Why do these drugs help?

It remains unclear as to why these particular drugs help OCD while similar drugs do not. Each has potent effects on a particular neurotransmitter, or chemical messenger, in the brain called serotonin. It appears that potent effects on brain serotonin are necessary (but not sufficient) to produce improvement in OCD. Serotonin is one of several neurotransmitter chemicals that nerve cells in the brain use in communicating with one another. Unlike some other neurotransmitters, its receptors are not localized in a few specific areas of the brain; hence, its uptake and release affects much of our mental life, including OCD and depression.

Neurotransmitters such as serotonin are active when they are present in the gap (referring to the synaptic cleft) between nerve cells. Transmission is ended by a process by which the chemicals are taken back up (Re-uptake) into the transmitting cell. The anti-obsessional drugs are called serotonin reuptake inhibitors or SRIs; they work by slowing the reuptake of serotonin, thus making it more available to the receiving cell and prolonging its effect on the brain. We think that this increased serotonin produces changes, over a period of a few weeks, in receptors (areas where serotonin attaches) in some of the membranes of the nerves. OCF also believe that these receptors may be abnormal in patients with OCD, and that the changes that occur in them due to these medications at least partly reverse the OCD symptoms. This is only part of how drugs work; it is very likely that other brain chemicals in addition to serotonin are involved. In fact, when activity in the brain's serotonergic system is altered, this changes the activity of other brain systems.

Experiments have been done with drugs that directly stimulate components of the serotonin system in the brain, and it was found that such so-called serotonergic agonists actually make OCD symptoms worse. However, after patients are successfully treated for OCD, these agonists do not worsen OCD symptoms, thus suggesting that there may be some changes in the brain's serotonergic system with effective drug treatment that somehow result in improvement in symptoms.

Don't worry if this does not make sense to you. Researchers do not know how the drugs work, and that is why this is all so confusing. The good news is that we do know, after decades of research, how to treat patients, even though OCF do not know exactly why our treatments work.

The information is sourced from an article written by : Michael A. Jenike, M.D.Chairman.

Back to Medication page