Treating OCD

Question 1

How do SSRIs work at a biological level?

Answer 1

• they prevent the reabsorption of serotonin into the pre-synaptic neuron
• this increases serotonin levels
• so they continue to stimulate the post-synaptic neuron
• so the message from the pre-synaptic neuron to the post-synaptic neuron is still conveyed
• Thus thus compensates for the low serotonin levels in someone with OCD and the symptoms of OCD are alleviated

Question 2

What is a typical dosage of SSRI and how long does it take to work (+ example)

Answer 2

Dosage is 20mg a day
Takes 3-4 months to have an impact on symptoms
e.g. fluoxetine

Question 3

What happens if SSRIs have no impact after 3-4 months?

Answer 3

Drug therapy can be combines with CBT or SNRIs, or the dosage can be increased from 20mg to 60mg daily

Question 4

Supporting evidence (effectiveness)

Answer 4

There is clear evidence for the effectiveness of SSRIs in reducing the severity of symptoms of OCD. For example, a review which compared SSRIs to placebos showed significantly better results for the SSRIs than for placebos. Effectiveness is greatest when SSRIs are combined with a psychological treatment, usually CBT. Typically, symptoms decline significantly for around 70% of patients taking SSRIs. Of the remaining 30%, alternative drug therapies or combinations of drugs and psychological treatments will be effective for some.

This suggests that drug therapies can help most patients with OCD and so is an effective way of treating OCD.

Question 5

Strength of drug therapies (appropriateness)

Answer 5

Drug therapies are cheap compared to psychological treatments. Using drugs to treat OCD is therefore good value for a public health system like the NHS. SSRIs are also less disruptive to patients’ lives. You simply take drugs until your symptoms decline, rather than having to engage with the hard work of psychological therapy.

This suggests that drug therapies are suitable for lots of patients as they are cost-effective and easy to access.

Question 6

Weakness of drug therapies (effectiveness, bias)

Answer 6

Some psychologists believe that evidence favouring drug treatments is biased because the research is sponsored by drug companies who do not report all of the evidence.

This suggests that drug therapies may be less effective than we are led to believe by the research.

Question 7

Weakness (effectiveness, relapse)

Answer 7

Some psychologists have suggested that drug therapies are not a lasting cure for OCD. This is indicated by the fact that patients often relapse within a few weeks if medication is stopped. Drugs reduce the anxiety associated with OCD to such a level that a more normal lifestyle can be achieved. However, they do not change the cognitions or behaviours.

This suggests that whilst drug therapies are effective in the short-term, they are less effective in the long-term. It may potentially be more effective to combine drug therapies with CBT to treat the cognitions and behaviours that drug therapies do not treat.