The Biological Approach to treating OCD (Drug therapy) Flashcards
The Biological Approach assumes…
…that abnormality stems from abnormal physiological processes.
Therefore, treatments based on the biological approach focus on dealing with these abnormal physiological processes.
Given the evidence that OCD is linked to abnormal levels of neurotransmitters (dopamine and serotonin), there are drug treatments to address this chemical imbalance.
Anti-Depressants (SSRIs)
Low levels of serotonin are implicated in the ‘worry circuit’ (see neural explanations), so increasing levels of the neurotransmitter may normalise activity in this part of the brain.
The most commonly used drug to do this is a Selective Serotonin Reuptake Inhibitor (SSRI) e.g. Prozac, which is generally used as an anti-depressant.
Anti-Depressants (SSRIs) – How do they work?
Serotonin is released into the synapse from the pre-synaptic neuron and targets receptor sites on the post-synaptic neuron.
After it has sent the message to the next neuron it is released back into the synaptic gap.
Serotonin is normally removed from the synaptic gap by reuptake sites (or transporter sites) on the pre-synaptic neuron.
SSRIs block the serotonin reuptake sites, allowing serotonin to remain active in the synapse for longer. This therefore leads to greater availability of serotonin in the synaptic space (to bind to receptor sites).
Anti-Anxiety Drugs
Benzodiazepines e.g. Valium, Diazepam.
BZ’s slow down the activity of the central nervous system by enhancing the activity of a natural biochemical substance called GABA (gamma-butyric acid).
GABA is the body’s natural form of anxiety relief (it has a quietening effect on the brain). GABA acts by…
It reacts with special sites on receiving (post-synaptic) neurons. It locks into these receptors causing a channel to open that increases the flow of chloride ions into the neuron.
Chloride ions make it more difficult for the neuron to be stimulated by other neurotransmitters - resulting in a reduction in activity and the person feeling more relaxed.
P: Research suggests that drug therapy, specifically anti-depressants (SSRIs) are effective in reducing OCD symptoms (both the obsessive thoughts and compulsive behaviour).
E: Soomro et al. (2008) reviewed 17 studies (meta-analysis) into the use of SSRIs vs. placebo treatments on 3,097 OCD patients and found SSRIs to be more effective than placebos at reducing symptoms in the short-term, up to 3 months after treatment.
C: This therefore suggests that the patients’ symptoms improved as a result of the medication elevating levels of serotonin, as opposed to the expectation that their symptoms would improve.
Is drug therapy a cure for OCD?
P: It could be argued that drug treatments do not actually cure OCD - essentially they just reduce the symptoms to enable the individual to lead a more normal life.
E: …which is indicated by the fact that patients often relapse (their symptoms return) within a few weeks if medication is stopped.
C: Therefore, drugs do not deal with the root cause of OCD – they ‘paper over the cracks’ - and so are not necessarily a good long-term treatment option.
Research has shown that the most effective treatment is to combine a drug treatment with a psychological treatment e.g. CBT.
What are some of the side effects associated with drug treatments?
P: A limitation is the side effects that OCD patients may experience.
E: SSRIs: Nausea, headaches, insomnia, low libido, loss of appetite.
BZs: Increased aggression, impaired memory and a risk of addiction - they should only be prescribed for a maximum of 4 weeks.
C: Therefore, it may be the case that the side effects are severe enough to outweigh the benefits of the drugs i.e. removing the symptoms of OCD.
Ease of use - why might drug therapy be preferable to a psychological therapy such as CBT?
P: Drug treatments are widely used to treat OCD and are often considered more user-friendly and preferable to psychological treatments like CBT.
E: Drug treatments require little effort and time, and are relatively cheap in comparison to CBT, where patients are expected to attend several sessions with a therapist, discuss their thoughts and complete ‘homework’ assignments outside of the therapy sessions.
C: Therefore, they are a popular option with patients who lack the time, motivation, commitment and verbal skills needed for CBT.
Drugs can also reduce anxiety and symptoms sufficiently for CBT to be successfully introduced later.
P: Drug treatments may not in fact reduce the obsessive symptoms associated with OCD.
E: Instead, it may be the case that they lesson the depressive symptoms associated with OCD.
C: This therefore casts doubt on the effectiveness of drug therapy as a treatment for OCD.
