APPROACHES TO TREATMENT- Biological Flashcards

1
Q

What are the 4 neurophysical treatments?

A

ECT (Electroconclusive Therapy)
tDCS (Transcranial Direct Current Stimulation)
TMS (Transcranial Magnetic Stimulation)
DBS (Deep Brain Stimulation)

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2
Q

What are the 4 types of psychotropic drugs?

A

antidepressants
antipsychotics
anxiolytics
psychostimulants

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3
Q

2 types of anxiolytics

A

BZs & BBs

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4
Q

2 types of antipsychotics

A

partial agonists & phenothiazines

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5
Q

4 types of antidepressants

A

Ketamine
SSRIs
Tricyclics
MAOIs

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6
Q

Role of MAOIs

A

inhibit activity of enzyme monoamine oxidase & increases activity of neurons that utilise noradrenaline/serotonin

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7
Q

LIMITATIONS OF MAOIs

A

Nasty side effects- cerebral haemorrhage
dangerous interactions with other drugs

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8
Q

Structure of Tricyclics

A

3 carbon rings

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9
Q

Role of Tricyclics

A

BLOCKS reuptake of THREE neurotransmitters: serotonin, noradrenaline & dopamine

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10
Q

What are Tricyclics effective for?

A

effective in treatment of mild & severe depression

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11
Q

LIMITATION OF TRICYCLICS

A

Toxic effects on the cardiovascular system

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12
Q

What are SSRIs?

A

Selective Serotonin Reuptake Inhibitors

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13
Q

What are SSRIs effective for?

A

As effective for mild depression as tricyclics

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14
Q

LIMITATIONS OF SSRIs

A

Side effects that get looked over/denied:
39% suicidality rate
60% felt emotionally numb

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15
Q

What is Ketamine an alternative for?

A

It’s an alternative to serotonin related treatments for depression

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16
Q

What does Ketamine act on?

A

GLUTAMATE

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17
Q

What is GLUTAMATE?

A

Neurotransmitter that is key in learning, plasticity and motivation

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18
Q

How effective is Ketamine?

A

Very effective
- immediate effect
- within 2hrs
- effect lasts for up to a week
- effective for patients with long term depression

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19
Q

LIMITATIONS OF KETAMINE

A
  • high risk of addiction
  • psychotic side effects
  • cystitis- bladder infection
  • increase blood pressure rapidly
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20
Q

What do beta blockers do?

A

BLOCKS effects of adrenaline & noradrenalin

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21
Q

What do Beta Blockers treat?

A

High blood pressure- from anxiety disorders

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22
Q

What does BZs treat?

A

severe anxiety

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23
Q

How do BZs act?

A

facilitates activity of GABA, binds with BZ receptor site & relaxes muscles

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24
Q

LIMITATIONS OF BZs

A
  • Highly ADDICTIVE
  • withdrawal effects- tremors/muscle twitching
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25
Q

What do Antipsychotics do?

A

Reduce psychosis, control delusions

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26
Q

What do Phenothiazines block?

A

They BLOCK dopamine

27
Q

How effective are phenothiazines?

A

Reduce feelings of anxiety within a FEW HOURS
- reduces hallucinations/delusions

28
Q

LIMITATIONS OF PHENOTHIAZINES

A

Not effective
Strong side effects- blurred vision, Parkinsonism, low blood pressure
High relapse rate due to horrid side effects

29
Q

What do partial agonists do?

A

raises dopamine activity in PFC & lowers activity in limbic system e.g. nucleus accumbens

30
Q

What does TMS stand for?

A

Transcranial Magnetic Stimulation

31
Q

What does tDCS stand for?

A

Transcranial Direct Current Stimulation

32
Q

What does ECT stand for?

A

Electroconclusive Therapy

33
Q

What does DBS stand for?

A

Deep Brain Stimulation

34
Q

LIMITATIONS OF TMS

A

discomfort
seizures
headaches

35
Q

Procedure of TMS

A

applies RAPID changing electo-magnetic fields to induce electrical currents

36
Q

Aim of TMS

A

To either increase or decrease cortisol excitability
Low frequency = INHIBITS
High frequency of stimulation = ACTIVATES

37
Q

LIMITATIONS OF DBS

A

Extremely INVASIVE
brain haemorrhage
risks of death
expensive & time consuming
not allows successful
Post-op headaches

38
Q

What is DBS?

A

electrodes are implanted in specific brain region and stimulated via an electric pulse

39
Q

What is placed under the skin during the procedure of DBS?

A

Internal Pulse Generator

40
Q

STRENGTHS OF DBS

A

common treatment for Parkinson’s
precise localisation & also fully reversible
evidence that it can be effective for depression & OCD too

41
Q

LIMITATIONS OF tDCS

A

not replicated easily
LOW SPATIAL RESOLUTION
causes skin irritations

42
Q

What is tDCS?

A

Non-invasive method of electrical stimulation
Using a WEAK direct current applied to the scalp through electrodes
Electrodes placed on EXACT region of the interest

43
Q

What are the two types of neuronal excitability?

A

andonal stimulation
cathodal stimulation

44
Q

What is andonal stimulation

A

an increase in neuronal excitability during tDCS

45
Q

What is cathodal stimulation?

A

Decrease in neuronal excitability during tDCS

46
Q

SHORT TERM LIMITATIONS OF ECT

A

epilepic fits
headaches/jaw pain

47
Q

LONG TERM LIMITATIONS OF ECT

A

memory disruption- retrograde amnesia
brain damage
affects immune system

48
Q

How does ECT work?

A

Modern ECT researchers don’t understand/know how to works!!

49
Q

How high voltage is given to patients during ECT?

A

70-150 volt shocks

50
Q

Procedure of ECT

A

1sec. shocks are given via electrodes placed on temples
This triggers a seizure

51
Q

How many treatments of ECT do patients need per week?

A

2-3 per. week

52
Q

What is Neurofeedback?

A

AKA ‘EEG biofeedback’
Patients modify their OWN brainwaves
& shows their brain activity in real time

53
Q

Aim of neurofeedback

A

To increase alpha rhythm

54
Q

How do brains communicate?

A

Electrically & chemically

55
Q

STRENGTHS OF NEUROFEEDBACK

A

Non-invasive
Inexpensive
Evidence its effective across range of disorders- insomnia, ADHD

56
Q

LIMITATIONS OF NEUROFEEDBACK

A

High no. of ps. seen no benefit
Trials haven’t been well controlled
Needs much more research

57
Q

Example of psychostimulant

A

Ritalin

58
Q

What ones Ritalin treat?

A

ADHD

59
Q

What does it act as?

A

Noradrenaline/ dopamine inhibitors

60
Q

How many times a day is ritalin administered?

A

2-3 per day

61
Q

Is it effective in treating ADHD?

A

Short term effective
Reduces impulsivity & lowers activity levels

62
Q

LIMITATIONS OF RITALIN

A

Loss of appetite
Highly irritated
Disturbed sleep pattern
Increase in blood pressure
Impaired socialisation = mistaken for a reduction of ADHD symptoms, but actually its own disorder which leads to social withdrawal

63
Q

Fluoxetine=

A
  • type of SSRI
  • 1st choice for males under 18 in the UK