treating OCD

• what is the most commonly used treatment for ocd?

  drug therapy
• how do antidepressants work?

  • Serotonin is released into the synapse from one neuron. It targets receptor cells on the receiving neuron at the receptor sites
  • afterwards, it is re-absorbed by the initial neuron sending the message.
  • In order to increase levels of serotonin at the synapse, and increase stimulation to the receiving neuron, the re-absorption (re-uptake) is inhibited.
• Antidepressant: tricyclics ?

  the tricyclic clomipramine was the first antidepressant to

  be used for OCD and today is primarily used in the

  treatment of OCD.
• how do tricyclics work?

  Tricyclics block the transporter mechanism that re-absorbs both serotonin and noradrenaline into the pre-synaptic cell after is has

  fired.

  As a result, more of these neurotransmitters are left in the synapse, prolonging their activity, and easing transmission of the next impulse.
• advantage of tricylics?

  they target more than one neurotransmitter
• disadvantage of tricylics?

  they have greater side effects so are used as a second-line treatment for patients where SSRIs are not effective.
• Benozodiapines ( BZs) ?

  • commonly used to reduce anxiety.
  • BZs slow down the activity of the central nervous system by enhancing the activity of the neurotransmitter GABA
  • GABA= a neurotransmitter that when released has a quieting effect on many of the neurons in the brain
• evaluation of drug therapy?

  • cheaper - require less monitoring
  • require little input from the user in terms of time and effort (eg, cbt requires the patient to attend regular meetings)
  • Soomro et al (2008) reviewed 17 studies of the use of SSRIs with OCD patients and found them to be more effective than placebos in reducing the symptoms of OCD up to three months after treatment.
  • Mania et al (2001) found that patients relapse within a few weeks if medication is stopped.
• ssris ?

  Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressant medications that work by increasing the levels of serotonin in the brain.
• how do ssris work?

  • serotonin is released from the pre synaptic neurons and travels across a synapse
  • the neurotransmitter chemically conveys the signal from the pre synaptic neuron to the post synaptic neuron
  • it is then reabsorbed by the pre synaptic neuron where it is broken down and reused
• combining ssris with other treatments?

  • drugs are usually used alongside cbt to treat ocd
  • the drugs emotionally help the patient, eg anxiety or depression
  • this means that people with ocd can engage more effectively with cbt