Bio-Treating OCD

• Drug therapy - Treatment involving drugs which are chemicals that have a particular effect on the functioning on the brain or some other body system. In psychological disorders such drugs usually affect neurotransmitter levels.
• The aim of drug therapy is to increase/decrease levels of neurotransmitters in the brain or t increase/decrease their activity. As low levels are associated with OCD , the drugs aim to increase levels of serotonin in the brain.
• Standard treatment for OCD involves a type of antidepressant know as selective serotonin reuptake inhibitors (SSRI)
• Serotonin is released by presynaptic neuron and travels across the synaptic gap to the post synaptic neuron where it chemically conveys the signal. Unused serotonin is then reabsorbed by the presynaptic neuron and reused. The SSRI's prevent this reuptake action effectively increasing the level of serotonin in the synapse thereby continuing to stimulate the post synaptic neuron. (3-4m)
• CBT is often used to treat symptoms of OCD. The drugs help to reduce, the anxiety so the patient can engage better with CBT.
• Alt to Fluoxetine:

  • Tricyclics - same effect on serotonin system but have more sever side effects so generally reserved for patients who don't respond to SSRI's
  • SNRI's - Serotonin noradrenaline reuptake inhibitors which increase levels of serotonin and noradrenaline, used for patients who don't respond to SSRI's.
• S of Treatments:

  • Drug therapy is effective in tackling OCD symptoms - Soomro et al reviewed 17 studies comparing SSRI's to placebos in the treatment of OCD and concluded they all showed significantly better results in SSRI condition, and this was more effective when combined with treatment (CBT)
  • Drugs are cost effective and non-disruptive - cheaper than psychological treatments and so a good use of NHS funds and less intrusive than psychological treatment which take a long time and require engagement. You just stop taking them when symptoms ease up.
• W of Treatment:

  • Drugs have side-effects - indigestion, blurred vision, and loss of sex drive (temporarily) Clomipramine can lead to erection problems, tremors and weight gain in about 10% users, 1% can become aggressive and suffer BP/heart problems
  • Some psyches believe the evidence favouring drug treatments is biased because the research is sponsored by drug companies who do not report all evidence (Goldacre)