treating OCD

• drug therapy:

  • aims to decrease/increase levels of neurotransmitters in the brain or their activity
  • low levels of serotonin associated with OCD
• selective serotonin reuptake inhibitors (SSRIs):

  • prevent the reabsorption in presynaptic neuron
  • increases levels, results in continued stimulation of postsynaptic neuron
  • compensates for lack of serotonin that would be naturally found
• normal serotonin diffusion:

  • released by presynaptic neuron and travels across synapse
  • chemically conveys signals from presynaptic to postsynaptic neuron
  • reabsorbed into presynaptic neuron, broken down, reused
• dosage of SSRIs:

  • typical dose of fluxetine (prozac) is 20mg
  • may be increased if no benefit
  • 3-4 months of daily use to see impact
• combining SSRIs:

  • often used alongside CBT
  • drugs reduce emotional symptoms, people engage more effectively with CBT
• SNRIs:

  • increase levels of serotonin and noradrenaline
  • used if not responsive to SSRIs
• tricyclics:

  • act on various systems including serotonin
  • more severe side effects, used only if patient hasnt been responsive to SSRIs
• EVALUATION: evidence of effectiveness

  • clear evidence to show decrease in symptom severity + increase in quality of life
  • soomro et al - 17 study review, compared placebos to SSRIs, better outcomes for SSRIs
  • drugs appear to be helpful for most people with OCD
• EVALUATION: cost effective + non disruptive

  • drugs are cheaper, thousands manufactured in time CBT session is conducted - drugs provide good value for health systems
  • non disruptive to lives - daily use more efficient than hours of therapy
  • drugs are a more popular treatment for OCD
• EVALUATION: serious side effects

  • SSRIs - indigestion, blurred vision, loss of sex drive - only temporary but distressing
  • tricyclics more severe and common - >10% erection problems, weight gain + potential heart problems
  • reduces quality of life, may stop using = cease to be effective
• EVALUATION: treat symptoms not cause

  • SSRIs work by increasing levels of serotonin, reducing anxiety + alleviating symptoms not treating cause
  • stop taking = prone to relapse
  • suggests psychological treatments are longer term solution - lasting treatment + potential cure