key question

Question 1

clinical key question

Answer 1

Should we be prescribing medication for depression?

Question 2

depression nhs cost

Answer 2

Depression medication costs the NHS around £780,000 per day, so it is vital to know if it
is an effective treatment method. (another calculation was 70.9million items are
prescribed yearly)…£672.5 million

Question 3

% of over 16s with depression symptoms

Answer 3

19.7% of people in the UK aged 16 and over have shown symptoms of anxiety or
depression.

Question 4

method of prescribing

Answer 4

Psychoactive drugs for treating mental disorders are available on prescription and
patients will be monitored by their GP to ensure they are responding to the drugs.
* Psychiatrists/GP’s will adjust the quantity of a drug so it is tailored to the level needed for
that patient. It is reviewed after the first two weeks of treatment, and then regularly
afterwards for the length of time the patient takes the drug.

Question 5

comparing drug treatment and cbt for depression

Answer 5

If Depression does have a biological cause e.g., monoamine imbalance, it would make
sense that you can treat it with a medical intervention.
* The use of medication for mental disorders can keep people in work so that the
government receives taxes and does not have to pay out some benefits.
* An alternative argument we might want to think about is CBT. If the
depression/imbalance is caused by life events or negative thinking as some evidence
suggests it needs to deal with these issues.
* Drugs have side-effects, which can cause attrition/non-adherence, whereas CBT doesn’t.
* Drug treatment might not be long lasting, whereas CBT is.
* Drug treatment might be socially controlling/depowering, whereas CBT is not.

Question 6

key question AO2 SSRIs

Answer 6

SSRIs stop the reuptake of serotonin to the presynaptic bulb which means there will be
more in the synapse. This will improve symptoms such as anxiety.

Question 7

key question Ao2 SNRIs

Answer 7

SNRI’s work in a similar way to SSRI’s except they stop the reuptake of both serotonin
and noradrenaline, improving symptoms such as concentration and low mood.

Question 8

key question AO2 MAOIs

Answer 8

MAOIs stops MAO from doing its job which means it doesn’t break down the
monoamines and their number increases. This improves symptoms such as energy and
pleasure.

Question 9

key question AO2 faulty thinking depression

Answer 9

Depression is caused by faulty thinking so CBT is a method that can be used to change the
maladaptive thoughts to more adaptive ones thus treating the depression. For example,
CBHT can teach you to de-catastrophise thoughts/not let them run away.

Question 10

key question AO2 serotonin

Answer 10

Low levels of serotonin (or low number of receptors/levels of receptor sensitivity) have
been linked to symptoms of depression like low mood/high anxiety, since serotonin is a
calming hormone.
* Serotonin also influences other monoamines like Dopamine (Reward) and Noradrenaline
(alertness/energy/concentration). We kniow that low serotonin lowers the others.
* High levels of the enzyme monoamine oxidase is also linked to Depression. This enzyme
breaks down monoamines meaning you have less of them.
* Drug treatments use psychoactive drugs that change the balance of neurotransmitters in
the brain e.g. anti-depressants increase the levels of Monoamines including Serotonin.