Treatments

• Biological treatments of OCD


  An OCD treatment which involves chemicals (drugs) that targets specific neurotransmitters within the brain to increase or decrease activity. The standard treatment is an SSRI
• SSRI


  •Antidepressant.

  •Dosages are individual to each person and can come in tablet or liquid form - prescription typically lasts 12-16 weeks.

  •usually prescribed alongside another form of treatment (CBT).

  •the drugs control the person's emotional responses which allow them to engage effectively in the therapy
• Synapse structure

  • current

  • AXON - impulses and neurotransmitters travel through

  • VESICLE - contains ones or more neurotransmitter

  • neurotransmitter

  • PRESYNAPTIC NERVE - previous neuron's terminal button

  • POSTSYNAPTIC NERVE - next neuron's dendrite

  • synaptic cleft

  • RECEPTORS - specific to neurotransmitters. Lock and key
• 4 outcomes can happen at the synapse:


  • fuse with post synaptic membrane

  • reuptake to pre synaptic neurone

  • digested by enzymes

  • diffusion
• How do SSRIs work?


  Neurons within the brain communicate with each other in groups (neural networks) by passing on messages to each other via an electrical pulse which moves through the neuron
• How do SSRIs work?


  1. When the electrical impulse reaches the end of the pre synaptic neuron, it triggers the release of neurotransmitters
• How to SSRIs work?


  2. The aim is for each neurotransmitter to reach the receptor in the post synaptic neuron
• How do SSRIs work?


  3. In some brains, neuro transmitters fail to reach the post synaptic neuron receptor. Instead return to their original neuron and don't pass on their message (reuptake)
• How do SSRIs work?


  4. The space between each neuron is the synapse - where SSRIs work
• How do SSRIs work?


  5. SSRIs block the receptors in the pre synaptic neuron which forces the neurotransmitter to pass on their message
• Alternatives to SSRIs 


  If ineffective within 3-4 months, dosage can be increased, or combined with other drugs (SNRIs, Tricyclics, BZs)
• SNRIs (1990s)


  Fairly new drugs. Increase levels of serotonin and noradrenaline
• Serotonin Noradrenaline Reuptake Inhibitors (Effexor) 


  SNRIs used when patients don't respond to SSRIs
• Tricyclics (1950s)


  An older antidepressant. Same effect as SSRIs but side effects are more severe (hallucinations, sweating, weight gain, sexual issues). Tricyclics such as Clomipramine only used for patient that don't respond to SSRIs
• Benzodiazepines (BZs)


  Slows down the activity in the brain by increasing GABA. When GABA binds to receptors it increases the flow of chloride ions into the neuron. Makes it harder to be stimulated
• ✅ - SOOMRO(2008)


  Reviewed 17 studies that used SSRIs and OCD patients. Found them to be more effective than placebos in reducing symptoms for up to 3 months
• ✅ - easy and not time consuming like talking therapies 


  Little effort to take pills, cheaper mass production compared to psychological treatment.
• ❌ - many people experience side effects 


  Nausea, insomnia, headaches. Enough for people to stop drug use - reduces effectiveness
• ❌- short term fix

  MAINA(2011) patients can relapse if they stop taking medication.
• ❌- publication bias


  Studies which show a positive correlation between drug use and OCD symptoms decreasing = more likely to be published than those that don't