Biological Approach To Treating OCD Flashcards
(20 cards)
What is the main aim of drug therapy?
To increase or decrease levels of neurotransmitters or their activity.
Drugs to treat OCD increase the levels of serotonin in the brain
What does SSRI stand for?
Selective serotonin reuptake inhibitor.
How do SSRIs work in the brain?
They work on the serotonin system.
What is the role of serotonin in neurotransmission?
Serotonin released by certain neurons in the brain, released from the presynaptic neuron and travels across a synapse. Transmits chemically, conveying the signal from the presynaptic neuron to the postsynaptic neuron
Reabsorbed by presynaptic neuron, broken down and reused
What do SSRIs do with serotonin?
Increase levels of serotonin in the synapse through preventing the reabsorption and break down
Means postsynaptic neuron contines to be stimulated and compensates for whatever is wrong with the serotonin system in OCD
What is the dosage of SSRIs?
Varies according to the SSRI prescribed, for example: a typical daily dose of fluoxetine (prozac) = 20mg. May increase if it’s not beneficial
Avaliable in capsule or liquid and takes 3-4 months to see impact on symptom
With what therapy are SSRIs often combined?
Cognitive Behavioral Therapy (CBT): drugs reduce emotional symptoms like anxiety or depression allowing OCD patients to better engage in CBT
Some people respond best to CBT alone, some benefit from fluoxetine and CBT. Sometimes other drugs are prescribed with SSRIs
What is a potential alternative if SSRIs are not effective?
Increasing the dose (up to 60mg) or trying different antidepressants after about 4 months
People respond very differently to different drugs
What’s an alternative to SSRIs?
Tricyclics (older antidepressants) like clomipramine that acts on various systems including serotonin
Has the same effect as SSRIs with more severe side effects thus kept in reserve for no response to SSRIS
What’s another alternative to SSRIs?
SNRI’s that are a different class of antidepressant drugs and are more recently used to treat OCD.
Increased levels of serotonin and another neurotransmitter called noradrenaline
What are SNRIs?
Serotonin-noradrenaline reuptake inhibitors.
What’s a strength of drug treatment related to evidence?
Good evidence for its effectiveness as it clearly shows SSRIs reduce symptom severity and improve quality of life for the person with OCD
Whats another strength of drug treatment related to a study?
Soomro et al reviewed 19 studies comparing SSRIs to placebos and found symptoms reduce in about 70% of people
Other 30% can be helped by alternative drugs, drug combinations or therapies
What is another strength of drug treatment related to cost?
Cost effective as its cheap compared to therpaies and represent a good use of limited funds
What’s another strength of drug treatment related to people’s lives?
Non disruptive of peoples lives as people dont have to cancel anything to attend sessions
What’s the last strength of drug treatment related to value?
Good value for public health systems as many thousands can be produced in the time of one therapy sessions
What is a limitation of drug therapy related to evidence?
Evidence suggests its helpful but not the most effective. Skapinakis et al carried out a systematic review of outcome studies and concluded cognitive and behavioural therapies were more effective than SSRIs.
Means drugs may not be the best treatment
What’s another limitation of drug therapy?
A small minority get no benefit
What’s another limitation of drug therapy related to side effects?
Potentially serious side effects like indigestion, blurred vision, loss of sex drive. Usually temporary but can be distressing and long lasting for the minority
What’s the last limitation of drug therapy related to clomipramine?
Side effects of clomipramine can be more serious as 1 in 10 experience erection problems and weight gain and 1 in 100 become aggressive and have heart related problems
