the biological approach to treating OCD

Question 1

drug therapy - SSRIs

Answer 1

• selective serotonin uptake inhibitor, type of antidepressant
• serotonin released by presynaptic neurons and travels across a synapse
• neurotransmitter chemically conveys signal from presynaptic neuron to postsynaptic neuron, reabsorbed by presynaptic neuron where it is broken down and reused
• SSRIs prevent reabsorption and breakdown, increase amounts of serotonin in the synapse, continue to stimulate the postsynaptic neuron
• takes 3-4 months of daily usage of SSRIs to have much impact on symptoms

Question 2

drug therapy - combining SSRIs with other treatments

Answer 2

• drugs often used alongside CBT
• drugs reduce emotional symptoms such as anxiety and depression, means that people can engage more effectively with CBT
• some people respond best to CBT alone whilst others benefit from using drugs like fluoxetine
• occasionally other drugs are prescribed alongside SSRIs

Question 3

drug therapy - alternatives to SSRIs

Answer 3

• if a SSRI is not effective after 3-4 months then the dosage can be increased or combined with other drugs

tricyclics - such as clomipramine, act on various systems including the serotonin system, usually have more severe side effects so are used for people who dont respond well to SSRIs

SNRIs - serotonin-noradrenaline reuptake inhibitors, different class of antidepressant drugs, second line of defence for those who dont respond to SSRIs, increase levels of serotonin as well as noradrenaline

Question 4

evaluation - evidence of effectiveness

Answer 4

• clear evidence to show that SSRIs reduce symptom severity and improve quality of life
• Mustafa Soomro reviewed 17 studies that compared SSRIs to placebos, all studies showed better outcomes for SSRIs than placebo
• symptoms typically reduce for around 70% of people taking SSRIs
• the other 30% can often be helped by alternative drugs, combinations of drugs or therapies

Question 5

evaluation - counterpoint to evidence of effectiveness

Answer 5

• some evidence to suggest that even if drug treatments are helpful, they may not be the most effective treatments
• Petros Skapinakis carried out a systematic review and concluded that both cognitive and behavioural studies were more effective than SSRIs

Question 6

evaluation - cost-effective and non-disruptive

Answer 6

• drug treatments in general are cheap comapred to psychological treatments, many tablets or liquid doses can be manufactured in the time it takes to conduct one session of therapy
• good value for public health systems, good use of limited funds
• SSRIs are non-disruptive to people’s lives, you can simply take drugs until your symptoms decline
• drugs are popular with many people with OCD and their doctors

Question 7

evaluation - serious side-effects

Answer 7

• although drugs such as SSRIs help most people, a small minority get no benefit
• some experience side effects such as indigestion, blurred vision and loss of sex drive
• usually temporary but can be quite distressing and for some will be long-lasting
• more than 1 in 10 people experience erection problems and weight gain, 1 in 100 become aggressive and experience heart-related problems
• some people have reduce quality of life as a result of taking drugs and may stop taking them altogether, meaning they cease to be effective