biological treatment of unipolar depression

Question 1

explain how monoamine oxidase inhibitors (MAOIs) treat depression

Answer 1

• the oldest type of antidepressant drug
• effects were discovered by accident when researchers noticed that the anti-tuberculosis drug isoniazid had the side effect of improving the mood of people with tuberculosis and causing euphoria
• a monoamine oxidase enzyme breaks down serotonin and noradrenaline, so it inhibits this action to stop the destruction of serotonin and noradrenaline
• leads to an increase in noradrenaline, serotonin and dopamine activity reducing the symptoms of depression
• monoamine oxidase inhibitors cannot be combined with certain food like chocolate or cheese as it leads to life-threatening complications

Question 2

explain how selective serotonin reuptake inhibitors (SSRIs) treat depression

Answer 2

• SSRIs increase the level of serotonin by inhibiting its reuptake into the pre-synaptic cell
• increases the level of serotonin available to bind to the post-synaptic receptor
• it may take up to 4 weeks before the full benefits of the drug are felt
• there are few side effects like nausea, headaches

Question 3

describe the withdrawal of antidepressants

Answer 3

• treatments with antidepressants have to be withdrawn gradually to avoid withdrawal symptoms including dizziness, insomnia or stomach upsets
• the withdrawal symptoms arise from the changes in neurotransmitter functioning that occurs when the drug is no longer taken

Question 4

what are the advantages of the biological treatment of depression?

Answer 4

• in 2005 the world health organisation published a report on the most effective way of diagnosing and treating depression
• which stated drugs are “well documented” treatments and have a “large number of studies” to show their effectiveness
• evidence for the world health organisation report came from a meta-analysis by Barbui which showed SSRIs to be very successful
• evidence from Geddes, cited in the world health organisation report carried out a review and found that using drug treatment for depression showed a relapse rate of 18% compared to 41% for a placebo group

Question 5

what are the disadvantages of the biological treatment of depression

Answer 5

• Muller cites a study done in the Netherlands where 222 patients had their symptoms examined over 10 years
• it was found that 76% of those who did not receive medication recovered and did not relapse compared to 50% who recovered without relapse having medication
• Caporino and Karver carried out a study to see what treatments for depression were acceptable to adolescent girls, they asked girls to rate 4 individual treatments and 3 treatment combinations
• they found that psychotherapy was more acceptable to the girls, this shows that even though drug treatment is effective it may not be acceptable

Question 6

what are the applications of the biological treatment of depression?

Answer 6

• there are side effects linked to drugs, but knowing them helps manage them
• most side effects are common and mild like nausea, but some are rare and severe like potentially lethal serotonin syndrome
• furthermore, monoamine oxidase inhibitors readily interact with other drugs and with chemicals in food
• these issues can be controlled with careful monitoring of the individual’s diet and additional medication
• this is a strength because managing these effects increases the credibility and acceptability of the treatment, so people are more likely to continue with it