The Biological Approach to Treating OCD

Question 1

What is the most commonly used treatment for OCD?

Answer 1

drug therapy

Question 2

Give 4 examples of drug therapies

Answer 2

1. antidepressants: SSRIs
2. antidepressants: tricyclics
3. anti-anxiety drugs
4. other drugs

Question 3

What do SSRIs do?

Answer 3

block the re-uptake of serotonin at the pre-synaptic membrane, increasing serotonin concentration at receptor sites on the post-synaptic membrane

Question 4

What are antidepressants used for (OCD patients)?

Answer 4

used to reduce the anxiety associated with OCD

Question 5

Give 3 brand names for SSRIs

Answer 5

Zoloft, Paxil and Prozac

Question 6

How do SSRIs work?

Answer 6

serotonin is released into a synapse from one nerve (neuron). It targets receptor cells on the receiving neuron at receptor sites and, afterwards, is re-absorbed by the initial neuron sending the message. In order to increase levels of serotonin at the synapse, and increase stimulation to the receiving neuron, this re-absorption (re-uptake) is inhibited

Question 7

Give an example of a brand that produce tricyclics

Answer 7

Anafranil

Question 8

What does tricyclics do?

Answer 8

block the transport mechanism that re-absorbs both serotonin and noradrenaline into the pre-synaptic ncell after it has fired.
As a result. more of these neurotransmitters are left in the synapse, prolonging their activity and easing transmission of the next impulse

Question 9

What do BZs do?

Answer 9

slow down the activity of the central nervous system by enhancing the activity of the neurotransmitter GABA, a neurotransmitter that, when released, has a general quieting effect on many of the neurons in the brain

Question 10

How do BZs work?

Answer 10

by reacting with GABA receptors on the outside of receiving neurons. When GABA locks into these receptors it opens a channel that increases the flow of chloride ions into the neuron. Chloride ions make it harder for the neuron to be stimulated by other neurotransmitters, thus slowing down its activity and making the person feel more relaxed

Question 11

What are the 5 evaluation points for the biological approach to treating OCD?

Answer 11

1. effectiveness
2. drug therapies are preferred to other treatments
3. side effects
4. not a lasting cure
5. publication bias

Question 12

What is the PEEL paragraph for the biological approach to treating OCD evaluation point; effectiveness?

Answer 12

P - there is considerable evidence for the effectiveness of drug treatments
E - typically a randomised control trial is used to compare the effectiveness of the drug versus a placeo
E - Soomro et al., (2008) reviewed 17 studies of the use of SSRIs with OCD patients and found them to be more effective than placebos in reducing the symptoms of OCD up to three months after treatment. One of the issues regarding the evaluation of treatment is that most studies are only of three to four months’ duration (Koran et al., 2007)
L - therefore, while drug treatments have been shown to be effective in the short term, the lack of long-term data is a limitation

Question 13

What is the PEEL paragraph for the biological approach to treating OCD evaluation point; drug therapies are preferred to other treatments?

Answer 13

P - one of the great appeals of using drug therapy is that it requires little input from the user in terms of effort and time
E - in contrast, therapies such as CBT require the patient to attend regular meetings and put considerable thought into tackling their problems.
E - drug therapies are also cheaper for the health service because they require little monitoring and cost much less than psychological treatments. Furthermore, patients may benefit simply from talking with a doctor during consultations
L - these benefits means that drug therapies are more economical for the health service than psychological therapies

Question 14

What is the PEEL paragraph for the biological approach to treating OCD evaluation point; side effects

Answer 14

P - all drugs have side effects, some more severe than others
E - for example, nausea, headache and insomnia are common side effects of SSRIs (Soomro et al., 2008). Although not necessarily severe, they are often are enough to make a patient stop taking the drug.
E - Tricyclic antidepressants tend to have more side effects (e.g. hallucinations and irregular heartbeat) than SSRIs and so are only used in cases where SSRIs are not effective
E - the possible side effects of BZs include increased aggressiveness and long-term impairment of memory. There are lso problems with addiction, so the recommendation is that BZ use should be limited to a maximum of four weeks (Ashton, 1997)
L - these side effects, and the possibility of addiction, therefore limit the usefulness of drugs as treatments for OCD

Question 15

What is the PEEL paragraph for the biological approach to treating OCD evaluation point; not a lasting cure

Answer 15

P - an issue with drug treatments is that they are not a lasting cure for people with OCD
E - Maina et al., (2001) found that patients relapse within a few weeks if medication is stopped.
E - Koran et al. (2007), in a comprehensive review of treatments for OCD sponsored by the American Psychiatric Association (APA), suggested that, although drug therapy may be more commonly used, psychotherapies such as CBT should be tried first
L - this suggests that, while drug therapy may require little effort and also may be relatively effective in the short term, it does not provide a lasting cure

Question 16

What is the PEEL paragraph for the biological approach to treating OCD evaluation point; publication bias

Answer 16

P - Turner et al. (2008) claim that there is evidence of a publication bias towards studies that show a positive outcome of antidepressant treatment, thus exaggerating the benefits of antidepressant drugs
E - the authors found that, not only were positive results more likely to be published, but studies that were not positive were often published in a way that conveys a positive outcome
E - drug companies have a strong interest in the continuing success of psychotherapeutic drugs and much of the research is funded by these companies
L - as Turner et al. suggest, such selective publication can lead doctors to make inappropriate treatment decisions that may not be in the best interest of their patient