Biological Therapies for Depression

Question 1

What is the description for drug therapy?

Answer 1

One of the most common treatments for depression is anti-depressant drugs, which work by increasing the amoun of serotonin in the brain.
There are 2 main types of anti-depressants

Question 2

What are MAOIs

Answer 2

o Mono amine oxidase inhibitor
o They work by blocking the enzymes that break down the neurotransmitter serotonin. This allows more serotonin to attach to the receptors as they are not being broken down.

Question 3

What are SSRIs

Answer 3

o Selective serotonin reuptake inhibitor
o These work by blocking the reuptake pump in the synapse. This allows more serotonin to attach to the receptors as it is not being taken away by the pump.

Question 4

Drug AO2 (side effects)

Answer 4

I Drug therapy may not be an appropriate treatment for all patients as MAOIs can have serious side effects
E When taking MAOIs eating certain foods and medications can cause cerebral hemorrhage (a type of stroke caused by a burst artery in the brain). So patients have to stick to a strict diet regime and avoid certain foods (e.. cheese, alcohol, Coffee, tea, cola and chocolate) and other medication (e.g. medication for high blood pressure, asthma, colds).
C This means that drug therapy is not appropriate for all people as it can affect people’s lives in a negative way, for example some people will not be able to take for other illnesses like asthma, which could endanger their lives.

Question 5

Drug AO2 (suicide)

Answer 5

I Drug therapy might not be an appropriate therapy for all patients as it can increase the risk of suicide in patients.
E The use of SSRIs may actually increase suicidal thoughts in vulnerable patients. It has been found that taking SSRIs increased the risk of suicide amongst adolescents, however, in adults the risk of suicide decreased. In particular those aged 65+ it was found that SSRIs had a protective effect against suicide attempts.
C This questions the appropriateness of drug therapy as this shows that it is not appropriate for all people, for example young people in the case of SSRIs

Question 6

Drug AO2 (Kirsch/Placebos)

Answer 6

I It has been suggested that SSRIs are effective in treating severe depression, however it might not be as effective for other types of depression.
E Kirsch found that SSRIs worked well for severe depression, but for moderately depressed people, placebos worked just as well as SSRIs
C This questions the effectiveness of drug therapy as this study shows that it may not be the actual drug that helps patients, but the thought of it being able to help you. This depends on the severity of the depression.

Question 7

Drug AO2 (time)

Answer 7

I The drug therapy might not be an effective treatment for depression as patients may stop taking them before they have had an effect.
E Drug therapy does not take effect straight away; they take a while before the effects can be felt by the patient. MAOIs in particular work instantly on the level of neurotransmitter; however the patient may stop taking the drugs before they have had a chance to be effective.
C This questions the effectiveness of drug therapy as some drugs may not help patients quick enough as people do not give them the chance to work

Question 8

ECT-

• Used for?
• how many?

Answer 8

• Electro convulsive therapy is a medical treatment used with patients suffering from depression where drug treatment has not worked.
• Used for patients who are suicidal
• Approximately 22,000 people receive ECT each year

Question 9

ECT order

Answer 9

o Oxygen given to the patient
o Patients given anaesthetic and muscle relaxant
o An electore is placed on either one side of the non-dominant hemisphere (unilateral ECT) or on both hemispheres (bilateral ECT)
o An electric current is passed through the brain for 0.5 seconds
o This makes the patient have a seizure
o ECT is given 3x per week totalling 3-15 treatments

Question 10

ECT- AO2 (side effects)

Answer 10

I ECT may not be an appropriate treatment for all patients as ECT can have serious side effects.
E ECT can have side effects such as impaired memory, Cardiovascular changes and headaches. These side effects are more severe with children, adolescents, the elderly and pregnant women.
C This questions the appropriateness of ECT because for certain groups of people, it can have serious side effects. This means that ECT is not appropriate for everyone.

Question 11

ECT- AO2 (ethics)

Answer 11

I ECT might not be an appropriate therapy as it breaks a number of ethical guidelines.
E ECT involves treating patients who are not in the position to make decisions for themselves as they are severely depressed and suicidal, so will feel like there is no hope. This makes it difficult for clinicians to gain informed consent from the patient. Also, the participants are risking serious side effects, so protection on participants is broken
C This questions the appropriateness of ECT as it is unethical to force it upon people who don’t want it.

Question 12

ECT- AO2 (Sham ECT)

Answer 12

I ECT is clearly effective, as sham ECT has been proved to not work as well as real ECT
E Gregory (1985) found that sham ECT, i.e ECT that is not conducted by trained professionals is significantly less effective in treating depression than legitimate ECT.
C This supports the effectiveness of ECT as Gregory’s research shows that real ECT is much more effective than sham ECT, suggesting that ECT is not a placebo and genuinely works. It is believed that it alters neurotransmitters in the brain, aiding recovery by releasing serotonin.