Flashcards in Biological Therapies - OCD Deck (23):
How do SSRIs work?
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
How effective do SSRIs seem to be (Dolberg)?
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
How do beta-blockers work? (use if just on drugs)
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
What percentage of clients benefit from SSRIs?
What are the relapse rates of drugs like?
Very high (90%) stay on the drug for a long time
How appropriate is drug therapy?
- 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
What did Mundo et al do?
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
What did Mundo et al find?
Results showed no significant differences between the 3 treatments and all worked well
What does Mundo et al's study show?
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
What did Figueroa et al do? (use if just on drugs)
7 patients treated with a tricyclic and an SSRI, follow up from onset of combination therapy
What did Figueroa et al find? (use if just on drugs)
- 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
What does Figueroa et al's study show? (use if just on drugs)
That drugs are not appropriate/effective for everyone
What is psychosurgery?
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
What did Baer et al do?
Unblinded follow up assessments in 18 patients with OCD after having psychosurgery
What did Baer et al find?
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
What does Baer et al's study show?
That psychosurgery is effective and appropriate for some
When is psychosurgery used?
Only when the patients is unresponsive to all other treatments = not appropriate for most people.
What are the side effects of psychosurgery?
Very dangerous, can caused seizures
Why are there ethical concerns surrounding psychosurgery?
Issues around informed consent - might no understand implications
What did Cosgrove find?
Only benefits 30% of patients = not effective
What is Transcranial Magnetic Stimulation (TMS)?
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
How do Tricyclics work?
Blocks the re-uptake of noradrenaline and serotonin