BA treating OCD

• Drug therapy efficacy- Soomro et al (AO3)


  • Reviewed studies comparing SSRIs to placebos in the treatment of OCD
  • Concluded all 17 studies reviewed and showed significantly better results for the SSRIs than placebos
  • 70% Patients taking SSRIs will have a significant decline in symptoms, remaining 30% may require combinations of treatments
  • SSRIs are therefore able to reduce the severity of OCD symptoms and improve patients' QOL
• How is OCD treated?

  • Drug therapy to increase or decrease levels of neurotransmitters or their activity
  • This is done through SSRIs, a combination of SSRIs and CBT or SNRIs or Tricyclics
• What is an SSRI?

  • A selective serotonin reuptake inhibitor
  • They work on the serotonin system
  • They prevent re-absorption and breakdown of serotonin, increasing its levels in the synapse to stimulate the PSN
  • This compensates for what is wrong with the serotonin system as a result of OCD
  • Typical dose of Fluoxetine is 20mg, takes 3-4 months to impact
• How may SSRIs be combined with CBT?

  • The drugs reduce a patient's emotional symptoms (e.g. anxiety or depression)
  • This way patients can engage more effectively with CBT
• What are the alternatives to SSRIs?

  • Both used for patients who don't respond to SSRIs
  • Tricyclics- a type of antidepressant such as Clomipramine, same effect as SSRIs
  • SNRIs (serotonin-noradrenaline reuptake inhibitors) increases levels or serotonin and noradrenaline
• Explain how SSRIs help treat OCD with reference to the neurotransmitter system

  • Serotonin is released by the presynaptic neurons and travels across a synapse.
  • The NT chemically conveys the signal from the presynaptic neuron to the postsynaptic neuron.
  • It is then reabsorbed by the presynaptic neuron where it is broken down and re-used.
  • SSRIs prevent the re-absorption and breakdown of serotonin,
  • They increase the serotonin levels in the synapse, continuing to stimulate the postsynaptic neuron
  • This compensates for what is wrong with the serotonin system in OCD
• What is a strength of drug therapy?

  • Cost effective and non disruptive
  • Cheap compared to psychological treatments, therefore good value for public health system
  • Non disruptive to patients lives and effective in targeting the neural abnormality
• Strength of drug therapy? (AO3)

  • Cost effective and non-disruptive
  • Good value to public health system (such as NHS)
  • Means drop-out rates may have less of an effect onto health systems
  • Additionally drugs are simple for patients to take in order to reduce symptom severity rather than long psychological therapy processes
  • Therefore may benefit the health economy and lead to a larger rate of improvement in syptoms due to being versatile (appropiate)
• Limitation of drug therapy? (AO3)

  • Side effects
  • Patients may experience side-effects from taking clomipramine
  • over 1 in 10 suffer from erection problems, tremors and weight gain
  • 1 in 100 may become aggressive and find blood pressure and heart rhythm is disrupted
  • Limitation as it may reduce efficacy of treatments, people are more likely to stop taking treatment leaving an inability to reduce symptoms
• Additional limitation due to cromer's research? (AO3)

  • OCD following in trauma
  • Issue as OCD may also have a psychological basis rather than just simply biological
  • May therefore be inappropriate or ineffective as it may require a psychological therapy