The biological approach to treating OCD

Question 1

What are SSRIs?

Answer 1

Selective serotonin reuptake inhibitors such as fluoxetine are antidepressants that are prescribed to treat many mental disorders including OCD.

Question 2

Why are SSRIs needed?

Answer 2

Serotonin carries chemical messages across the brain by travelling down a presynaptic neuron and being released into a synapse. These chemical messages are then received on the receptor sites of the postsynaptic neuron. Any serotonin that is ‘left over’ is then reabsorbed by the reuptake sites where it can be resused.
However, those with OCD reabsorb it too quickly

Question 3

How do SSRIs work?

Answer 3

SSRIs block reuptake sites on the presynaptic neuron, so serotonin remains in the synapse for longer, meaning it has more chance of being taken up by the receptor sites on the postsynaptic neuron- this then increases serotonin levels- decreases the symptoms of OCD (roughly after three/four months of use)

Question 4

What are the alternatives to SSRIs?

Answer 4

alternative drugs may be used if SSRIs show little improvement after several months. One alternative may be tricyclics which work in a very similar way to SSRIs however, also work on other neurotransmitter systems such as norepinephrine. An example is known as clomipramine. They have more severe side effects so are only prescribed if SSRIs haven’t worked

Question 5

What are the strengths of treatment of OCD?

Answer 5

1. There is research to support the effectiveness of SSRIs in treating OCD- Soomro et al (2009)- reviewed 17 studies and found that SSRIs are more effective than placebos- 70% who received them saw a decrease in their symptom severity- proves it can be helpful
2. cheap and require little effort- 1 months work of SSRIs cost the NHS around £4.21 but CBT can cost hundreds of pounds per patient depending on how many sessions they use- also the patients must attend and complete homework tasks for CBT but SSRIs are easy to take- cost-effective and easy to use

Question 6

What are the limitations of treatment of OCD?

Answer 6

1. many side effects- anxiety, digestive, visual and sleeping problems- replacing one set of problems with another- may stop taking them altogether if the side-effect outweigh the symptoms of OCD- adding to the problem
2. evidence to suggest that SSRIs are best when combined with a psychological therapy- Foa et al (2003)- clomipramine when combined with cognitive behavioural therapy (CBT) was more effective- CBT alone was better than clomipramine alone- CBT has more benefit
3. Drugs are considered more unethical- not very empowering- dont require any real effort