APPROACHES TO TREATMENT- Biological Flashcards
What are the 4 neurophysical treatments?
ECT (Electroconclusive Therapy)
tDCS (Transcranial Direct Current Stimulation)
TMS (Transcranial Magnetic Stimulation)
DBS (Deep Brain Stimulation)
What are the 4 types of psychotropic drugs?
antidepressants
antipsychotics
anxiolytics
psychostimulants
2 types of anxiolytics
BZs & BBs
2 types of antipsychotics
partial agonists & phenothiazines
4 types of antidepressants
Ketamine
SSRIs
Tricyclics
MAOIs
Role of MAOIs
inhibit activity of enzyme monoamine oxidase & increases activity of neurons that utilise noradrenaline/serotonin
LIMITATIONS OF MAOIs
Nasty side effects- cerebral haemorrhage
dangerous interactions with other drugs
Structure of Tricyclics
3 carbon rings
Role of Tricyclics
BLOCKS reuptake of THREE neurotransmitters: serotonin, noradrenaline & dopamine
What are Tricyclics effective for?
effective in treatment of mild & severe depression
LIMITATION OF TRICYCLICS
Toxic effects on the cardiovascular system
What are SSRIs?
Selective Serotonin Reuptake Inhibitors
What are SSRIs effective for?
As effective for mild depression as tricyclics
LIMITATIONS OF SSRIs
Side effects that get looked over/denied:
39% suicidality rate
60% felt emotionally numb
What is Ketamine an alternative for?
It’s an alternative to serotonin related treatments for depression
What does Ketamine act on?
GLUTAMATE
What is GLUTAMATE?
Neurotransmitter that is key in learning, plasticity and motivation
How effective is Ketamine?
Very effective
- immediate effect
- within 2hrs
- effect lasts for up to a week
- effective for patients with long term depression
LIMITATIONS OF KETAMINE
- high risk of addiction
- psychotic side effects
- cystitis- bladder infection
- increase blood pressure rapidly
What do beta blockers do?
BLOCKS effects of adrenaline & noradrenalin
What do Beta Blockers treat?
High blood pressure- from anxiety disorders
What does BZs treat?
severe anxiety
How do BZs act?
facilitates activity of GABA, binds with BZ receptor site & relaxes muscles
LIMITATIONS OF BZs
- Highly ADDICTIVE
- withdrawal effects- tremors/muscle twitching
What do Antipsychotics do?
Reduce psychosis, control delusions
What do Phenothiazines block?
They BLOCK dopamine
How effective are phenothiazines?
Reduce feelings of anxiety within a FEW HOURS
- reduces hallucinations/delusions
LIMITATIONS OF PHENOTHIAZINES
Not effective
Strong side effects- blurred vision, Parkinsonism, low blood pressure
High relapse rate due to horrid side effects
What do partial agonists do?
raises dopamine activity in PFC & lowers activity in limbic system e.g. nucleus accumbens
What does TMS stand for?
Transcranial Magnetic Stimulation
What does tDCS stand for?
Transcranial Direct Current Stimulation
What does ECT stand for?
Electroconclusive Therapy
What does DBS stand for?
Deep Brain Stimulation
LIMITATIONS OF TMS
discomfort
seizures
headaches
Procedure of TMS
applies RAPID changing electo-magnetic fields to induce electrical currents
Aim of TMS
To either increase or decrease cortisol excitability
Low frequency = INHIBITS
High frequency of stimulation = ACTIVATES
LIMITATIONS OF DBS
Extremely INVASIVE
brain haemorrhage
risks of death
expensive & time consuming
not allows successful
Post-op headaches
What is DBS?
electrodes are implanted in specific brain region and stimulated via an electric pulse
What is placed under the skin during the procedure of DBS?
Internal Pulse Generator
STRENGTHS OF DBS
common treatment for Parkinson’s
precise localisation & also fully reversible
evidence that it can be effective for depression & OCD too
LIMITATIONS OF tDCS
not replicated easily
LOW SPATIAL RESOLUTION
causes skin irritations
What is tDCS?
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
What are the two types of neuronal excitability?
andonal stimulation
cathodal stimulation
What is andonal stimulation
an increase in neuronal excitability during tDCS
What is cathodal stimulation?
Decrease in neuronal excitability during tDCS
SHORT TERM LIMITATIONS OF ECT
epilepic fits
headaches/jaw pain
LONG TERM LIMITATIONS OF ECT
memory disruption- retrograde amnesia
brain damage
affects immune system
How does ECT work?
Modern ECT researchers don’t understand/know how to works!!
How high voltage is given to patients during ECT?
70-150 volt shocks
Procedure of ECT
1sec. shocks are given via electrodes placed on temples
This triggers a seizure
How many treatments of ECT do patients need per week?
2-3 per. week
What is Neurofeedback?
AKA ‘EEG biofeedback’
Patients modify their OWN brainwaves
& shows their brain activity in real time
Aim of neurofeedback
To increase alpha rhythm
How do brains communicate?
Electrically & chemically
STRENGTHS OF NEUROFEEDBACK
Non-invasive
Inexpensive
Evidence its effective across range of disorders- insomnia, ADHD
LIMITATIONS OF NEUROFEEDBACK
High no. of ps. seen no benefit
Trials haven’t been well controlled
Needs much more research
Example of psychostimulant
Ritalin
What ones Ritalin treat?
ADHD
What does it act as?
Noradrenaline/ dopamine inhibitors
How many times a day is ritalin administered?
2-3 per day
Is it effective in treating ADHD?
Short term effective
Reduces impulsivity & lowers activity levels
LIMITATIONS OF RITALIN
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
Fluoxetine=
- type of SSRI
- 1st choice for males under 18 in the UK
