Drug Therapy

Question 1

Describe Anti-Depressants SSRI’S

Answer 1

• SSRI’S are a group of drugs that are used to reduce the
  anxiety experienced in OCD.
  -These drugs are specifically designed to bind to the serotonin receptors of the post-synaptic neuron in order for the serotonin that has been released from the pre-synaptic neuron to remain
  available in the synaptic cleft for re-use.
  -This means that there is more serotonin available for use and this
  increases the activity of the serotonergic pathway.
• As low levels of serotonin activity are associated with
  anxiety, increasing this activity reduces the anxiety associated with OCD.

Question 2

Describe Anti-Anxiety Drugs - Benzodiazepines (BZs)

Answer 2

-Psychoactive drugs are one way of reducing anxiety associated with OCD. BZs e.g., Valium, increase the
efficiency of synaptic action of the inhibitory neurotransmitter GABA. BZs target pathways that, when activated by stress, lead to the turning on of the fight or flight stress response, and the release of stress hormones adrenaline and cortisol.
-BZs decrease activity in these pathways by approx. 40%, resulting in lower activation of the stress response, lower levels of stress hormones, and so a lesser feeling of anxiety in OCD individuals

Question 3

A03 - Zohar and Deny

Answer 3

Zohar et al (1996) found that selective serotonin reuptake inhibitors (SSRIs) have been shown to reduce
symptoms for up to 60% of OCD sufferers by increasing the amount of serotonin available for use in the
synaptic cleft. Hence, serotonin seems to be linked to the cause of OCD symptoms. Likewise, Denys et al
(2004) found that patients may benefit from the addition of antipsychotics, which reduce dopamine activity, to
their ongoing SSRI treatment.

• However, not all patients respond to drug therapy, for instance, in the Zohar et
  al study 40% of OCD patients did not respond to SSRIs, suggesting that, in some individuals, low levels of
  serotonin and high levels of dopamine are not the key influential factor.
  Hence, there may be other causation factors such as the environment and learned behaviours, this
  questions the neural explanation as a comprehensive one for all individuals.

Question 4

A03 - Side effects

Answer 4

-Common side effects of SSRIs include nausea, drowsiness and weight gain.
-Additionally, the common side effects of BZs include impairment of psychomotor performance and withdrawal symptoms after long term treatment,

• Adverse side-effects of BZs appear to be far greater in older adults. This included dizziness, over
  sedation and greater number of bone fractures from falling.
  -Hence, SSRI’s may not be appropriate for every
  individual and BZs might not be appropriate for older adults.

Question 5

A03 - Appeal

Answer 5

-Patients find drug therapy to be a quick and easy solution, compared to the average 20/30 sessions required for CBT, as well as the emotional effort of challenging one’s own thought processes. Further, the ease of use may lead to patients sticking to their therapy, and this may contribute to longer-term effectiveness.

-Whilst this may temporarily improve a patient’s condition, drugs will only have an effect whilst they are being taken. As soon as a person stops taking the drugs the symptoms may reappear and their effectiveness ceases.
- Support for this comes from Maina et al (2001) who found that most patients relapse back to their symptoms within a few weeks of the stopping of their medication. Questioning the therapy’s use to enable an individual to
overcome OCD.