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SEM 2 Mental Health and Distress > Biological interventions for mental distress > Flashcards

Biological interventions for mental distress Flashcards

1
Q

How might psychiatric drugs work? List 2 models

A

1) Disease-centred model
2) Drug-centred model

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2
Q

What is a disease-centred model of taking drugs/medication?

A

Correcting a defective/diseased brain, or a “chemical imbalance” in the brain

Drug treatment makes your brain more “normal” (assumption of abnormality)

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3
Q

Correcting a defective/diseased brain, or a “chemical imbalance” in the brain

Drug treatment makes your brain more “normal” (assumption of abnormality)

This is known as…?

A

A disease-centred model of taking drugs/medication

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4
Q

Correcting a defective/diseased brain, or a “chemical imbalance” in the brain

Does this follow the disease-centred or drug-centred model?

A

Disease-centred model

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5
Q

Drug treatment makes your brain more “normal” (assumption of abnormality)

Does this follow the disease-centred or drug-centred model?

A

Disease-centred model

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6
Q

Reverses the underlying abnormality/imbalance (akin to physical medicine e.g., insulin for diabetes)

A

Disease-centred model

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7
Q

Names of psychiatric drugs in the disease-centred model reinforce the notion of…… and suggest …..?

A

a. Reversing underlying abnormality/imbalance
b. Specificity (antidepressants, antipsychotics etc.)

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8
Q

What is the drug-centred model of taking medication/drugs?

A

All psychoactive drugs alter the functioning of the nervous system

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9
Q

All psychoactive drugs alter the functioning of the nervous system

This is known as…?

A

The drug-centred model of taking medication/drugs

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10
Q

According to the drug-centred model of taking medication/drugs, drugs create ……?

A

An abnormal brain state

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11
Q

According to the drug-centred model of taking medication/drugs, drugs create an abnormal brain state.

What does this mean?

A

Drugs superimpose onto the manifestations of distress

(alcohol use reduces anxiety in those who are socially anxious – i.e., alcohol deficiency is not being targeted or another chemical imbalance).

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12
Q

Drugs do not specifically and uniquely target psychiatric symptoms

Does this follow the disease-centred or drug-centred model?

A

Drug-centred model

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13
Q

Drugs create an abnormal brain state – superimposes onto manifestations of distress

Does this follow the disease-centred or drug-centred model?

A

Drug-centred model

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14
Q

Drugs normalise an abnormal brain state that is responsible for symptoms

Does this follow the disease-centred or drug-centred model?

A

Disease-centred model

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15
Q

Drugs create an abnormal brain state

Does this follow the disease-centred or drug-centred model?

A

Drug-centred model

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16
Q

Psychiatric drugs are psychoactive drugs.

Does this follow the disease-centred or drug-centred model?

A

Drug-centred model

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17
Q

Drugs as treatments of disease

Does this follow the disease-centred or drug-centred model?

A

Disease-centred model

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18
Q

Useful effects are a consequence of alterations to normal brain functioning

Does this follow the disease-centred or drug-centred model?

A

Drug-centred model

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19
Q

Therapeutic effects derived from effects on disease pathology

Does this follow the disease-centred or drug-centred model?

A

Disease-centred model

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20
Q

Examples: insulin for diabetes; salbutamol for asthma

Does this follow the disease-centred or drug-centred model?

A

Disease-centred model

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21
Q

Examples: alcohol for social anxiety

Does this follow the disease-centred or drug-centred model?

A

Drug-centred model

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22
Q

What are psychoactive drugs?

A

Chemical compounds that act on the CNS to produce changes in perception, mood, consciousness and behaviour

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23
Q

Chemical compounds that act on the CNS to produce changes in perception, mood, consciousness and behaviour

This is known as…?

A

Psychoactive drugs

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24
Q

Altered mental states vary across substances and their impact on particular ….?

A

Neurotransmitters

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25
Q

True or False?

Activation of brain systems is independent of the activity of individual neurons.

A

False

Activation of brain systems is dependent on the activity of individual neurons.

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26
Q

The activity of individual neurons is mediated by the …?

A

Amount of neurotransmitter available at the postsynaptic receptor site

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27
Q

What is the goal of drug therapies?

A

To modify the levels of neurotransmitters believed to be involved in symptoms

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28
Q

The goal of drug therapies is to modify the levels of neurotransmitters believed to be involved in symptoms

What are the 2 routes to achieve this?

A

1) Agonist drugs
2) Antagonist drugs

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29
Q

What do agonist drugs do?

A

Increases the action of a neurotransmitter by increasing its availability

Prevents re-uptake at the synapses to prevent degradation within the synaptic cleft or replacing low levels of a particular neurotransmitter with its pharmacological equivalent

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30
Q

What type of drugs increase the action of a neurotransmitter by increasing its availability?

A

Agonist drugs

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31
Q

What type of drugs prevent re-uptake at the synapses to prevent degradation within the synaptic cleft or replace low levels of a particular neurotransmitter with its pharmacological equivalent?

A

Agonist drugs

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32
Q

What do antagonist drugs do?

A

Inhibit the action of a neurotransmitter

Decreases the availability of the neurotransmitter or replaces the active transmitters with an inert chemical

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33
Q

What type of drugs inhibit the action of a neurotransmitter?

A

Antagonist drugs

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34
Q

What type of drugs decreases the availability of the neurotransmitter or replaces the active transmitters with an inert chemical?

A

Antagonist drugs

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35
Q

What are the main groups of psychiatric medication? List 6

A

1) Depressants (reduce arousal and stimulation, e.g., sedatives)

2) Stimulants (induce temporary improvements in either mental or physical functions, e.g., amphetamines, Ritalin)

3) Antidepressants

4) Antipsychotics

5) Mood stabilisers

6) Anxiolytics

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36
Q

What is the role of depressants?

A

Reduces arousal and stimulation

e.g. sedatives

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37
Q

What is the role of stimulants?

A

Induces temporary improvements in either mental or physical functions

e.g., amphetamines, Ritalin

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38
Q

How do antidepressants work as psychiatric medication?

A

They work by correcting deficiency of neurotransmitters (i.e., noradrenaline, serotonin) thought to underlie depressive symptoms.

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39
Q

Which type of drug works by correcting a deficiency of neurotransmitters (i.e., noradrenaline, serotonin) thought to underlie depressive symptoms?

A

Antidepressants

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40
Q

The use of antidepressants is recommended for…?

a. Severe to extreme depression
b. Moderate depression only
c. Mild to moderate depression
d. Moderate to severe depression

A

d. Moderate to severe depression

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41
Q

What is the main negative psychological effect of antidepressants?

A

May effectively distance someone from their current emotions/negative thoughts

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42
Q

May effectively distance someone from their current emotions/negative thoughts

This is a negative psychological effect of which type of drug?

A

Antidepressants

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43
Q

Drugs that increase serotonin activity are called…?

A

Selective serotonin reuptake inhibitors (SSRIs)

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44
Q

What are examples of Selective serotonin reuptake inhibitors (SSRIs)?

A

Fluoxetine (Prozac) and Citalopram

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45
Q

What are selective serotonin reuptake inhibitors (SSRIs)?

A

Drugs that increase serotonin activity

46
Q

True or False?

There are more side effects of SSRIs compared to older medications

A

False

There are fewer side effects of SSRIs compared to older medications

47
Q

How do SSRIs increase serotonin activity?

A

They block the reuptake of serotonin by limiting re-absorption in the presynaptic cell, therefore increasing levels of neurotransmitters in the synaptic cleft

48
Q

What type of drugs block the reuptake of serotonin by limiting re-absorption in the presynaptic cell, therefore increasing levels of neurotransmitters in the synaptic cleft?

A

SSRIs

49
Q

Antidepressants are commonly prescribed but their efficacy in mild/moderate of depression is disputed

True or False?

A

True

50
Q

SSRIs are associated with mild adverse effects

True or False?

A

False

SSRIs are associated with serious adverse effects

51
Q

SSRIs are associated with serious adverse effects such as…? List 4

A

1) Agitation
2) Nausea
3) Sickness
4) Increase in suicidality in young people under 25 years old

52
Q

1) Agitation
2) Nausea
3) Sickness
4) Increase in suicidality in young people under 25 years old

These are serious adverse effects from which type of drug?

A

SSRIs

53
Q

What are the withdrawal symptoms of SSRIs? list 7

A
  • Anxiety
  • Irritability
  • Flu-like symptoms
  • Insomnia
  • Nausea
  • Sensory disturbances
  • Hyperarousal
54
Q
  • Anxiety
  • Irritability
  • Flu-like symptoms
  • Insomnia
  • Nausea
  • Sensory disturbances
  • Hyperarousal

These are the withdrawal effects of which type of drug?

A

SSRIs

55
Q

How long can the withdrawal effects of SSRIs last?

A

Weeks or months

56
Q

…..% of SSRI users experience withdrawal effects and of these, …….% describe them as severe

A

a. 56%
b. 46%

57
Q

…..% report feeling addicted to SSRIs

A

40%

58
Q

What are drug therapies for psychosis/schizophrenia? List 3

A

1) Antipsychotics
2) Mood stabilisers
3) Anxiolytics

59
Q

What does the dopamine hypothesis of schizophrenia propose?

A

Theories have focused on abnormal dopamine functioning

60
Q

What do drug therapies for psychosis/schizophrenia aim to do?

A

To increase dopamine receptor sites (D2 receptors) on the post-synaptic terminal rather than increase the levels of the neurotransmitter

To make people “supersensitive” to normal levels of dopamine

61
Q

True or False?

Drugs for psychosis/schizophrenia increase the levels of the neurotransmitter to make people “supersensitive” to normal levels of dopamine

A

False

They increase dopamine receptor sites (D2 receptors) on the post-synaptic terminal rather than increase the levels of the neurotransmitter

To make people “supersensitive” to normal levels of dopamine

62
Q

What can antipsychotics help reduce?

A

The impact of psychotic symptoms but people continue to experience distressing symptoms despite antipsychotic medications

63
Q

What type of drug therapy is this?

It can reduce the impact of psychotic symptoms but people continue to experience distressing symptoms despite antipsychotic medications

A

Antipsychotics

64
Q

What are the 3 main side effects of antipsychotics?

A

1) Block dopamine D2 receptors, reducing dopamine signalling

2) Transient Parkinson’s-like symptoms

2) Increase appetite/weight gain

65
Q

What happens when antipsychotics block dopamine D2 receptors and reduce dopamine signalling?

A

There would be reduced activity of dopamine in the basal ganglia, which controls movement and influences thought, emotion and motivation

66
Q

What are the transient Parkinson’s-like symptoms derived from antipsychotics? List 3

A
  • Stiffness in arms and legs
  • Flat facial expressions)
  • Tardive dyskinesia (characterised by repetitive, involuntary, purposeless movements)
67
Q

What are the side effects of atypical antipsychotics such as clozapine, olanzapine, and quetiapine?

A

Less movement side effects but increase appetite/weight gain

68
Q

Mood stabilisers are prescribed to individuals with…? List 2 types of patients

A

1) Bipolar disorder
2) Intense and sustained mood swings (e.g., borderline personality disorder, schizoaffective disorder).

69
Q

What types of substances fall under mood stabilisers? List 4

A
  • Lithium
  • Carbamazepine
  • Sodium valproate (anticonvulsants)
  • Some new antipsychotics (olanzapine)
70
Q

Patient studies indicate relapse rates are higher in those who take mood stabilisers, but the mechanism of action is poorly understood

True or False?

A

False

Patient studies indicate relapse rates are higher in those who don’t take mood stabilisers, but the mechanism of action poorly understood

71
Q

All mood stabilisers have sedative effects that likely impact …?

A

Mania symptoms

72
Q

True or False?

Healthy volunteer studies show lithium improves mental abilities

A

False

Healthy volunteer studies show lithium impairs mental abilities/dulling

73
Q

What are the 4 main side effects of mood stabilisers?

A

1) Hypothyroidism
2) Impaired renal function
3) Lethargy
4) Weight gain

74
Q

What is a primary type of drug which falls under anxiolytics?

A

Benzodiazepines (e.g., diazepam)

75
Q

What are Benzodiazepines (e.g., diazepam)?

A

Drugs that enhance the action of gamma
amino butyric acid (GABA - inhibitory neurotransmitter)

76
Q

Drugs that enhance the action of gamma
amino butyric acid (GABA - inhibitory neurotransmitter)

This is known as…?

A

Benzodiazepines (e.g., diazepam)

77
Q

What do Benzodiazepines (e.g., diazepam) impact and what type of effects do they produce?

A

Impact:
- Regions of the limbic system

Effects:
- Muscle-relaxing effects
- Reduction of alertness/hypervigilance
- Sedation (i.e., they counteract physical/somatic signs of anxiety)

78
Q

What type of drugs produce these effects:

  • Muscle-relaxing effects
  • Reduction of alertness/hypervigilance
  • Sedation (i.e., they counteract physical/somatic signs of anxiety)
A

Benzodiazepines (e.g., diazepam)

79
Q

What types of drugs impact regions of the limbic system?

A

Benzodiazepines (e.g., diazepam)

80
Q

True or False?

Benzodiazepines (e.g., diazepam) have severe withdrawal effects (gradual withdrawal over extended periods of time required)

A

True

81
Q

What are the 5 main side effects of Benzodiazepines (e.g., diazepam)?

A
  • Drowsiness
  • Memory loss
  • Depression
  • Acute rage
  • Aggressive behaviour
82
Q

What are the 6 main criticisms of drug therapies?

A

1) Distressing, debilitating side effects, and decreased life expectancy

2) Many patients are over-medicated

3) Withdrawal symptoms and relapse following drug discontinuation

4) Patients are offered no alternatives other than taking drugs

5) There is little evidence for the disease-centred model

6) Drugs are a temporary fix, not a cure

83
Q

….% of people accessing mental health services are prescribed two or more medications

A

90%

84
Q

For those on antipsychotics, ….% take more than one (even though national clinical guidelines recommend only one at any one time).

A

43%

85
Q

….% of people were prescribed more than the safe maximum daily dose of antipsychotic medication.

A

36%

86
Q

True or False?

There is plenty of consistent, independent evidence that there are specific abnormalities in dopamine for people with schizophrenia or serotonin in people with depression

A

False

There is no consistent, independent evidence that there are specific abnormalities in dopamine for people with schizophrenia, or serotonin in people with depression

87
Q

True or False?

There is no consistent evidence that specific drugs work better for specific disorders

A

False

88
Q

Even though drugs are a temporary fix and not a cure, they may act as a barrier to addressing other factors that may be involved in …?

A

The maintenance of mental health difficulties (interpersonal difficulties, trauma, other psychosocial factors)

89
Q

What is Electroconvulsive therapy (ECT)?

A

Invasive medical interventions (such “psychosurgery”/prefrontal lobotomy developed by Egas Moniz)

90
Q

Invasive medical interventions (such “psychosurgery”/prefrontal lobotomy developed by Egas Moniz)

This is known as…?

A

Electroconvulsive therapy (ECT)

91
Q

Who developed Electroconvulsive therapy (ECT)?

A

2 psychiatrists:
Ugo Cerletti and Lucio Bini in the 1930s

92
Q

How did Ugo Cerletti and Lucio Bini develop Electroconvulsive therapy (ECT)?

A

After witnessing how pigs were stunned with electroshocks in abattoirs, often causing seizure

93
Q

What did Ugo Cerletti and Lucio Bini assume about seizures and what they can help with?

A

That having seizures could prevent/cure schizophrenia since many believed that those diagnosed with epilepsy were immune to the disorder

94
Q

What happens in Electroconvulsive therapy (ECT)?

A

Brief discharge of an electric current through the brain with the aim of inducing a controlled epileptic convulsion

Used while the patient was fully conscious, now used with general anaesthesia with muscle relaxants to prevent injury (i.e., bone fractures)

95
Q

How long are Electroconvulsive therapies (ECT)?

A

2 x week for 3-6 weeks (over 6-12 sessions in total)

96
Q

Are Electroconvulsive therapies (ECT) conducted when patients are conscious or unconscious?

A

Conscious

97
Q

In Electroconvulsive therapy (ECT), an electric current goes through the brain in order to…?

A

Induce a controlled epileptic convulsion

98
Q

How many people in the UK undergo Electroconvulsive therapy (ECT)?

A

Approximately 2,500 people

99
Q

Most recipients of Electroconvulsive therapy (ECT) are…?

a. Male over 60 years old
b. Female over 60 years old

A

Female over 60 years old (67%)

100
Q

NICE (National Institute for Health and Care Excellence) recommends Electroconvulsive therapy (ECT) to be used in …? List 3 types of disorders

A
  • Treatment-resistant depression
  • Mania
  • Catatonia

Any disorder where there is a high risk of suicide

101
Q

Is Electroconvulsive therapy (ECT) effective?

A

ECT is effective in certain groups but a number of uncertainties remain

e.g., long-term outcomes

102
Q

True or False?

Evidence suggests that ECT prevents suicide deaths

A

False

No evidence suggests that ECT prevents suicide deaths

103
Q

True or False?

Less than 1/3 of ECT given without consent

A

False

More than 1/3 of ECT given without consent

104
Q

What are the adverse effects of ECT? List 2

A
  • Permanent memory loss
  • Major adverse cardiac events
105
Q

Why does ECT remain controversial? List 3 points

A

1) More than 1/3 of ECT given without consent

2) Adverse effects, e.g., permanent memory loss, major adverse cardiac events

3) Mechanism unknown (assumed to be serotonin sensitivity in post-synaptic neurons)

106
Q

True or False?

Psychiatric medications are the least common intervention for mental health difficulties

A

False

Psychiatric medications are the most common intervention for mental health difficulties

107
Q

Do psychiatric medications work in a…?

a. Drug-centred way
b. Disease-centred way

A

a. Drug-centred way

108
Q

True or False?

Some people can experience substantial side effects from psychiatric drugs

A

True

109
Q

True or False?

It is clear that drugs do help everyone, all the time

A

False

It is clear that they do help some people, some of the time, but their widespread use is criticised on multiple grounds

110
Q

True or False?

ECT continues to be controversial

A

True

SEM 2 Mental Health and Distress (10 decks)

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