Treatments for OCD Flashcards
The biological approach to treating OCD
What are the two biological treatments used to treat OCD:
- SSRIs
- Tricyclics (SRI)
What does SSRI stand for
Selective Serotonin Reuptake Inhibitors
What is an example of SSRIs
Prozac (Fluoexetine)
SSRIs:
- They r antidepressants, e.g Prozac
- Used to reduce anxiety associated with OCD
- Since OCD is due to low levels of serotonin, SSRIs increase lvel of serotonin in the synapse
- This regulates mood + decreases anxiety
- Work by blocking reuptake back into PRE-SYNAPTIC neuron, leaving more serotonin in the synapse
- More serotonin to influence activity of post SN prolonging the activation of serotonin receptors, wich makes transmission of the inhibition signal to the next neuron, easier
- This addresses the deficiency of serotonin in the synapse
- Can take 3-4 months of daily use of SSRIs to have impact on OCD symptoms
How long does daily use of SSRIs take to have an impact on OCD:
3-4 months
What does SRI stand for
Serotonin Reuptake Inhibitors
What was the first anti-depressant to be used for OCD:
The tricyclic clomipramine
Tricyclics:
- SRIs work same as SSRIs but r less selective in their action
- Block mechanism for reabsorbing serotonin and noradrenaline into presynaptic neuron
- More neurotransmitters left in synapse, prolonging activity of receptors, making transmission to the next neuron easier
- Used when SSRIs r not effective due to side effects
- Have the advantage of targeting more than one NT
Strength: supporting evidence of effectiveness of SSRIs in treatment of OCD
Ev - Soomro (2008) reviewed 17 studies on use of SSRIs to treat OCD. Found SSRIs more effective than placebo in reducing OCD symptoms: up to 3 months after treatment. Symptoms decline for around 70%.
Ev -Of remaining 30%, alt. drug treatments/ combo of drug + psychological treatments effective for some.
Ex - Shows that →
1. SSRI is effective - remission in most of the cases when SSRIs are taken.
2. SSRI is a flex. treatment - can be dispensed alongside psych. trt to make a lasting impact on OCD symptoms.
Weakness: Problem with drugs: not a lasting cure: risk of relapse after discontinuation.
Ev - Simpson et al: 45% of patients on clomipramine (SRI) relapsed back into OCD symptoms within 12 weeks after finishing course. Relapse rate was higher than that for patients who went through psychological therapy (12%)
Ex- Shows that → Drugs do not cure OCD (proven by high relapse rate) + They only temporarily treat the symptoms of OCD + For more long term treatment, patients would be better of using psychological therapies.
L - This shows biological treatments like drugs are limited in their effectiveness.
Weakness: drug therapy not app. for all patients: some may suffer from side-effects.
Ev - Common side-effects when taking SSRIs include nausea, headache, insomnia, loss of sex drive (Soomro et al 2008).
Ev - Tricyclic drugs (clomipramine): even more serious side effects: hallucination, weight gain, irregular heartbeat.
EX -
1. This Reduces effectiveness of SSRIs → people may stop taking them + drop the treatment to avoid SEs.
2. Reduces appropriateness of SSRIs vs. psychological treatments like CBT (which have no SE) → As people with existing cardiovascular/sleep conditions cannot take drug therapy.
Strength: Drugs often the preferred treatment for OCD:
Ev 1 - Non-disruptive to patient’s life - requires little effort from user and barely any time. → compared to CBT: patient has to attend regular appointments,+ have hwk to complete
Ex 1 → means that for patients who do not suffer SE - likely to have low attrition rates + patients more likely to stick to treatment + complete it
Ev 2 → Drugs are also a good value for health service providers like NHS: as cheaper than psych treatment: as do not require a therapist to administer treatment.
Ex 2 → Since drugs are easily dispensable + cost effective → increases appropriateness of drugs for organisations like NHS
