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Describe and evaluate the biological approach to treating OCD
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A level psychopathology 16 marker full mark essay
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Describe and evaluate the biological approach to treating OCD. (16 marks).There are several biological treatments used for OCD patients. For many patients, drugs
remain an easy and accessible means of dealing with their obsessions and compulsions.
According to Gava et al., drug therapy is currently the most used treatment for OCD.
The first type of medication used to treat OCD are antidepressants. These are useful for
treating the abnormal levels of neurotransmitters associated with OCD. There are two types
of antidepressants used to treat OCD. The first type is SSRI’s. SSRI’s help to increase the
levels of serotonin, which is implicated in the ‘worry-circuit’. As a result, taking SSRI’s can
help to normalise this circuit by helping the caudate nucleus to supress any worries.
Furthermore, SSRI’s are also very beneficial for reducing the anxiety involved in OCD as
increasing levels of serotonin will help to regulate the patient’s mood and anxiety. SSRI’s
work by releasing serotonin into a synapse from one neuron. It targets receptor cells on the
receiving neuron at receptor sites and is then reabsorbed by the initial neuron. To increase
levels of serotonin at the synapse, re-uptake is inhibited. The other type of antidepressant
for OCD is tricyclics. Tricyclics work by blocking the transporter mechanism that reabsorbs
both serotonin and noradrenaline into the pre-synaptic cell after it has fired. As a result,
more of these neurotransmitters are left in the synapse, prolonging its activity.
Another type of medication that helps to treat OCD is anti-anxiety drugs, for example BZ’s.
BZ’s are commonly used to reduce anxiety by enhancing the activity of the neurotransmitter
GABA (which has a quietening effect on many neurons in the brain) to slow down the
activity of the central nervous system. It does this by reacting with special sites on the
outside of receiving neurons. When GABA locks into these receptors it opens a channel that
increases the flow of chlorine ions into the neuron. This makes the person feel more
relaxed. Finally, other drugs such as D-Cycloserine has an effect on reducing anxiety and is
helpful for using in conjunction with psychotherapy.
A strength of using drug therapy to treat OCD is the considerable evidence for the
effectiveness of such treatments. For example, in 2008, Soomro et al. reviewed 17 studies of
the SSRI’s and found them to be more effective than placebos in reducing symptoms up to
three months after. However, an issue regarding the evaluation of treatment is that most of
the studies only consist of up to 3 or 4 months long, therefore little long term data exists,
suggesting that drug therapy is only a short-term cure. In 2007, Koran et al. suggested that,
although drug therapy may be more commonly used, CBT should be tried first. Although
drug therapy requires little effort, it is not a lasting cure, as indicated by its high relapse
rates. Therefore, CBT therapies, such as ERP, should be tried due to between 60-90% of
adults who try it finding it effective.
Drug therapies are considerably preferred to other treatments due to the little time and
effort required compared to CBT. Furthermore, from the point of view of the health service,
they are a lot cheaper due to requiring very little monitoring. However, one thing to
consider when using drug therapy is the range of side effects that they can cause. Firstly,
SSRI’s can commonly cause nausea, headaches and insomnia which is enough for an
individual to not want to take the drug. Secondly, tricyclics tend to have even more side
effects, for example hallucinations and an irregular heartbeat. BZ’s tend to increase
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