The biological approach to treating OCD

Question 1

What is drug therapy?

Answer 1

Treatment that involves drugs which have an effect on the functioning of the brain

Question 2

What does drug therapy do?

Answer 2

• Increases or decreases neurotransmitter levels, and their activity in the brain
• E.g: increase serotonin levels to treat OCD

Question 3

What are SSRIs?

Answer 3

• Selective serotonin reuptake inhibitors

Question 4

What do SSRIs do?

Answer 4

• Serotonin is released by neurons in the brain, and travel across a synapse (presynaptuc neuron)
• Serotonin chemically conveys a signal from presynaptic neuron to postsynaptic neuron- reabsorbed by presynaptic neuron and is broken down and reused
• SSRIs prevent reabsorption and breakdown, so increases levels of serotonin in the synpase, stimualting postsynaptic neuron- compensates for low levels of serotonin in OCD

Question 5

What is the dose and time frame of SSRIs?

Answer 5

• Capsules or liquid form
• 20mg of fluoxetine= average dosage
• 3-4 months to impact symptoms

Question 6

What are SSRIs typically combined with?

Answer 6

• CBT
• Drugs (reduce emotional symptoms) so engagement with CBT is effective

Question 7

What are tricyclics and how do they work?

Answer 7

• Antidepressant that acts on serotonin system- same effects as SSRIs
• BUT, more severe side effects- reserved for those who don’t respond to SSRIs

Question 8

What are SNRIs and how do they work?

Answer 8

• Serotonin- noradrenaline reuptake inhibitors
• Form of antidepressant
• Increases serotonin and noradrenaline levels

Question 9

What are the strengths of the bio treatment for OCD?

Answer 9

• Evidence for effectiveness
• Cost-effective and non-disruptive

Question 10

What are the limitations of the bio treatment for OCD?

Answer 10

• Better alternatives
• Serious side-effects
• Biased evidence

Question 11

Strength:
I- Evidence for effectiveness

Answer 11

D- Soomro et al- reviewed 17 studies comparing SSRIs to placebos. All studies showed better outcomes for SSRIs. Symptoms reduce by 70%. Reduce symptom severity and improve quality of life
E- Means drugs appear to be helpful for OCD

Question 12

Limitation:
I- Better alternatives

Answer 12

D- Even if drug treatments are helpful, they are not most effective. Skapinakis et al carried out a systematic review of outcome studies, concluding cognitive and behavioural therapies were more effective than SSRIs
E- Means drugs may not be the optimum treatment for OCD

Question 13

Strength:
I- Cost-effective and non-disruptive

Answer 13

D- Cheap compared to psychological treatment. Using drugs is good for public health systems (NHS) and represents a good use of limited funds. Non-disruptive= take drugs until symptoms decline
E- Means drugs are the ideal treatment for OCD

Question 14

Limitation:
I- Serious side-effects

Answer 14

D- Small minority do not benefit from SSRIs. Side effects include: indigestion, blurred vision, loss of sex drive. Temporary effects normally, but can cause distress or be long-lasting. 1 in 10 on clompipramine= erection problems and weight gain, 1 in 100= aggression, heart related problems
E- Means drugs reduce quality of life, so are ineffective

Question 15

Limitation-
I- Biased evidence

Answer 15

D- Evidence may be biased due to sponsorships with drug companies. Goldacre- users select positive outcomes for sponsors’ profits . Unconscious or conscious bias- want the drug to work, so believe it does
E- Evidence may be inaccurate