Treating OCD

Question 1

Antidepressants - SSRI’s

Answer 1

• Work on serotonin system in the brain.
• Released by presynaptic neurons and travels across the synapse.
• NT chemically conveys signal from presynaptic neuron to post synaptic neuron and reabsorbed by post synaptic neuron where it’s broken down and reused.
• SSRI’s increase serotonin levels in the synapse and continue to stimulate the postsynaptic neuron.
• Compensated for errors in serotonin system in OCD.
• 3 to 4 months of daily use for it to have an impact.

Question 2

Antidepressants - alternatives to SSRI’s

Answer 2

• Tricyclics - same effect on serotonin system as SSRI’s but can have much more severe side effects.
• SNRI’s - more recent. Increase serotonin levels as well as noradrenaline which is another Neurotransmitter.
• Anti anxiety drugs - combined with anti depressants. Don’t treat OCD alone. BZs slow down activity of CNs by enhancing activity of NT GABA. Causes relaxation.
• Beta Blockers - given to treat immediate symptoms. Act on heart and blood pressure to reduce physical symptoms.

Question 3

Evaluation of treatment - effective drugs

Answer 3

• Clear evidence for effectiveness of SSRIs in reducing severity of OCD symptoms and improving quality of life for patients.
• Soomro et al reviewed students comparing SSRIs to placebos in treatment of OCD and concluded that all 17 studies reviewed showed significantly better results for SSRIs compared to the placebo.
• Strength - suggests drugs are an effective treatment.

Question 4

Evaluation of treatment - cost effective drugs

Answer 4

• Non disruptive and cost effective for economy.
• Drugs cost pence to manufacture compared to CBT which is significantly more experience through NHS or paging privately.
• Strength - simply take drugs until symptoms decline and not engage with hard work of psychological therapy.

Question 5

Evaluation of treatment - side effects

Answer 5

• Drugs can have side effects.
• Some patients will get no benefit and some will suffer from side effects such as blurred vision. Usually temporary. Those taking clonipramine, side effects are common and severe. More than 1 in 10 will suffer tremors, weight gain and erection problems. More than 1 in 100 will become aggressive and suffer distruptuon to heart rhythm.
• Weakness - side effects can cause patients to stop taking them and OCD is not being managed.

Question 6

Evaluation of treatment - not a cure

Answer 6

• Drugs reduce symptoms of OCD but don’t cure them.
• Combining drug therapy and psychological treatments such as CBT tends to be most effective.
• Weakness - symptoms often return once drugs are stopped. Patient is in an endless cycle of gaining prescriptions for drugs, revolving door syndrome.