Biological Approach to Treating OCD

Drug Therapy:Drug therapy for mental disoders aims to increase/decrease levels of neurotransmitters in the brain or to increase/decrease their activity. OCD is associated with low levels of seratonin so drugs work in various ways to increase the level of seratonin in the brain. SSRIs:The standard drug treatment for OCD uses SSRIs - Selective Seratonin Reuptake Inhibitor. SSRIs work on the seratonin system. Seratonin is released by certain neurons in the brain. It is released by the presynaptic neurons and travels across a synapse. The neurotransmitter chemically conveys the signal from the presynaptic neuron to the postsynaptic neuron and then it is reabsorbed by the presynaptic neuron where it is broken down and reused. By preventing the re-absorption and breakdown of seratonin, SSRIs effectively increase its levels in the synapse and thus continue to stimulate the postsynaptic neuron. This compensates for whatever is wrong with the seratonin system in OCD. It takes 3-4 months of daily use for SSRIs to have much impact on symptoms.Combining SSRIs with other treatments:Drugs are often used alongside CBT to treat OCD. The drugs reduce a patients emotional symptoms such as feeling anxious/depressed. This means that patients can engage more effectively with CBT. In practice some people respond best to CBT alone while others benefit more from drugs.Alternatives to SSRIs:Where an SSRI is not effective after 3-4 months the dose can be increased or it can be combined with other drugs. Sometimes different antidepressants are tried. People respond very differently to different drugs and alternatives work well for some people and not at all for others. Tricyclics are sometimes used such as clomipramine. These have the same effect on the seratonin system as SSRIs. Clomipramine has more severe side-effects than SSRIs so it is generally kept in reserve for patients that do not respond to SSRIs SNRIs - Seratonin Noradrenaline Reuptake Inhibitors. In the last 5 years a different class of antidepressant drugs called SNRIs has also been used to treat OCD. These are a second line of defence for patients that don't respond to SSRIs. SNRIs increase levels of seratonin as well as another different neurotransmitter - noradrenaline

Evaluation: There is evidence for the effectiveness of SSRIs in reducing the severity of OCD symptoms and so improving quality of life for OCD patients. Somoro et al. reviewed studies comparing SSRIs to placebos in the treatment of OCD and concluded that all 17 studies reviewed showed significantly better results for the SSRIs than for placebo conditions. Effectiveness is greatest when SSRIs are combined with a psychological treatment, usually CBT. Typically symptoms decline significantly for around 70% of patients taking SSRIs. Of the remaining 30% alternative drug treatments or combinations of drugs and psychological treatments will be effective for some. So drugs can help most people with OCD. Drugs are cheap compared to psychological treatments. Using drugs to treat OCD is therefore good value for a public health system Compared to psychological therapies, SSRIs are also non-disruptive to patients lives Drugs can cause side effects such as indigestion, blurred vision and loss of sex drive. These side effects are usually temporary. The side effects of clomipramine are more serious. More tan one in ten patients suffer erection problems, tremors and weight gain. More than one in a hundred become aggressive and suffer disruption to blood pressure and heart rhythm