biological approach to treating OCD - drug therapy

• antidepressants

  1. SSRIs
  2. tricyclics
• SSRIs

  • used to artificially increase serotonin levels
  • achieved by blocking the re-uptake of serotonin at receptor sites, increasing concentration at the post-synaptic membrane
  • mean more inhibition (dampen mood down) of post-synaptic neuron
  • this combats hyperactivity that has been associated with OCD symptoms in some brain circuits
• tricyclics

  • may be prescribed if SSRIs do not lead to improvement/or resistant to SSRIs
  • they inhibit the re-uptake of both serotonin and noradrenaline
• strengths

  supporting research that SSRIs can be an effective treatment in many OCD cases

  • zohar et al. (1996) found SSRIs alleviated symptoms in 60% of patients with OCD
  • helps increasing serotonin levels
  • combats symptoms
• strength

  drug treatments usually appropriate for wide range of people and lifestyles:

  • prescribing them requires relatively little effort, meaning that most people can use them
  • also take less time + considerably cheaper to fund
• why might drugs be more important that CBT?

  • CBT = takes more time + effort, not everyone is willing
  • drugs = take it and does the job immediately
• limitations

  drug therapy not appropriate for all = side effects

  • include nausea, headaches + insomnia
  • can lead to patients choosing to discontinue medication, increasing chances of relapse + re-admission to hospital (expensive)
  • BUT, if drugs works = enable care in the community = allow sufferer learn life skills + save money on costly inpatient treatment
  • tricyclics have more side effects, so taken only in cases were SSRIs shown to be ineffective
• what might the implications of this be for the economy?

  • get better quicker with taking drugs at home = less absenteeism/go back to work quicker
  • less costly for community as no need for treatment in hospital
• limitation

  drugs treat the symptom of the disorder rather than the cause = not a long term cure

  • patients often relapse within a few weeks after medication has stopped
  • there can become trapped into taking drugs long term
  • described as a 'pharmacological strait jacket'
• limitation

  biological treatments for OCD may be both reductionist + deterministic

  • treatment does work in all cases (zohar - 60%) suggest serotonin levels unlikely the only factor in OCD development
  • other treatments need to be taken into account

  therefore, interactionist treatments will use multiple treatments

  • often more effective that individual treatments alone
• 2 drug therapies

  1. anti-depressants = SSRIs
  2. anti-anxiety benzodiazepines
• SSRIs

  • used to treat OCD by artificially increasing serotonin levels
  • achieved by blocking the re-uptake of serotinin at the receptor sites, increasing concerntration at the post-synaptic membrane
  • this combats the hyperactivity associated with OCD in some of the brain circuits
• benzodiazepines

  • slows down CNS activity of neurotransmitter GABA (gamma-aminobutyric acid)
  • when released, has a quietening affect of neurons in the brain
  • it reacts with special sites (GABA receptors on the outside of recieving neurons)
  • when GABA lcoks into the receptors, it opens a channel than increases the flow of chloride ions into the neuron
  • chloride ions make it harder for the neuron to be stimulated by other neurotranmitters
  • slows down it activity + feel relaxed
  • common manufacturers = Librium, Xanax, Valium, Diazepam
• SSRI diagram explanation

  • serotonin is released into a synapse from one nerve
  • it targets receptor cells on the recieving neuron at receptor sites
  • afterwards, is re-absorbed by the initial neuron sending the message
  • in order to increase serotonin levels at the synapse, and increase stimulation to the recieving neuron, this re-absorption (re-uptake) is inhibited