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Obsessive Compulsive Disorder (OCD) Libyan International Medical University Faculty of Pharmacy Obsessive Compulsive Disorder (OCD): “A battle with unwanted thoughts” Submitted by: Safaa Omar Abbas Heba Farag Zainoba Under the supervision of Dr . Narges Kablan Supervisor's Approval: --------------------------------Date: ---------------------------- A thesis submitted to Libyan International Medical University in partial fulfillment of the require ments for the Bachelor of Pharmacy degree. Declaration This is to certify the research work embodied in this thesis entitled (Obsessive compulsive disorder) has been written by both of us and under the supervision of Dr. Narges kablan Safaa Omar Abbas Heba Farag Zainoba 2 Abstract Obsessive compulsive disorder (OCD), one of the anxiety disorders, is a potentially disabling condition that can persist throughout a person's life. The individual who suffers from OCD becomes trapped in a pattern of repetitive thoughts and fears (obsessions) and behaviors (compulsions) that are senseless and distressing but extremely difficult to overcome. OCD occurs in a spectrum from mild to severe, but if severe and left untreated, can destroy a person's capacity to function at work, at school or even in the home. The causes of the OCD are still unknown, but there are factors that may increase the risk of developing or triggering the disorder which include:(Neurobiological, behavioral, cognitive, environmental, infection or genetic factors) The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or medication. More specifically, the most effective treatments are a type of CBT called Exposure and Response Prevention (ERP), and/or a class of medications called serotonin reuptake inhibitors (SSRIs). In severe cases of OCD and in individuals who do not respond to medical and behavioral therapy, more drastic options might be useful such as brain surgeries. OCD is a chronic disease that requires long-term treatment with frequent follow up and a regular behavioral therapy. OCD needs more attention and awareness especially in the Arab world, an aim that is intended to be reached in this study by spotting the light on the concept, signs and symptoms and the treatment of this disease. 3 Table of contents Abstract ..........................................................................................................................................3 seLo t o tsiL ..................................................................................................................................6 seLo t e tsiL .................................................................................................................................6 ttsiae oetbL seLo t ......................................................................................................................7 I eois C ...........................................................................................................................................9 Cbostutooetb .......................................................................................................................................9 Cbostutooetb ................................................................................................................................. 10 Di ebeoetb t fID..................................................................................................................... 11 DeLots t fID ........................................................................................................................ 11 Deeuioetst t fID ................................................................................................................. 12 L oeotoL t fID de bL bu ..................................................................................................... 13 ftLiLLetbL .............................................................................................................................. 13 ItoetsLetb .............................................................................................................................. 14 d oeotoL ue isiboi eb o esusibc utsiLoiboL bu utsoL ......................................................... 15 :DLLtoe oiu otbueoetbL sis oiu ot fID....................................................................................... 15 Itoeseo oetbL t fID ................................................................................................................ 17 : fID bu ise iseb a ootsLI tLiL t .................................................................................... 17 :sitsttetst eo s ootsL .............................................................................................................. 18 :distotbeb tbtso seoeiL.......................................................................................................... 19 :si aets s bu ot beoeai ootsL ............................................................................................ 22 :Dbaestboibo s ootsL............................................................................................................. 22 :Cb iooetb ootsL ...................................................................................................................... 23 :sibioeo ootsL ....................................................................................................................... 23 De btLeL t fID ....................................................................................................................... 24 :sibis s oseoise sintesiu ts ue btLeL t fID ebostui ...................................................... 24 :i i ttLiLLetbL otLo oiio o iLi oseoise .............................................................................. 24 :ItoetsLetbL otLo oiio o iLi oseoise ................................................................................... 24 De btLoeo o ssib iL ............................................................................................................. 25 D b ioibo t fID .................................................................................................................. 25 oDRetLtsi bu xiLetbLi Esiaiboetb oDxE ........................................................................... 25 Diueo oetbL tLiu ts fID ...................................................................................................... 26 4 ib eeo fIDEsi b bo eto..................................................................................................... 28 deui i ioo ................................................................................................................................ 28 iseo oseo boeuiesiLL bo bu Do eeo s boeeL o toeoL ................................................................. 28 Diueo oetb ts Eiue oseo fID ..................................................................................................... 30 Dtsi CboibLeai feoetbL ts fID e oeiboL bto siLetbueb ot os ueoetb s o is e .................... 31 Duueoetb s isi ooibo feoetbL ts fID ................................................................................... 32 ss eb dts is ts fID ............................................................................................................ 32 oDboisets oeb tstoto o ts eb Lts is ...................................................................................... 32 oDboisets o eLtstoto ots eb Lts is ...................................................................................... 33 s oo fbe i isi ooibo ts fID .......................................................................................... 33 oDiie ss eb doeots oetb oDsd................................................................................................. 34 :a ottL eitesi eeo fID.......................................................................................................... 35 I eois CC ........................................................................................................................................ 37 ItbostLetb bu xiotooibu oetbL ............................................................................................... 37 ItbostLetb .................................................................................................................................. 38 xiotooibu oetb ........................................................................................................................ 38 xi isiboi.................................................................................................................................... 39 5 List of tables Table 1: Displays the suggested starting doses, known effective doses, maximum recommended doses, and maximum doses occasionally prescribed for each SRI……………………………………………………………………………………….26 Table 2: Displays the suggested effective dose for children………………………..30 List of figures Figure.1 Areas of the brain implicated in the pathophysiology of OCD…………………………19 Figure.2 Serotonin mode of action in the brain…………………………………………………..20 Figure.3 Positron emission tomography scan showing a lower level of serotonin in OCD suffer than normal one ………………………………………………………………………………………...............20 Figure.4 Mechanism of action of SSRI…………………………………………………………..27 Figure.5 Mechanism of action of tricycle antidepressants……………………………………….29 Figure .6 Mechanism of action of atypical antipsychotic include rapid dissociation of D2 receptor……….…29 Figure.7 fluoxetine mechanism of action…………… ………………………………………...31 Figure.8 Anterior Cingulate Cortex (highlighted in gold………………………………………...33
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