biological approach to treating OCD

• Outline the use of drug therapy for OCD using SSRIs as an example.

  -Low levels of serotonin are associated with OCD, therefore drugs work in various ways to increase the level of serotonin in the brain.

  -For example, 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 the abnormalities in the serotonin system in OCD.
• What is an SSRI? Name two specific SSRI's.

  -Selective Serotonin Reuptake Inhibitor (Drug)

  Three examples are Paxil, Fluoxetine and Prozac
• Explain the typical dosage of SSRIs

  -A typical daily dose of Fluoxetine (an SSRI) is 20mg , although this may be increased (to 60mg) if it is not benefiting the patient.

  -It takes 3 to 4 months of daily use for SSRIs to impact upon symptoms.
• What are alternative to SSRIs?

  -Tricyclics

  -SNRIs
• What are tricyclics?

  -AKA Clomipramine

  - Older antidepressant

  - Same effect on serotonin system as SSRIs

  - More severe side effects=kept in reserve
• What are SNRIs?

  - serotonin-noradrenaline reuptake inhibitors

  - increase serotonin and noradrenaline levels
• Why are SNRIs and Tricyclics second choice?


  Due to their more intense side effects
• Why are antidepressants used for OCD patients?

  Antidepressants (like anti-anxiety drugs) improve mood and reduce anxiety which is experienced by patients with OCD.
• How are SSRIs combined with other treatments?

  -Used with CBT to treat OCD=reduce emotional symptoms=engage more effectively
• What are the evaluations for treating OCD through the biological approach?

  S: Soomro: studies of SSRIs vs placebos=17 studies showed SSRI>placebo - drugs help OCD patients OCD symptoms reduce 70% taking SSRIs - 30% helped by alternative drugs/drug combos/& CBT

  S: cheaper=good value for NHS; non disruptive to patients lives

  W: minority of sufferers side effects: indigestion/blurred-vision ;tricyclics= tremors/weight gain=patients stop meds

  W: controversy: psychologists believe evidence biased=research sponsored by drug companies (don't report all evidence)=unreliable
• what is the use of drug therapies for OCD?

  they target abnormal neurotransmitter levels.
• what are SSRI's? (selective serotonin reuptake inhibitors)

  they're antidepressants that are used to reduce the anxiety associated with OCD. they're currently the preferred drug for treating OCD.
• what do SSRI's do?

  they increase levels of the neurotransmitter serotonin, which regulates mood and anxiety. they work by blocking the reabsorption of serotonin at the pre-synaptic nerve leaving more serotonin available in the synapse.
• what is the end result of SSRI?

  there is an increased amount of serotonin available to be taken up by other neurons. if a deficiency of serotonin is associated with the development of OCD, you can expect drugs that increase serotonin will prove effective in treating OCD.
• how long does it take for SSRI to work?

  3-4 months of daily use.
• what are anxiolytic drugs?

  anti anxiety drugs used to treat the anxiety associated with OCD. BZ's are widely used.
• how do anti anxiety drugs work?


  by increasing the effectiveness on the brain activity and this reduces the anxiety experienced by OCD sufferers.
• whats a strength of drug therapy for treating OCD?

  there's research support that comes from Piggott and Seay who reviewed studies testing the effectiveness of drug therapies and found SSRI's to be consistently effective in reducing OCD symptoms.
• what is a limitation of using drug therapies for treating OCD?

  it's not a lasting cure as the relapse rate following discontinuation of medication is quite high. according to Simpson et al, 45% of patients treated with SRI relapsed back into the disorder within 12weeks of completing medication. this poor in comparison to only a 12% relapse rate in the same period of those who had received a psychological therapy. this suggests that although drugs are most commonly used, psychotherapies such as CBT should be tried.
• what are the side effects of drug therapy for treating OCD?

  common side effects of SSRIs include nausea, headache, insomnia, loss of sex drive, indigestion, and blurred vision. possible side effects of BZs are aggressiveness, Long term impairment of memory, and addiction. side effects reduce the effectiveness of the drug as people might stop taking the medication. psychological therapies are more appropriate for those having side effects. Greist found that ERPT was just as effective as a treatment for OCD as drugs and didn't have side effects and high relapse rates associated with drug treatment.
• how is drug therapy being the preferred treatment for OCD a strength? (eclectic approach)

  it's non-disruptive to the patients life as it requires little effort from the user and little input in terms of time; compared to CBT where the patient has to attend regular appointments. from the point of view of the health service, drugs are good value as they are cheaper than psychological therapies partly becuse they don't require a therapist to administer them. However, drug therapy is not successful with all OCD sufferers. this suggests that the causes of OCD may not originate solely with levels of serotonin and there are other factors that play a role in its origins. therefore, an eclectic approach to therapy may be more successful.