neurons in the brain before it travels…
across the synapse
How does serotonin travel across the synapse?
Diffuses from the presynaptic neuron to the postsynaptic neuron
What happens when serotonin reaches the postsynaptic neuron?
It is reabsorbed by the presynaptic neuron where it is broken down and reused
What do SSRIs do?
Increase levels of serotonin in the synapse
How do SSRIs increase levels of serotonin in the synapse?
By preventing the reabsorption and breakdown of it, thus continuing to stimulate the postsynaptic neuron
What does preventing the reabsorption and breakdown of serotonin cause?
Continued stimulation of the postsynaptic neuron
What does continued stimulation of the postsynaptic neuron as a result of an SSRI compensate for?
Whatever is wrong with the serotonin system in OCD
Dosage and any other advice regarding SSRIs vary according to…
which SSRI is prescribed
What’s a typical daily dose of sertraline (zoloft)?
50mg
Why may the dose of an SSRI be increased?
If it is not benefitting the person
How much daily use of an SSRI does it take for there to be much impact?
Three to four months
What can happen when an SSRI is not effective after three to four months?
The dose can be increased or it can be combined with other drugs
True/False: People respond very differently to different drugs
True
Tricyclics are an older/newer type of antidepressant
older
Which system does clomipramine act on?
Various systems including the serotonin system
Clomipramine has the same/different positive effects as SSRIs
the same
True/False: Clomipramine has less severe side-effects than SSRIs
False, more
Clomipramine is generally kept…
in reserve for people who don’t respond to SSRIs
What have SNRIs recently been used to treat?
OCD
SNRIs are a/the same/different class of antidepressant drugs than/as SSRIs
a different than
True/False: Like clomipramine, SNRIs are second in line of defence for people who don’t respond to SSRIs
True
What do SNRIs do?
Increase levels of serotonin as well as another different neurotransmitter - noradrenaline
What is drug therapy for OCD often used alongside?
CBT
Drug therapy for OCD tend to reduce a person’s _________ symptoms
emotional
Give an example of a symptom of OCD that drug therapy is likely to reduce
Any emotional symptom such as feeling anxious or depressed
How is drug therapy beneficial when it comes to CBT?
People can engage more effectively as a result of their emotional symptoms being reduced
True/False: In practice some people respond best to CBT alone instead of combining it with drug therapy
True
True/False: Occasionally other drugs are prescribed for OCD alongside SSRIs
True
There is clear evidence to show that SSRIs reduce what and improve what for people with OCD?
Reduce symptom severity and improve quality of life
What did Soomro et al. find in their review of 17 studies that compared SSRIs to placebos in the treatment of OCD?
All 17 studies showed significantly better outcomes for SSRIs than for the placebo conditions
Soomro et al. reviewed __ studies that compared SSRIs to placebos in the treatment of OCD
17
Soomro et al. found that typically OCD symptoms reduce for around __% of people taking SSRIs
70
What did Soomro et al. find for the remaining 30% of people taking SSRIs who didn’t find a reduction in their OCD symptoms?
Most could be helped by either alternative drugs or combinations of drugs and psychological therapies
Soomro et al.’s findings show that drugs do/don’t appear to be helpful for most people with OCD
do
True/False: There is some evidence to suggest that even if drug treatments are helpful for most people with OCD they may not be the most effective treatments available
True, Skapinakis et al. (2016)
What did Skapinakis et al. (2016) conclude from their systematic review of outcome studies for OCD?
Both cognitive and behavioural therapies were more effective than SSRIs in the treatment of OCD - drugs may not be the optimum treatment for OCD
True/False: A large majority will not benefit from SSRIs
False, only a small minority will not
Give 2 examples of side-effects some may experience as a result of SSRIs
Any from indigestion, blurred vision, loss of sex drive, etc.
True/False: Side-effects for SSRIs are usually long-lasting
False, they are usually temporary
True/False: Side-effects for SSRIs can be long-lasting
True
Drugs can have potentially serious…
side-effects
With clomipramine, side-effects are more…
common and can be more serious
1 in __ people taking clomipramine experience erection problems and weight gain
10
1 in ___ people taking clomipramine become aggressive and experience heart-related problems
100
As a result of side-effects, some people have a reduced what as a result of taking drugs?
Quality of life
Some people may stop taking drugs as a result of their side-effects. What does this mean for the effectiveness of the drugs?
They cease to be effective for the person
Drugs are cheap/expensive compared to psychological treatments
cheap
How are drugs cheap compared to psychological treatments?
Many thousands of tablets or liquid can be manufactured in the time it takes to conduct one session of a psychological therapy
Why is using drugs to treat OCD good for public systems like the NHS in particular?
It is good value for money and represents a good use of limited funds
Compared to psychological therapies, SSRIs are disruptive/non-disruptive to people’s lives
non-disruptive
True/False: If you wish you can simply take drugs until your symptoms decline
True
If you wish you can simply take drugs until your symptoms decline. How is this different from psychological therapy?
Psychological therapy involves time spent attending therapy sessions.
The fact that drugs are ___-__________ to people’s lives means they are popular with many people with OCD and their doctors
non-disruptive
Why do some psychologists believe that the evidence for drug effectiveness is biased?
Researchers are sponsored by drug companies and may selectively publish positive outcomes for the drugs their sponsors are selling
True/False: There is a lack of independent studies of drug effectiveness
True
There is a lack of independent studies of drug effectiveness. What’s the problem with this?
Research on psychological therapies may be biased
The best evidence available is supportive of/against the usefulness of drugs for OCD
supportive
