10. The Biological Approach to Treating OCD

• 1. The Biological Approach to Treating OCD

  Drug Therapy:

  • Chemical imbalance in brain, corrected by drugs.
  • Increase/decrease neurotransmitter in brain.
  • Can be combined w/ CBT.
• 1a. The Biological Approach to Treating OCD

  SSRI Process:

  • Increase serotonin level available in synapse = prevents reabsorbed into sending cell.
  • Increase, more serotonin received by receiving cell (post-synaptic neuron).
• 1b. The Biological Approach to Treating OCD

  SSRIs (Antidepressants):

  • By preventing reabsorption/serotonin breakdown, compensates for what‘s wrong w/ serotonin system = increase activity level.
  • E.g. Fluoxetine (20mg).
• 1c. The Biological Approach to Treating OCD

  SSRIs + CBT:

  • Mental clarity to engage w/ treatment.
  • CBT combat underlying anxiety/depression.
  • Combination favoured, holistic solution.
• 2. The Biological Approach to Treating OCD

  Tricyclics, SNRIs (Antidepressants):

  • Increase norepinephrine + serotonin levels.
  • Blocks action of acetylcholine.
  • Main neurotransmitter of parasympathetic nervous system, responsible for bodily functions.
  • Work on more than one neurotransmitter = more side effects.
• 2a. The Biological Approach to Treating OCD

  Benzodiazepines (Anti-Anxiety):

  • Xanax, Valium, Diazepam.
  • Slow down activity of central nervous system by increasing activity of neurotransmitter GABA.
  • Forces GABA bind to receptor = increase flow of chloride ions into neuron.
  • Chloride ions, hard for neuron be stimulated by anything other than GABA = calming effect.
• 3. The Biological Approach to Treating OCD

  *Look at picture in notes!!!*

  1. Action potential reaches end of presynaptic neurone.
  2. Vesicles move to membrane, releases neurotransmitters.
  3. Neurotransmitter binds to receptors.
  4. Increase/decrease chance of action potential in postsynaptic neurone.
  5. Neurotransmitter diffuses, broken down by enzyme or recycled back into neurone (‘reuptake’).
• The Biological Approach to Treating OCD (Evaluation)

  Strength:

  P - evidence for effectiveness.

  E - Soomro et al. (2009), 17 studies comparing SSRIs to placebo; symptoms reduced for 70% (SSRIs).

  E - remaining 30%, alternative drugs or drugs w/ therapy (CBT).

  L - drugs helpful for majority people w/ OCD.
• The Biological Approach to Treating OCD (Evaluation)

  Limitation:

  P - drugs not cost-effective.

  E - systematic review, concluded cognitive + behavioural (exposure) therapies more effective than SSRIs in OCD.

  L - drugs not optimum treatment.
• The Biological Approach to Treating OCD (Evaluation)

  Strength:

  P - cost-effective + non-disruptive.

  E - cheaper than psychological treatments; thousands pill/liquids manufactured in time it takes for one therapy session.

  E - non-disruptive, can take drugs until symptoms decline.

  L - cost-effective = good value in public health; use of limited funds.
• The Biological Approach to Treating OCD (Evaluation)

  Limitation:

  P - side effects.

  E - e.g. indigestion, blurred vision; temporary but an be distressing.

  E - tricyclic clomipramine, side effects serious; 1 in 10 weight gain, 1 in 100 aggressive.

  L - reduced quality life; stop taking = not effective.