Biological Therapies - OCD Flashcards

1
Q

How do SSRIs work?

A

Increase the availability of serotonin:
- Serotonin usually reabsorbed by nerve cells after carrying a message, SSRIs block this reuptake so serotonin can carry further messages across nearby nerve cells

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2
Q

How effective do SSRIs seem to be (Dolberg)?

A

More effective and produce more relief from symptoms than either tricyclics or placebos
Dolberg: 50-70% of patients reported some reduction in symptoms, compared to 5% of a placebo

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3
Q

How do beta-blockers work? (use if just on drugs)

A

Usually used for the management of cardiac arrhythmias:
- Block the action of adrenaline and noradrenaline on beta-receptors
= stops flight/fight response as no increased heart rate - less stressed reaction

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4
Q

What percentage of clients benefit from SSRIs?

A

30-50%

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5
Q

What are the relapse rates of drugs like?

A

Very high (90%) stay on the drug for a long time

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6
Q

How appropriate is drug therapy?

A
  • Much easier for a GP to administer compared to therapy and relativity cheap for the NHS = front-line treatment
    BUT argued they may be dehumanising, take away personal responsibility
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7
Q

What did Mundo et al do?

A

OCD patients underwent a 10 week randomised treatment using 3 different SSRIs:

  • Ratings preformed under blind conditions every 2 weeks
  • 3 different scales used inc. YBs
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8
Q

What did Mundo et al find?

A

Results showed no significant differences between the 3 treatments and all worked well

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9
Q

What does Mundo et al’s study show?

A

That SSRIs are an effective treatment but are also appropriate as some SRRIs are very expensive but this shows the NHS are free to prescribe generic cheap versions

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10
Q

What did Figueroa et al do? (use if just on drugs)

A

7 patients treated with a tricyclic and an SSRI, follow up from onset of combination therapy

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11
Q

What did Figueroa et al find? (use if just on drugs)

A
  • Drug combination effective the 2 patients with OCD but no mood/anxiety comorbidity
  • Side effects appeared in 5/7 patients e.g. cardiovascular, insomnia and sexual dysfunction
    BUT combination therapy found to be more effective than monotherapy
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12
Q

What does Figueroa et al’s study show? (use if just on drugs)

A

That drugs are not appropriate/effective for everyone

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13
Q

What is psychosurgery?

A

A procedure to destroy a small amount of tissue in the cingulated gyrus which links the prefrontal cortex to the lymbic systems in the brain
- Probes inserted through the skull, tips heated and tissue burnt

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14
Q

What did Baer et al do?

A

Unblinded follow up assessments in 18 patients with OCD after having psychosurgery

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15
Q

What did Baer et al find?

A

27 months after treatment; 5 patients met criteria for treatment responders, 3 for partial responders. 25-30% who were previously unresponsive to medication and behavioural therapy were significantly improved

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16
Q

What does Baer et al’s study show?

A

That psychosurgery is effective and appropriate for some

17
Q

When is psychosurgery used?

A

Only when the patients is unresponsive to all other treatments = not appropriate for most people.

18
Q

What are the side effects of psychosurgery?

A

Very dangerous, can caused seizures

19
Q

Why are there ethical concerns surrounding psychosurgery?

A

Issues around informed consent - might no understand implications

20
Q

What did Cosgrove find?

A

Only benefits 30% of patients = not effective

21
Q

What is Transcranial Magnetic Stimulation (TMS)?

A

Involves stimulation brain cells using magnetic fields but without any direct contact to the brain
- Thought to increase the availability of serotonin and other neurotransmitters in the brain = not permanent

22
Q

How do Tricyclics work?

A

Blocks the re-uptake of noradrenaline and serotonin

23
Q

How effective do tricyclics seem to be?

A

Some suggest they are only effective for people who are also depressed and that in any case the benefits are short lived