Treating OCD

Drug Therapy for Mental Disorders

• Aim of Drug Therapy

  • Increase or decrease levels of neurotransmitters in the brain

  • Increase/decrease neurotransmitter activity

• SSRIs (Selective Serotonin Reuptake Inhibitors)

  • Work on serotonin system in the brain

  • Prevent reabsorption and breakdown of serotonin

  • Increase serotonin levels in the synapse

  • Stimulate postsynaptic neuron

  • Example: Fluoxetine (Prozac) - typical daily dose, impact duration

• Combining SSRIs with Other Treatments

  • Often used alongside Cognitive Behaviour Therapy (CBT)

  • Reduce emotional symptoms, enhance engagement with CBT

• Alternatives to SSRIs

  • Tricyclics

    • e.g., Clomipramine

    • Acts on serotonin system

    • More severe side-effects, reserved for non-responders

  • SNRIs (Serotonin-Noradrenaline Reuptake Inhibitors)

    • Second line of defense for non-responders to SSRIs

    • Increase serotonin and noradrenaline levels

Evaluation of Evidence of Effectiveness of Drug Treatment for OCD

• Strengths of Drug Treatment for OCD

  • Good evidence for effectiveness

    • SSRIs reduce symptom severity and improve quality of life

    • Review by G. Mustafa Soomro et al. (2009) showed better outcomes for SSRIs compared to placebos in 17 studies

    • Around 70% of people show symptom reduction with SSRIs

  • Most people with OCD can be helped by drugs or combinations of drugs and psychological therapies

• Counterpoint

  • Some evidence suggests cognitive and behavioral therapies are more effective than SSRIs

    • Study by Petros Skapinakis et al. (2016) concluded therapies were more effective in treating OCD

• Cost-Effectiveness and Non-Disruptive Nature

  • Drugs are cost-effective and non-disruptive

    • Cheaper compared to psychological treatments

    • SSRIs are non-disruptive to daily life, unlike therapy sessions

• Limitations of Drug Treatments for OCD

  • Serious side-effects

    • Some individuals may not benefit from drugs

    • Side-effects like indigestion, blurred vision, loss of sex drive

    • Tricyclic clomipramine can cause more serious side-effects

    • Some individuals may have reduced quality of life due to side-effects, leading to discontinuation of drugs