Biological approach to treating OCD

Question 1

strength of drug treatments

Answer 1

1. evidence of effectiveness
   - clear evidence to show that SSRIs reduce symptoms severity and improve the quality of life for people with OCD
   - Soomro et al (2009) reviews 17 studies that compared SSRIs to placebos in the treatment of OCD
   - all 17 studies showed significantly better outcomes for SSRIs than for the placebo conditions
   - typically symptoms reduce for 70% of people taking SSRIs
   - drugs appear to be helpful for most people with OCD
2. cost effective and non disruptive
   - cheaper than psychological treatments because thousands of tablets can be manufactured in the time it takes to conduct one session of a psychological therapy
   - drugs are a good value for the NHS and represent a good use of limited funds
   - SSRIs are also non disruptive to peoples lives
   - less time consuming
   - drugs are popular with many people with OCD and their doctors

Question 2

limitation of drug treatment

Answer 2

1. serious side effects
   - a small minority will get no benefit form SSRI
   - some people experience side effects like indigestion, blurred vision and loss of sex drive
   - side effects can be distressing for people and can be long lasting
   - for those taking tricyclic clompramine side effects are more common and can be more serious
   - 1- 10 experience erection problems and weight gain
   - 1 in 100 become aggressive and experience heart related problems
   - this means that some people have a reduced quality of life as a result of taking drugs and may stop taking them altogether meaning the drug ceases to be effective

Question 3

alternatives to SSRIs

Answer 3

• if SSRIs are not effective after 4 months the dosage can be increased or combined with other drugs
  1. tricyclics (older type)
• eg clomipramine
• acts on the serotonin system where it has the same effects as SSRIs
• clomipramine has more severe side effects than SSRIs so is used for people who do not react to SSRIs
  2. SNRIs (serotonin noradrenaline re uptake inhibitor)
• second line of defence for people who do not respond to SSRIs
• increase levels of serotonin and noradrenaline

Question 4

combining SSRIs with other treatments

Answer 4

• drugs are often used alongside CBT to treat OCD
• drugs reduce a persons emotional symptoms like feeling anxious or depressed
• this means a person can engage more effectively with CBT

Question 5

SSRIs

Answer 5

• selective serotonin re uptake inhibitor
• SSRIs work in the serotonin system in the brain
• serotonin is released by the presynaptic neurone and travels across a synapse
• the neurotransmitter chemically conveys the signal form the presynaptic neuron to the post synaptic neuron and is then reabsorbed by the presynaptic neuron where it is broken down and reduced
• by preventing the absorption and breakdown SSRIs effectively increase levels of serotonin in the synapse and thus continues to stimulate the postsynaptic neuron
• this compensates for whatever is wrong with r he serotonin system in OCD
• a typical dosage of fluoxetine is 20 mg although this may be increased to 60 my if its not benefiting the person
• available as a capsule or liquid
• take 4 months of daily use for SSRIs to make much impact on symptoms