Biological Treatments For Depression

Question 1

Two biological treatments

Answer 1

Antidepressants (SSRIs)

Electroconvulsive therapy

Question 2

How do SSRIs work

Answer 2

SSRIs such as Prozac work by blocking the serotonin reuptake at the presynaptic nerve. This means that serotonin has longer to move across the synapse whiteout being broken down.
These are usually administered in pill and taken daily.

Question 3

Furukawa

Answer 3

Conducted a meta-analysis of 35 studies and found that SSRIs are more effective than a placebo

Question 4

Kirsch

Answer 4

Conducted a meta-analysis of new research into SSRIs and found there was little evidence that SSRIs were better than a placebo

Question 5

Publication bias

Answer 5

Pharmaceutical companies generally only want to publish studies that show their drugs work, therefore it is hard to get a true measure of efficacy on treatments.

Question 6

Turner et al

Answer 6

Conducted a study looking at all studies conducted on antidepressants. Out of 70 trials published to FDA, 37 were positive and 33 negative. Of these studies 37/37 positive results were published but only 7/33 negative trials were published.

Question 7

Appropriacy of antidepressants on severely depressed

Answer 7

Many drug trials don’t use severely depressed patients, therefore research only tells us if they are appropriate for people with mild or moderate depression.

Question 8

Barbui et al

Answer 8

Found a link between SSRIs and suicides in adolescents. SSRIs are no banned for under 18s, aside from Prozac, except for in extreme cases.

Question 9

Major problems with antidepressants

Answer 9

Side effects including nausea and blunted thinking
Drug treatments have problems with dependency
Relapse rate is often high

Question 10

ECT procedure

Answer 10

Patient is given general anaesthetic, a nerve blocking agent, oxygen and a muscle relaxant.
ECT can happen in two ways, unilateral, where one electrode is placed on the patients dominant temple and one on the forehead, and bilateral, where one electrode is placed on wither temple (this method is no longer used)
A 0.6A current is passed through for around half a second which induces a minute long seizure.
It is usually given 3x a week for between 1-5 weeks

Question 11

Gregory et al

Answer 11

Compared ECT to a sham ECT and found the real ECT was more effective in treating depressed patients

Question 12

Scott

Answer 12

Conducted a meta-analysis of 35 studies and 1144 patients comparing ECT to antidepressants and found that ECT was significantly more effective

Question 13

Appropriacy of ECT

Answer 13

Because of the severity and intrusiveness of the treatment, ECT should only be used as a last resort

Question 14

Problems with ECT

Answer 14

General anaesthetic is quite dangerous
Side effects include memory loss
Can be administered to severely depressed patients without their consent, 59% of ECT treatment is given without consent