This document contains notes on the biological approach to treat OCD for the psychopathology topic in paper 1 of psychology AQA A level. All content follows the AQA specification.
DRUG THERAPY
● When serotonin is released from the presynaptic cell into the synapse, it travels to
the receptor sites on the postsynaptic neuron.
● Serotonin that is not absorbed into the postsynaptic neuron is reabsorbed into the
presynaptic neuron.
● SSRIs increase the level of serotonin available in the synapse by preventing it from
being reabsorbed into the sending cell.
● Increases levels of serotonin in the synapse, more serotonin is received by the
postsynaptic neuron.
SYNAPTIC TRANSMISSION
1. An electrical impulse is triggered from the presynaptic neuron.
2. The impulse travels down the axon to the axon terminal.
3. Triggers the release of neurotransmitters from vesicles.
4. Neurotransmitter diffuses across the synapse, this is a chemical transmission.
5. Neurotransmitter binds to the receptors on the dendrites of the postsynaptic
neuron.
6. Chemical message is turned into an electrical impulse, and the process repeats.
SSRIs: Blocks reuptake, more serotonin can pass messages between neurons.
● SSRIs aim to compensate for whatever is wrong with the serotonergic system in
OCD.
● Dosage and other advice vary according to which SSRI is prescribed.
○ A typical dose of Fluoxetine is 20mg, may be increased if it is not helping.
● Comes in capsules or liquid. 3-4 months of daily use to have an impact on symptoms.
● Drugs are used with CBT. Some benefit from CBT alone, others benefit more from
drugs like Fluoxetine. Other drugs are prescribed alongside SSRIs.
● Drugs reduce emotional symptoms so patients can engage more with the CBT.
Tricyclics: Has the same effect on the serotonin system as SSRIs but has more severe side
effects, only used if a patient doesn’t respond to SSRIs (e.g. Clomipramine).
SNRIs: Those who don’t respond to SSRIs, increase levels of serotonin and noradrenaline.
LIMITATION: Drugs have Side Effects
P: Significant minority will get no benefit. Some patients suffer side-effects.
E: Clomipramine - side-effects are more common and serious. 1 in 10 suffer tremors and
weight gain. 1 in 100 become aggressive and suffer disruption to blood pressure.
J: Reduce effectiveness as sufferers stop taking meds.
LIMITATION: Big Pharma - Ulterior Moves?
P: SSRIs are effective and any side-effects will be short term, but there is some controversy.
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