Biological treatment for OCD

• Drug therapy is the treatment of OCD used by the biological approach
• Neurotransmitters

  Drug therapy for mental disorders aims to increase or decrease 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 level of serotonin in the brain.
• Selective serotonin reuptake inhibitors (SSRIs)


  SSRIs prevent the reabsorbtion and breakdown of serotonin in the brain. This increases its level in the synapse and thus serotonin continues to stimulate the postsynaptic neuron. This compensates for whatever is wrong with the serotonin system in OCD.
• Typical dosage of SSRI

  A typical dosage of fluoxetine is 20mg although this may be increased if it is not benefitting the person. It takes 3-4 months of daily use for SSRIs to impact upon symptoms. Dose can be increased if this is appropriate.
• SSRIs and CBT

  Drugs are often used alongside cognitive behavioural therapy to treat OCD. The drugs reduce the emotional symptoms which means they can engage more effectively with CBT.
• Alternatives to SSRI

  Tricyclics - is an older type of antidepressant and are sometimes used. An example of one is clomipramine. These have the same effect on the serotonin system as SSRIs but the side effects can be more severe.
• Evaluation

  One strength is drugs are cost effective and non disruptive. They are a cheaper alternative to other psychological treatments. Using drugs to treat OCD is therefore good value for the NHS. As compared to psychological therapies, SSRIs are also non disruptive to peoples lives. If you wish you can simply take drugs until the symptoms decline rather than spending time going to therapy sessions. This means many people with OCD prefer drug treatments.
• Evaluation

  One limitation is drug treatment 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. For those taking clomipramine, side effects are more common and can be more serious. More than 1 in 10 people experience erection problems and weight gain, 1 in 100 become aggressive. This means that peoples quality of life is poor and the outcome is they may stop taking drugs altogether which reduces the effectiveness.
• Evaluation

  One strength of drug therapies are their effectiveness. Soomro 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. However, they may not be the most effective treatment as CBT may be a better alternative. This means that drugs may not be the optimum treatment for OCD.