Treatment of OCD

SSRIs

Selective serotonin reuptake inhibitors

E.g. antidepressants such as fluoxetine

How do SSRIs work?

Block the reuptake sites on the presynaptic neuron so serotonin remains in the synapse for longer meaning it has more chance of being taken up by the receptor sites on the post synaptic neuron

This increases serotonin levels and decreases symptoms of OCD after roughly 3 or 4 months of use

Alternative to SSRIs

Tricyclics

How do tricyclics work?

Work similarly to SRRIs but also work on other neurotransmitter systems such as norepinephrine like clomipramine

These have more severe side effects so will often only be prescribed when SSRIs have been tried by have not helped the patient

Strength - research to support

Research to support the effectiveness of SSRIs in the treatment of OCD by Soomro et al (2009)

Reviewed 17 studies and found that SSRIs were more effective than placebos in reducing symptoms of OCD

70% of those who received SSRIs saw a decrease in their symptom severity which supports the fact that SSRIs can be helpful for those suffering with OCD

Limitation - side effects

Many side effects when drugs are used to treat OCD

Some side effects include anxiety, digestive problems, visual problems and sleeping problems

These won’t be experienced by everyone but those who do may be replacing one set of problems with another set of problems

Sufferer may stop taking the drugs altogether if the side effects outweigh their symptoms of OCD

Limits how appropriate the use of drugs are to treat OCD if they are adding to the problems

Limitation - evidence

Evidence to suggest that drugs are best when combined with a psychological therapy

Foa et al (2003) carried out study using OCD patients and found that when drugs were combined with CBT, symptoms were reduced more than when one was used on their own

Limits the use of drugs to treat OCD

CBT more effective on own than drugs on own

Strength - price

Drugs cheap and require little effort from patient

Months worth of drugs cost the NHS £4.21 to dispense

CBT would cost the NHS hundreds per patient depending on how many sessions they need - this also requires effort from the patient

Supports drugs in terms of their cost-effectiveness and ease of use for patients

However, drugs considered more unethical as they are not very empowering and don’t require any effort - CBT requires more effect but is empowering for them because they are helping themself become better