Biological treatments for OCD

• Biological treatments for OCD

  Drug therapy

  • The most commonly used biological therapy for anxiety disorders is drug therapy.  
  • This therapy assumes that there is a chemical imbalance in the brain 
  • This can be corrected by drugs, which either increase or decrease the levels of neurotransmitters in the brain.
• Selective serotonin reuptake inhibitors

  • The standard medical treatment used to tackle the symptoms of OCD are SSRIs
  • SSRIs work on increasing certain neurotransmitter in the brain by preventing the reabsorption of serotonin. 
  • By preventing the reabsorption of serotonin, SSRIs effectively increase its levels in the synapse and thus continue to stimulate the postsynaptic neuron.
• SSRIs: typical treatment

  A typical dose of Fluoxetine (an SSRI - brand name is Prozac) is 20mg although this may increase if not benefiting to the patient.

  It takes 3-4 months of daily use of SSRIs to impact upon symptoms

  It can increase to 60mg a day if necessary

  Fluoxetine is probably the best known SSRI (sold under the brand name Prozac). 

  Other SSRIs include citalopram (Cipramil), paroxetine (Seroxat) and sertraline (Lustral).
• Combining SSRIs with other treatment

  Where an SSRI is not effective after three to four months the dose can be increased or it can be combined with other drugs

  Patients respond differently to different drugs and sometimes alternatives work well for some people and not at all for others 

  Tricyclics

  SNRIs
• Combining SSRIs with other treatment

  Drugs are often used alongside cognitive-behavioural therapy (CBT) to treat OCD.

  The drugs reduce the sufferer’s emotional symptoms, such as anxiety or depression. This means that the patient can then engage more effectively with CBT. 

  Some sufferers may respond best to CBT alone without the need for medication.
• It IS effective

  (+)Drug therapy is effective at tackling OCD symptoms

  There is clear research to suggest that SSRIs are effective in reducing the severity of OCD symptoms (Soomro: 2009). 

  (+)Drugs are cost-effective and non-disruptive

  Drug treatments are cheap in comparison to psychological treatments and, unlike psychotherapy, they are non-disruptive to patients’ lives.
• It is NOT effective

  (-)Drugs can have side-effects 

  Although the use of drugs is effective for most, a significant minority receive no benefit and/or may suffer side-effects: weight gain, dry mouth, sexual dysfunction and loss of memory.  Coming off a drug is a slow process in which the dosage has to be gradually reduced over a period of six months – risk of relapse.
• It is NOT effective

  (-)Unreliable evidence for drug treatments

  If drug companies sponsor the research they may decide to suppress any results that do not support the drug they are marketing. Currently many drug companies do not publish all of their results and may indeed be suppressing evidence.This suggests that the data on the effectiveness of drugs may not be trustworthy.
• It is NOT effective

  (-)Some cases of OCD follow trauma 

  Although OCD is widely believed to be biological in origin, it is also accepted that OCD can have different causes. There is a case for proposing that cases of OCD where there is no family history of OCD, but there is a relevant life event, should be treated differently from those where there is a family history and no trauma. It may be that for these cases drugs are not appropriate.