The Biological Approach to treating OCD

Question 1

What are drug therapies?

Answer 1

• drug treatments that aim to increase/ decrease levels of specific neurotransmitters in the brain to increase/ decrease their activity
• e.g. low levels of serotonin is associated with OCD so drug therapies work by increasing the level of serotonin in the brain

Question 2

What are SSRIs?

Answer 2

selective serotonin re-uptake inhibitor (SSRI) is a type of antidepressant that works on the serotonin system in the brain

Question 3

How do SSRIs work?

Answer 3

• serotonin is released by specific neurons in the brain by the presynaptic neuron where it travels across the synapse to chemically convey the signal to the postsynaptic neuron
• it is then re-absorbed by the presynaptic neuron where it is broken down & re-used
• SSRIs work by preventing the re-absorption & breakdown of serotonin so there are high levels of it in the synapse so it can continue to stimulate the postsynaptic neuron, making up for whatever is wrong with the serotonin system that is causing the OCD
• dosage varies according to what SSRI is prescribed
• a typical daily dose of Fluoxetine is 20mg but can be increased if necessary
• it is available as capsules or a liquid and takes 3-4 months of daily use for SSRIs to have an impact on symptoms

Question 4

Why are SSRIs combined with other treatments?

Answer 4

• drug are often used alongside CBT to treat OCD
• the drug reduces the patient’s emotional symptoms so they’re able to engage effectively with CBT
• some people respond best to CBT alone whilst other benefit more from drug therapies

Question 5

What are the alternatives to SSRIs?

Answer 5

• if an SSRI isn’t effective after 3-4 months the dosage is increases or combined with other drugs
• people respond differently to different drugs & alternatives work well for some people but not at all for others
  e.g. of alternatives
• tricyclics - older type of antidepressant like Clomipramine that has the same effect on the serotonin system as SSRIs but has more severe side effects so is used as a 2nd option after SSRIs
• SNRIs - serotonin-noradrenaline reuptake inhibitor is also used as a 2nd option for those who don’t respond to SSRIs, they increase levels of serotonin & also noradrenaline which is another neurotransmitter

Question 6

Evaluation: Effective at tackling OCD symptoms

Answer 6

• lot of evidence shows the effectiveness of SSRIs in reducing OCD symptoms & improving the patient’s quality of life
• e.g. Soomro et al. reviewed studies comparing SSRIs to placebos in treatments for OCD & found from all 17 studies that SSRIs has significantly better results than the placebo
• it was also found that effectiveness was the greatest when SSRIs was combined with CBT
• usually symptoms decline in 70% of patients treated with the drug & the other 30% use alternative drug treatments or combine it with psychological treatments
• this shows that drugs can help most patients with OCD

Question 7

Evaluation: Drugs are cost-effective & non-disruptive

Answer 7

• a strength of drug treatments is that they’re generally cheaper than psychological treatments
• this means that using drugs is a good value for a public health system like the NHS
• compared to psychological treatments, SSRIs are non-disruptive to patients’ lives
• this is because you can simply take the drugs until your symptoms reduce & not have to engage with the work of psychological therapies
• this is a strength for drug therapies as many doctors & patients lean more into drug treatment for these reasons

Question 8

Evaluation: Drugs can have side effects

Answer 8

• a limitation of SSRIs is that a significant minority doesn’t benefit from it since drugs work differently in people
• some patients also suffer from side effects from taking the drugs like indigestion, blurred vision & loss of sex drive (usually temporary side effects)
• e.g. side effects of Clomipramine are more common & can be more serious
• more than 1/10 patients suffer from erection problems, tremors & wight gain
• more than 1/100 people become more aggressive & suffer disruption to blood pressure and heart rhythm
• this is a limitation for drug treatments as these factors reduce the effectiveness since people stop taking the medication

Question 9

Evaluation: Unreliable evidence for drug treatments

Answer 9

• although SSRIs are fairly effective & any side effects are usually temporary there is controversy surrounding it like all drug treatments
• e.g. some psychologists believe the evidence favouring drug treatments is biased since the research is sponsored by drug companies who don’t report all evidence