Biological Therapies for OCD

Summary of biological therapies for OCD, including psychosurgery and chemotherapy.

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Biological Therapies for OCD
Psychosurgery
Capsulotomy and cingulotomy
Performed for anxiety disorders, including OCD
Such operations remove the capsule (involved with emotion and anxiety)
and the cingulum (links to the obitofrontal cortex to the caudate nucleus)
Low success rate, so is a last resort
Study 45% of patients at least partly improved after cingulotomy
Jung et al found similar recovery rates
However, surgery may just reduce motivation and energy levels, giving the
impression that OCD symptoms have been treated.
Side effects can be severe (as permanent changes are made ­ severing
connections/removing whole regions) ­ such as personality changes and seizures
Real Life Application ­ Mary Lou Zimmerman
Suffered with OCD for many years which wasn't relieved by drugs or therapies
Capsulotomy and cingulotomy was performed
Unable to walk, stand, eat by herself etc
Ethics ­ case study highlights the potential dangers of such operations
Methodological Issue ­ but with all case studies, all cases are unique to the individual and any
conclusions are difficult to generalize due to the individuals exclusive characteristics
Chemotherapy
Drug therapy is currently the most common treatment for OCD
Anti-anxiety drugs used to reduced the anxiety associated with OCD.
Benzodiazepines (BZs) (e.g. Valium) slow down the central nervous system
through enhancing the activity of GABA (neurotransmitter that calms many
neurons in the brain)
Leaves the sufferer feeling more relaxed
Anti-depressants are more commonly prescribed that anti-anxiety drugs and also reduce
anxiety
SSRIs (e.g. Prozac) increase Serotonin. Low serotonin is associated with OCD which can
be problematic for the `worry circuit.' So increased levels may normalize the circuit.
Tricyclics prevent reuptake of both serotonin and noradrenalin by blocking
receptors. So serotonin levels increase, and sufferer has energy to fight obsessions
- More effective than SSRIs but are less commonly prescribed due to having more
side effects. Therefore are only used when SSRIs are not effective.
Most drugs have side effects:
SSRIs ­ nausea, headaches, insomnia etc
Tricyclics ­ hallucinations, irregular heartbeats etc
Valium ­ addictive
But they are easy to take and require little motivation

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They are effective at reducing symptoms of OCD and have been found to be more effective
than placebos ­ shows drugs actually work, not just positive thinking with the idea of getting
treatment
But may just treat symptoms, not the cause ­ when drugs are stopped, the symptoms return
after a few weeks, suggesting it is not a long term solution
Behavioural therapy may be better ­ it has been shown to reduce activity in
the caudate nucleus in a similar way to anti-depressants, i.e.…read more

Comments

MrsMacLean

A useful summary document of therapies for OCD, many thanks.

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