Treatment of OCD

Question 1

Changing levels of neurotransmitters

Answer 1

Drug therapy for mental disorders aims to increase/decrease levels of neurotransmitters in the brain or increase/decrease their activity. Low levels of serotonin are associated with OCD, therefore drugs work to increase the levels of serotonin

Question 2

Selective serotonin reuptake inhibitors (SSRIs)

Answer 2

SSRIs prevent the reabsorption and breakdown of serotonin in the brain. This increases its levels in the synapse and thus serotonin continues to stimulate the postsynaptic neuron. This compensates for whatever is wrong with the serotonin system in OCD

Question 3

Typical dosage - OCD treatment drug therapy

Answer 3

A typical daily dose of fluoxetine (an SSRI) is 20mg although can be increased. Takes 3-4 months of daily use for SSRIs to impact upon symptoms.

Question 4

Combining SSRIs with CBT

Answer 4

Drugs are often used alongside CBT to treat OCD. The drugs reduce emotional symptoms (anxiety, depression), this means they can engage more effectively with CBT

Question 5

Alternative to SSRI- tricyclics

Answer 5

Tricyclics (an older antidepressant) are used such as clomipramine. These have the same effect on the serotonin system as the SSRIs but with more severe side effects.

Question 6

Alternative to SSRI- SNRIs

Answer 6

In the last five years Serotonin Noradrenaline Reuptake Inhibitors (SNRIs) have been used to treat OCD. These are a plan B for those who SSRIs dont work for. They increase serotonin and noradrenaline levels.

Question 7

Strength of drug therapy for OCD- effective

Answer 7

Soomro et al (2009) reviewed 17 studies of SSRIs for treatment. All 17 students showed better outcomes following SSRIs than placebos. OCD symptoms reduce for 70% of people taking SSRIs.

Question 8

Counterpoint of the effectiveness of drug therapy for OCD

Answer 8

Although drug treatments may be better than placebos, they may not be the most effective treatments. Cognitive and behavioural therapies may be more effective than SSRIs. (Skapinakis et al 2016)

Question 9

Strength of drug therapy for OCD- cost effective and non-disruptive

Answer 9

Cheap compared to psychological treatments; good value for NHS. Non disruptive to people’s lives -taking the drugs is more convenient than going into therapy sessions.

Question 10

Limitation of drug therapy for OCD- side effects

Answer 10

Some taking SSRIs get no benefit, some get bad side effects. Indigestion, blurred vision, loss of sex drive. (although these are usually temporary side effects. Side effects with Clomipramine are more common and serious. More than 1 in 10 people on it experience erection problems and weight gain, 1 in 100 become aggressive. (drugs make quality of life poor and therefore people may stop the treatment)