Biological approach to treating OCD

• What is the biological approach to treating OCD

  Drug therapy
• drug therapy: changing levels of neurotransmitters

  drug therapy aims to increase/decreases levels of neurotransmitters in the brain or to increase/decrease their activity.

  low levels of serotonin are associated with OCD

  therefore drugs work in various ways to increase the levels of serotonin in the brain
• drug therapy: SSRIs

  SSRIs (selective serotonin uptake inhibitors)

  SSRIs prevent the reabsorption and breakdown of serotonin in the brain. this increases its levels in the synapse and thus serotonin continues to stimulate the postsynaptic neuron. this compensates for whatever is wrong with the serotonin system in OCD
• drug therapy: typical dosage

  a typical daily dose of fluoxetine (SSRI) is 20mg although this may be increased if its not benefitting the person. it takes 3-4 months of daily use for SSRIs to impact upon symptoms. does can be increased e.g. 60mg a day if its appropriate
• drug therapy: combining SSRIs with CBT

  drug therapies are often used alongside cognitive behavioural therapy to treat OCD. the drugs reduce a persons emotional symptoms such as feeling anxious or depressed. this means that they can engage more effectively with CBT
• alternatives to SSRIs: tricyclics

  tricyclics are a type of antidepressant e.g. clomipramine. these have the same side effect on the serotonin system as SSRIs but the side effects can be more severe
• alternatives to SSRIs: SNRIs

  on the last 5 years a different class of antidepressant drugs called serotonin noradrenaline reuptake inhibitors have also been used to treat OCD. like tricyclics there are a second line of defence for people who dont respond to SSRIs. SNRIs increase levels of serotonin as well as noradrenaline
• one strength of drug therapy is its effectiveness

  Soomro (2009) reviewed 17 studies of SSRIs for the treatment of OCD. all 17 studies showed better outcomes following SSRIs than placebos. typically OCD symptoms reduce for around 70% of people taking SSRIs. this means that drugs can be of help to most people with OCD
• one strength of drug therapy is its effectiveness: counterpoint

  although drug treatments may be better than placebos, they may not be the most effective treatments. cognitive and behavioural (exposure) therapies may be more effective than SSRIs in the treatment of OCD (Skapinakis 2016). this means that drugs may not be the optimum treatment for OCD
• another strength is that drugs are cost effective and non-disruptive


  a strength of drug treatments for psychological disorders in general is that they are cheap compared to other psychological treatments. using drugs to treat OCD is therefore good value for the NHS. as compared to psychological therapies, SSRI’s are also non disruptive to peoples lives. it you wish you can simply take drugs until your symptoms decline rather than spending time going to therapy sessions. this means that many doctors and people with OCD prefer drug treatments
• one limitation is that drugs can have serious side effects


  a minority of people taking SSRIs get no benefit. some people also experience side effects such as indigestion, blurred vision and loss of sex drive (although they are usually temporary). for those taking clomipamine, side effects are more common and can be more serious. more than 1/10 people experience erection problems and weight gain, 1/100 become aggressive. this means that peoples quality of life is poor and the outcome is they may stop taking the drugs altogether, reducing the effectiveness of the treatment.