Biological Approach To Treating OCD

Question 1

SSRIs:

Answer 1

1. SSRIs work on the serotonin system in the brain, serotonin is released by certain neurons.
2. It is released by the presynaptic neurons and travels across a synapse. Neurotransmitter chemically conveys the signal from the presynaptic neuron to the postsynaptic neuron and then it is reabsorbed by the presynaptic neuron where it is broken down and reused.
3. By preventing the re-absorption and breakdown of serotonin SSRIs effectively increases its levels in the synpase and thus continue to stimulate the postsynaptic neuron.
4. Available as capsules or liquid and takes 3-4 months of daily use.

Question 2

Combining SSRIs with other treatments

Answer 2

1. Drugs are often used alongside CBT to treat OCD.
2. Drugs reduce a patients’ emotional symptoms, such as feeling anxious or depressed.

Question 3

Alternatives to SSRIs: Tricyclics

Answer 3

1. Older type of antidepressant, like Clompiramine.
2. Same effect on the serotonin system as SSRIs. Has severe side effects than SSRIs. Reserved for patients who do not respond to SSRIs.

Question 4

Alternatives to SSRIs: SNRIs

Answer 4

1. Serotonin noradrenaline reuptake inhibitors.
2. Antidepressant. Second line of defence for patients who don’t respond to SSRIs. Increase SNRIs increase levels of serotonin as well as noradrenaline

Question 5

E: Drug Therapy is effective at tackling OCD symptoms

Answer 5

1. Soomro et al. 2009 reviewed studies comparing SSRIs to placebos in the treatment of OCD and concluded that all 17 studies reviewed showed significantly better results when SSRIs are combined with a psychological treatment, usually CBT.
2. Typically symptoms decline siginificantly for around 70% of patients taking SSRIs. Of the remaining 30% alternative drug treatments or combinations of drugs and psychological treatments or combinations of drugs and psychological treatments will be effective.
3. So drugs can help most patients with OCD.

Question 6

E: Cost effective and non disruptive

Answer 6

1. Cheap compared to psychological treatments, good value for a public health system like the NHS.
2. Compared to psychological therapies SSRIs are also non-disruptive to patients’ lives. If you wish can simply take drugs until your symptoms decline and not engage with the hard work of psychological therapy.

Question 7

E: DRugs can have side effects

Answer 7

1. A significant minority will not benefit from drugs.
2. Side effects: indigestion, blurred vision and loss of sex drive. Usually temporary.
3. For those taking, Clomipramine, side effects are more common and can be serious. More than one in ten patients suffer erection problems, tremors and weight gain. More than one in a hundred become aggressive and suffer disruption to blood pressure and heart rhythm.
4. Reduce effectiveness, stop taking medication.

Question 8

E: Unreliable evidence

Answer 8

1. SSRIs are fairly effective and any side-effects will probably be short term , like all drug treatments they have some controversy attached.
2. Some psychologists believe the evidence favouring drug treatments is biased because the research is sponsored by drug companies who do not report all the evidence (Goldacre 2013).

Question 9

E: Some Cases of OCD Follow Trauma

Answer 9

1. OCD is widely believed to be biological in origin, makes sense that the standard treatment should be biological.
2. OCD can have other causes and be a response to a traumatic life event.