Treating OCD

Question 1

What approach does the treatment of OCD link to?

Answer 1

The biological approach

Question 2

Which drug is the standard when treating OCD?

Answer 2

SSRI’s, or Selective Serotonin Reuptake Inhibitors

Question 3

What type of drug are SSRI’s?

Answer 3

Antidepressants

Question 4

How do SSRI’s work biologically?

Answer 4

They disrupt the reabsorption of serotonin by preventing them from being reabsorbed into the presynaptic neuron, meaning that they remain in the synapse for longer. This increases the chance of them being transmitted successfully into the postsynaptic neuron

Question 5

What does the daily dosage for SSRI’s typically start at?

Answer 5

20mg

Question 6

How long must SSRI’s be taken for before they reduce symptoms of OCD?

Answer 6

3-4 months

Question 7

What is typically prescribed alongside SSRI’s when treating OCD?

Answer 7

CBT or Cognitive Behavioural Therapy

Question 8

Which 2 alternative antidepressants may be used if SSRI’s don’t work?

Answer 8

• Tricyclics, which target more than one system at once
• SNRI’s, which increase noradrenaline levels as well as serotonin levels

Question 9

What may be done if SSRI’s haven’t worked after 3-4 months? (3 Alternatives)

Answer 9

• Dosage increased
• Combined with other drugs
• Alternative antidepressants may be prescribed instead

Question 10

Why are the alternative antidepressants to SSRI’s not prescribed first?

Answer 10

They both have more severe symptoms

Question 11

What review supports the effectiveness of SSRI’s in treating OCD?

Answer 11

Soomro et al’s review, who found a 70% reduction in symptoms for those who take OCD, which was a greater reduction in symptoms that those who took a placebo drug instead

Question 12

What are 5 potential side effects of taking SSRI’s?

Answer 12

• Weight gain
• Suicidal thoughts
• Lack of sex drive
• Blurred vision
• Heart problems

Question 13

Why may SSRI’s be favoured over other alternative treatments?

Answer 13

They are cost effective and non-disruptive compared to other treatments, such as CBT

Question 14

What evidence suggests that SSRI’s don’t cure OCD?

Answer 14

Simpson, who found that 45% who take SSRI’s relapsed within 12 weeks, compared to only 12% who had CBT

Question 15

What evidence suggests SSRI’s may not be the most effective treatment?

Answer 15

Skapinaki’s systematic review, in which he concluded that both cognitive and behavioural therapies were more effective than SSRI’s

Question 16

Why is the time delay involved with taking SSRI’s an issue? (2 Points)

Answer 16

• May lead to patients seeking other treatments that may combat their symptoms faster
• SSRI’s increase serotonin within hours, yet typically don’t begin to reduce symptoms until 3-4 months, which doesn’t make sense if low levels of serotonin are the sole cause of OCD symptoms