The Biological Approach to Treating OCD

Drug Therapy

As we saw in the biological explanation of OCD, the condition is associated with low levels of Serotonin, therefore the biological approach to treating OCD focuses on increasing the level of Serotonin in the brain.

Snap question - what is serotonin?



SSRI's

SSRI stands for selective serotonin reuptake inhibitor which is the standard prescribed medical treatment for OCD. SSRI's are a particular type of antidepressant drug and they are also used to treat other mental health conditions including depression.

SSRI's work by preventing the reuptake of serotonin after it is released across the synapse. This ensures that more serotonin is absorbed by the postsynaptic neuron and ensures that more serotonin remains in the body system. The increased serotonin goes on to improve mood and regulate the amount of required serotonin to help the patient deal with OCD.

There is a huge variety of SSRI drugs available and the impact on patients can vary, taking at least a month for the patient to feel any different and see symptoms lessen. A commonly prescribed SSRI in UK is called Citalopram. 

See the below videos for more information.



Controversially, on 20 July 2022 a paper was released that got a lot of media attention that suggested there was no link between serotonin and depression/anxiety, and it called into doubt the effectiveness of antidepressant medications. Follow the link below

https://news.sky.com/story/antidepressants-called-into-question-as-researchers-find-no-convincing-evidence-depression-is-caused-by-chemical-imbalance-12655342

Combining SSRI's with Cognitive Behaviour Therapy (CBT)

Drugs are often used alongside CBT to treat OCD. The drugs reduce a person's emotional symptoms while CBT can help to bring about changes in thinking and behaviour.


Alternatives to SSRI's

When an SSRI is ineffective the dosage can be increased or it can be taken along with the medications. Sometimes other antidepressants are taken and we will now explore these.

  • Tricyclics - this drug work on other neurotransmitters as well as serotonin but it has more severe side effects so it given to patients who do not respond to initial SSRI medication
  • SNRI's - this is an additional type of medication available for patients who do not respond to SSRI's. This drug increases serotonin as well as a different neurotransmitter - noradrenaline.

Evaluation

- Strength - effectiveness. There is a lot of evidence to show the effectiveness of SSRI's in treating OCD. A study by  Soomro et al (2009) showed that SSRIs were highly effective. The study reviewed 17 studies that compared the effectiveness of SSRIs against placebos and showed that symptoms were reduced for 70% of patients. This shows a high level of success.

- Strength - Cost effective for NHS and not time consuming for patients, e.g. no need to attend therapy sessions.

- Limitation - Side effects including headache, blurred vision, nausea, loss of sex drive.

- Limitation - medications can often take a long time to take effect, e.g. 3-4 months, and even then they might not be effective. Patients may need to try a range of medications over a long period of time to find one that is effective.









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