biological treatment for ocd: drug therapy

Question 1

what is drug therapy used for in ocd?

Answer 1

• used for people with more severe symptoms
• used when cbt doesn’t work

Question 2

how does drug therapy help with ocd?

Answer 2

• changes the activity of neurotransmitters in the brain
• mostly targets serotonin

Question 3

what type of drug is used to treat ocd?

Answer 3

• antidepressants
• usually ssris (selective serotonin reuptake inhibitors)

Question 4

how do ssris work in ocd treatment?

Answer 4

• block reuptake of serotonin in presynaptic neuron
• more serotonin stays in the synapse
• more can pass to the postsynaptic neuron
• increases serotonin levels in the brain

Question 5

why is serotonin important in treating ocd?

Answer 5

• helps balance mood
• higher levels improve well-being and happiness

Question 6

what are examples of ssris used for ocd?

Answer 6

• sertraline
• fluoxetine

Question 7

how are ssris used differently in ocd than in depression?

Answer 7

• higher doses used for ocd
• can take up to 12 weeks to work

Question 8

what other drugs can be used to treat ocd?

Answer 8

• anti-anxiety drugs
• called benzodiazepines
• example is valium

Question 9

how do benzodiazepines work?

Answer 9

• increase the effect of gaba
• gaba is a chemical that reduces anxiety
• helps lower arousal and calm the body

Question 10

what are beta blockers used for in ocd?

Answer 10

• help reduce physical symptoms of anxiety
• example is propranolol

Question 11

how do beta blockers work?

Answer 11

• block stress hormones from adrenal glands
• stop increased heart rate and other anxiety symptoms
• reduce physical stress = fewer obsessional thoughts and compulsions

Question 12

what is a major concern about drug treatments for ocd?

Answer 12

• much research is funded by drug companies
• may not report negative results
• can mislead doctors and patients

Question 13

what did ben goldacre say about drug companies?

Answer 13

• they resist sharing bad results
• focus on sales over safety
• wrote about this in bad pharma (2012)

Question 14

how common is antidepressant use in england?

Answer 14

• 64.7 million items dispensed in 2016
• doubled since 2006
• only some of this is for ocd

Question 15

how can drug companies influence prescriptions?

Answer 15

• gps get advice from drug reps
• drug companies have a big impact on choices

Question 16

what are the strengths of drug therapy for ocd?

Answer 16

• helps when cbt doesn’t work
• backed by scientific research
• can be combined with cbt for better results
• reduces need for neurosurgery

Question 17

what studies support the effectiveness of drug therapy?

Answer 17

• soomro et al (2007) found antidepressants better than placebo
• koran et al (2002) found long-term benefits and fewer relapses
• pots study showed adding drugs to cbt improved results

Question 18

what are the limitations of drug therapy for ocd?

Answer 18

• can cause side effects like nausea and headaches
• some people may stop taking them because of side effects
• in rare cases can increase anxiety or risk of suicide
• needs active monitoring by others

Question 19

why is drug therapy not enough on its own?

Answer 19

• works best when combined with cbt
• not effective for everyone
• takes up to 12 months before reducing medication
• relapse is common if stopped

Question 20

what do studies say about individual differences in response to drugs?

Answer 20

• brody et al (1998) found brain differences affect response to treatment
• ravizza et al (1995) found ssris don’t work for 40% of people
• pet scans needed to predict best treatment, which aren’t widely available