Biological Approach - Treat OCD

What antidepressants are used to treat OCD?

SSRIs and Tricyclics

How do SSRIs work?

Increases the level of serotonin in synapse by blocking re-uptake at pre-synaptic neuron

• More serotonin stays longer in synapse

• Increases stimulation to receiving neuron

• Allows more serotonin to bind to receptor sites on post-synaptic neuron.

How do tricyclics work and how are they used?

Blocks re-uptake of serotonin and noradrenaline

• More left in synapse, prolonging their activity

Have greater side effects, only used w. patients where SSRIs are ineffective

What are BZs used for?

Reduce anxiety by slowing down activity in CNS

How do BZs work?

Enhances activity of GABA neurotransmitter

• Binds to GABA receptors on receiving neurons

• Once bound, increases flow of Cl^- ions

  • Blocks other neurotransmitters e.g. dopamine from binding to receptor site

• Nervous system slowed down, making client feel more relaxed

DIS1: Not lasting

P: An issue w. drug treatments is that they’re not a lasting cure for people w. OCD

Ev: Maina et al (2001) found patients relapse within a few week if medication is stopped. Koran et al (2007), suggested that although drug therapy may be more commonly used, psychotherapies such as CBT should be tried first

Ex/L: This suggests that, while drug therapy may require little effort, & also may be relatively effective in the short term, it doesn’t provide a lasting cure, overall, reducing its ability to treat OCD.

AD1: Preferred treatment

P: A benefit of using drug therapy is that it requires little effort & time from user

Ev: In contrast, therapies like CBT require the patient to attend regular meetings & put considerable thought into tackling their problems.

Ex: Drug therapies are also cheaper for health service as they require little monitoring & cost much less than psychological treatments. Furthermore, patients may benefit from talking w. a doc during consultations

L: These benefits means that drug therapies are more economical for the health service than psychological therapies

DIS2: Publication bias

P: Turner et al (2008) claimed there is evidence of publication bias towards studies that show a positive outcome of antidepressant treatment, thus exaggerating the benefits of antidepressant drugs

Ev: Authors found, not only were positive results more likely to be published, but studies that weren’t positive were often published in a way conveying positive outcome.

Ex: Drug companies have a strong interest in the continuing success of psychotherapeutic drugs & much of the research is funded by these companies

L: As Turner et al suggests, such selective publication can lead docs to make inappropriate treatment choices that may not be in the best interest of their patients

DIS3: Side effects

P: All these drugs have side effects, some more severe than others

Ev: Nausea, insomnia, & headache are common side effects of SSRIs, which are often enough to stop patients from taking the drug. Tricyclics also have hallucinations & irreg. heartbeat, so only used when SSRIs ineffective.

Ev: BZs possible side effects include increased aggressiveness & long-term memory impairment. Also addiction problems, so BZs should be limited to mx. 4 weeks (Ashton, 1997)

L: These side effects, & possibility of addiction, limit the usefulness of drugs as treatments for OCD