biological treatment of OCD

• OCD: repetitive behaviour + obsessive thinking
• drug therapy - SSRI's

  serotonin released -> travels synapse -> receptor on post synaptic -> some not absorbed -> reabsorbed by pre-synaptic neurone (SSRI's prevent this by blocking reuptake receptors)
• 20mg fluoxetine 3-4 months capsules or liquids

  can reduce emotional symptoms for CBT

  dose can be increased to 60mg
• alternatives: clomipramine (increased side effects), SNRI's (also increase noradrenaline)
• supporting evidence✅

  • soomro et al
  • 17 studies
• supporting evidence✅

  • soomro et al
  • 17 studies
  • SSRI's better than placebo
  • > effectiveness with CBT
  • symptoms decline for 70% of patients
• positives of drugs ✅

  • cost effective (good for NHS)
  • non-disruptive (work + social life)
• side effects🚫

  • e.g indigestion, loss of sex drive
  • clomipramine - 1/10 weight gain 1/100 blood pressure + heart rhythm
• unreliable evidence 🚫

  • alot of studies are from drug companies = bias
• • drug therapies assume faulty neurochemical imbalances (low levels of serotonin) are implicated by OCD - drugs work to correct this
  • SSRI's like fluoxetine inhibits rapid re-uptake of serotonin - increases serotonin in synapse
  • increases chance of serotonin binding to receptor sites and stimulate post-synaptic neuron, allows transmission of 'mood related' info - results in improved mood, reduced anxiety
  • SSRI's - daily 3-4 months until it reduces obsessive thoughts and compulsions
• supportive research ✅

  • soomro - meta analysis 17 studies, SSRIs more effective reducing OCD symptoms than placebo
  • supports use of drug therapy - SSRI's increasing serotonin in synapse improves quality of lives for many OCD sufferers
  • however the research only looked at short term impact 🚫 we can't draw conclusions on whether they're effective in long term
• side effects 🚫

  • soomro found SSRIs lead to nausea, headaches, insomnia
  • BZ - increased aggression, LTM impairments
  • OCD sufferers may stop their drug treatment altogether - ceasing effectiveness
  • maina found that relapse of symptoms is common if medication is stopped within first few weeks
• julien countered this argument

  • SSRI's reduced 50-80% of OCD symptoms in patients
  • helps them to return to a normal way of living
  • drugs require little effort compared to CBT which requires commitment and thought in tackling their problems
  • effective for sufferers finding it difficult to discuss obsessive thoughts