The Biological Approach to Treating OCD

What type of drugs are primarily used to treat OCD?

A group of antidepressant drugs called SSRIs eg Fluoxetine (also known as Prozac)

What does SSRI stand for?

Selective serotonin reuptake inhibitor

How do SSRIs reduce anxiety in OCD patients?

They only influence (select) serotonin in the brain, as reuptake inhibitors, they inhibit (slow down) the reuptake process in the synapse. Therefore serotonin is still present in the synaptic cleft and continues to stimulate the postsynaptic neuron. This decreases anxiety by normalising the activity of the worry circuit

How long do SSRIs take to work and what happens if they are not effective?

Can take 3 to 4 months to reduce symptoms, and for some patients, SSRIs are not effective. The dosage can be increased for drug resistant patients or other treatment options can be attempted such as anti-anxiety drugs like benzodiazepines

What are benzodiazepines and how do they work?

Anti anxiety drugs which work by enhancing a neurotransmitter called GABA, slowing the central nervous system and resulting in general relaxation

What other drug types may be used if SSRIs are ineffective, and how do they work?

Tricylics and SNRIs work by increasing serotonin and noradrenaline, these drugs can be effective when SSRIs fail, but because they work multiple multiple neurotransmitters (non-selective), they tend to have more intense side effects

AO3 - Soomro

Conducted a meta analysis combing the data from 17 studies that compared SSRIs to placebos. In total, there were 3097 participants. The results of this large scale meta analysis showed that SSRIs significantly reduced the symptoms of OCD compared to placebos between 6 and 17 weeks post treatment. These results suggest drug therapy is effective in the short term

AO3 - Goldacre

Points out that most research studies on drug therapies are conducted by the pharmaceutical companies that created them. This means the companies have a financial interest in showing the drugs are effective, this, and the file drawer problem (the fact that many negative results stay unpublished), means any meta analysis may be skewed, and drug therapies may not be as effective as claimed

AO3 - Drug therapy is inexpensive and more convenient

In comparison to psychological therapies like CBT, which require the patient to find time for multiple sessions with a trained therapist. As CBT is much more expensive than drug therapy, from an economic perspective, health services like the NHS are more likely to provide drug therapy

AO3 - Many patients prefer CBT due to drug therapies side effects

In Soomro’s meta analysis, it was found nausea, headache and insomnia were the most common side effects. Also, with drug therapy, it can take four months before the patient experiences symptom reduction and patients can become dependent on the drugs. Therefore some patients may opt for CBT

AO3 - Drug therapies may only cover up the symptoms of OCD, not treat the cause

It’s argued serotonin imbalance is a result of OCD, not the cause. This means the origin of OCD may not be biological but instead due to a traumatic experience. Cromer (2007) showed 54% of 265 participants with OCD reported at least 1 traumatic life event, and those with traumatic life events reported increased severity of OCD symptoms. This suggests drug therapy is a temporary solution and psychological therapies that address these life events may be more effective long term