The Biological Approach to Treating OCD

Question 1

Drug Therapy

Answer 1

• Treatment involving drugs, i.e., chemicals that have a particular effect on the functioning of the brain or body system.
• Psychological disorder: drugs affect neurotransmitter levels.
• Serotonin: neurotransmitter in the brain, low serotonin observed in OCD patients, so particular drug to increase serotonin levels is prescribed.

Question 2

Selective Serotonin Reuptake Inhibitors

Answer 2

• Serotonin released by presynaptic neurons, conveys signal to postsynaptic neuron, then broken down and reabsorbed.
• SSRI’s prevent reabsorption and breakdown.
• SSRI increase levels of serotonin in the synapse and stimulate postsynaptic neuron.
• Fluoxetine (Prozac) is typically 20mg but may be higher.
• Capsule or liquid.
• 3-4 months of daily use to have impact on symptoms.

Question 3

Combining SSRIs with other treatments

Answer 3

• Drugs combined with cognitive behaviour therapy (CBT) for OCD.
• Drugs reduce emotional symptoms.
• Some respond best to CBT alone while others benefit more from drugs.
• Drugs can be prescribed with SSRIs.

Question 4

Alternatives to SSRIs

Answer 4

• Tricyclics (older type of depressant) ex: clomipramine.
• Same effect as SSRIs.
• More severe side effects.
• Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs).
• Different class of antidepressant drugs.
• SNRIs increase serotonin levels and noradrenaline.

Question 5

• Tricyclics (older type of depressant) ex

Answer 5

clomipramine.
- Same effect as SSRIs.
- More severe side effects.

Question 6

• Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs).

Answer 6

• Different class of antidepressant drugs.
• SNRIs increase serotonin levels and noradrenaline.

Question 7

Evaluation
evidence of effectiveness

Answer 7

Evidence of effectiveness
- Clear evidence: SSRIs reduce symptom severity and improve quality of life for patients.
- Soomro et al. (2009) reviewed 17 studies comparing SSRIs to placebos.
- Result: all 17 studies showed better outcome for SSRI patients

Question 8

Evaluation
counter point

Answer 8

Counterpoint: Skapnikas et al. (2016) reviewed outcome studies and concluded that cognitive and behavioral therapies are more effective than SSRIs

Question 9

eval cos

Answer 9

Cost effective and non-disruptive
- Strength: drugs are cost effective and non-disruptive to life.
- Drug treatments are cheap compared to psychological treatments.

Question 10

eval effects

Answer 10

Serious Side Effects
- Small minority of people receive no benefit.
- Side-effects: indigestion, blurred vision, loss of sex drive.
- Ex: tricyclic clomipramine. 1 in 10 erection issues and weight gain, 1 in 100 aggression and heart problems.

Question 11

eval bvi

Answer 11

Biased Evidence
- Goldacre 2013: researchers sponsored by drug companies and may selectively publish positive outcomes for the sponsored drug.
- Lack of independent studies of drug effectiveness and research on psychological therapies may be biased.
- The best evidence available is supporting usefulness of drugs for OCD.