Biological Approach: Treating Ocd


– Drug therapy for disorders aims to increase or decrease levels of neurotransmitters in the brain or to increase/decreases their activity.


– The standard medical treatment used to tackle the symptoms of OCD involves a particular type of antidepressant drug called a selective serotonin reuptake inhibitor.

– SSRIs work on the serotonin system in the brain.

– Serotonin 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 where it is broken down and re-used.

– By preventing the re-absorption and breakdown of serotonin SSRIs effectively increase its levels in the synapse and thus continue to stimulate the postsynaptic neuron.

– This compensates for whatever is wrong with the serotonin system in OCD.

– Dosage and other advice vary according to which SSRI is prescribed.

– A typical daily dose of Fluoxetine is 20mg although they may be increases if it is not benefiting the patient. – The drug is available as capsules or liquid.

– It takes three to four months of daily use of SSRIs to have much impact on symptoms.


– Drugs are also used alongside CBT to treat OCD.

– The drugs reduce a patient’s emotional symptoms, such as feeling anxious or depressed.

– This means that patients can engage more effectively with the CBT.


– Where an SSRI is not effective after three to four months the dose can be increased or it can be combined with other drugs.

– Alternatives work well for some people and not at all for others.


– Are sometimes used, such as Clomipramine.

– These have the same effect on the serotonin as SSRIs but more severe side-effects and so are kept in reserve for patients do not respond to SSRIs.


– These are serotonin-noradrenaline reuptake inhibitors.

– These are a second line of defence for patients who don’t respond to SSRIs and they increase the levels of serotonin as well as another different neurotransmitter – noradrenaline.



Low Cost

– An advantage of drug treatments in general is that they are cheap compared to psychological treatments. – Using drugs to treat OCD is therefore good value for a public health system like the NHS.

– As compared to psychological therapies SSRIs are also non-disruptive to patients’ lives.

– Drugs can have side-effects. For example, some patients suffer from indigestion, blurred vision and loss of sex drive.

– These side effects are usually temporary.

– Such factors reduce effectiveness because people stop taking the medication.


– There is evidence towards the effectiveness of drug therapies

– A randomised control trial is used to compare the effectiveness of the drug versus a placebo

– Soomro et al reviewed 17 studies of the use of SSRIs with OCD patients and found them to be more effective than placebos in reducing the symptoms of OCD

– However, there is a lack of long term data


Other Factors

– OCD is widely believed to be biological origin.

– It makes sense, therefore, that the standard treatment should be biological.

– However, it is acknowledged that OCD can have a range of other causes, and that in some cases it is a response to a traumatic life event.

– This may mean that drugs are not the appropriate form of treatment for this type of OCD.

Side Effects

– Neusa, headaches and insomnia are common side effects of SSRIs

– Although not always server, they are often enough to mean the patient stops taking the drug

– Tricyclic antidepressants tend to have more side effects than SSRIs and are only used when SSRIs are not effective

– The possible side effects of BZs include increased aggressiveness and long term impairment of memory

– There are also problems with addiction, so the recommendation is that BZ use should be limited to a maximum of 4 weeks

– These side effects, and the possibility of addiction, therefore limit the usefulness of drugs as treatments