Treating OCD

• What is drug therapy as a biological treatment for OCD?

  • Aims to increase or decrease levels of neurotransmitters in the brain to increase or decrease their activity
  • Low levels of serotonin being associated with OCD means treatment drugs will work to increase the level of serotonin in the brain
• What are SSRIs?

  • Selective serotonin reuptake inhibitors (SSRIs) prevent the reabsorption and breakdown of serotonin in the synapse to continue to stimulate the postsynaptic neuron, compensating for whatever is wrong with the serotonin system in OCD patients
  • Typical daily dose of Prozac (fluoxetine) is 20mg but can be increased if not beneficial, and takes around 3-4 months of daily use to have impact on symptoms
  • Can be used alongside CBT as it reduces emotional symptoms meaning a patient can engage with the therapy more effectively
• What are some alternatives to SSRIs?

  • Tricyclics: an older type of antidepressant which acts on various systems including the serotonin system, but has more severe side-effects so is kept in reserve for those who do not respond to SSRIs
  • SNRIs: serotonin-noradrenaline reuptake inhibitors increase levels of serotonin and noradrenaline and are also used as a second line of defence for people who don't respond to SSRIs
• What is one strength of drug therapy as a treatment for OCD?

  • Research support for effectiveness: Soomro et al. (2009) reviewed 17 studies comparing SSRIs to placebos and all showed significantly better outcomes for SSRIs
  • Typically symptoms reduce for about 70% of patients on this drug, remaining 30% can be helped by alternative drugs or therapies
  • Means that drugs appear to be helpful for most people with OCD
• What is another strength of drug therapy as a treatment for OCD?

  • Cost effective: generally cheaper compared to psychological treatments, thousands of tablets can be manufactured in the time it takes to conduct one session of psychological therapy
  • Therefore drugs have good value for public health systems like NHS representing a good use of limited funds
  • Non-disruptive: taking drugs until symptoms decline is easier than spending time attending therapy sessions, meaning drugs are popular with many doctors and patients
• What is one limitation of drug therapy as a treatment for OCD?

  • Serious side-effects: indigestion, blurred vision, can be distressing and even long-lasting for a minority
  • Those taking the alternative tricyclic clomipramine side-effects are more serious e.g. more than 1 in 10 people experience erection problems and weight gain and 1 in 100 become aggressive and experience heart-related problems
  • Means drugs can lead to a reduced quality of life and people may stop taking them altogether, weakening their effectiveness
• What is another limitation of drug therapy as a treatment for OCD?

  • Biased evidence: Goldacre (2013) some psychologists believe the evidence for drug effectiveness is biased as researchers are sponsored by drug companies and may selectively publish positive outcomes for the drugs their sponsors are selling
  • Lack of independent studies of drug effectiveness, meaning only the best evidence available is supportive of the usefulness of drugs for OCD
  • We do not fully know about its' effects if evidence is biased and selective