Treating OCD

• How does the biological approach to treating OCD have side effects?

  Patients may suffer side-effects; indigestion, blurred vision and loss of sex drive.

  
  

  Comipramine

  • Side effects are more common and more serious; erection problems, tremors and weight gain
  • More than 1/10 become aggressive and disruption to blood pressure/ heart rhythm
  • Reduce effectiveness because people stop taking medication
• 1 limitation of using the biological approach to treat OCD

  Drugs may have side effects
• How is using the biological approach to treat OCD cost effective and non-disruptive?


  They are cheap compared to psychological treatments.

  • good value for a public health system like the National Health Service
  • Non-disruptive to patients lives
  • not engage with the hard work of psychology therapy
• What is the evidence of the effectiveness of SSRI's?

  Soomro et al

  • reviewed studies comparing SSRI's to placebos
  • concluded that all 17 studies reviewed showed significantly better results for the SSRI's
  • Effectiveness is greatest when SSRI's are combined with CBT Symptoms decline by around 70%
  • Drug can help most patients with OCD
• 2 strengths of using the biological approach to treat OCD

  - effective at treating OCD symptoms

  - Cost-effective and non-disruptive
• What are SNRI's ?

  Serotonin-noradrenaline re-uptake inhibitors

  • Second line of defence for patients
  • Increases the levels of serotonin as well as another different neurotransmitters (noradrenaline)
• What are Tricyclics?

  An older type of antidepressants

  • such as Clomipranmine Same effect on the serotonin system
  • Has more side effects so reserved for patients who do not respond to SSRI's
• What's are the alternatives to SSRI's?

  - Tricyclics

  - SNRI's
• What does a synapse look like?

  
• How does the serotonin system in the brain work?

  1. Serotonin is released by certain neurons in the brain, it is released by the the presynaptic neuron and travel across the synapse

  2. The neurotransmitter chemically conveys the signal from the presynaptic neuron to the post synaptic neuron

  3. Then it is absorbed by the postsynaptic neuron where it is broken down and re-used
• What is the typical daily dose of SSRI's?

  20mg of Fluoxetine (may be increased if not benefiting patients to 60mg)

  • 3 - 4 months of daily loose to have impact
• How do SSRI's work?

  Prevents the re-absorption and breakdown of serotonin

  
  

  - therefor increasing the levels of serotonin in the synapse and thus continuing to stimulate the postsynaptic neuron
• What type of antidepressant is a standard medical treatment used to tackle the symptoms of OCD?


  Selective serotonin re uptake inhibitor (SSRI)
• What is Drug therapy aim?

  To increase/decrease levels of neurotransmitters in the brain to increase/decrease thier activity.