Lesson 13

Question 1

SSRI drugs

Answer 1

• Selective Serotonin Re-uptake Inhibitors
• Aim to prevent the re-uptake of serotonin in the synapse so it works for longer
• Patients will feel less anxious
• Prevents damage to the caudate nucleus caused by low serotonin and the orbital frontal cortex can function at normal levels.
• Increases serotonin, reduces worry circuit

Question 2

Worry Circuit

Answer 2

Caudate Nucleus detects hazards and generates worry signals. If the caudate nucleus is damaged it cannot filter out minor worries from the major ones.

The Thalamus will transfer both minor and major worry signals to the Orbital Frontal Cortex and the circuit becomes overactive

The Orbital Frontal Cortex will receive these messages and the individual will overreact to minor worries, like in OCD sufferers.

Question 3

SNRI drugs

Answer 3

• A drug used for OCD sufferers who cannot tolerate SSRI’s
• Inhibits the re-uptake of serotonin and noradrenaline/norepinephrine.
• Noradrenaline/norepinephrine are involved in the fight or flight response, and are activated in response to stress.

Question 4

Weaknesses of SSRI drugs

Answer 4

• Koran (2007)
• SSRI’s may not work on some OCD sufferers and they have to take other medications
• SSRI’s come with very bag side effects like indigestion and loss of sex drive
• 30% of patients do not experience a decline in OCD symptoms after taking the drug, and they tend to opt for a combination of medication and psychological treatments. Maybe SSRI’s are more effective with other treatments?

Question 5

Koran (2007)

Answer 5

• Weakness of SSRI drugs
• Criticises the use of medication as it requires little effort and only provides a short term solution.
• Patients may relapse within a few weeks
• Does not provide a lasting cure

Question 6

Strengths of SSRI drugs

Answer 6

• Soomro (2009)
• 70% of patients experience a decline in OCD symptoms after taking SSRI’s
• Relatively cheap compared to psychological therapies

Question 7

Soomro (2009)

Answer 7

• Strength of SSRI’s
• Meta-analysis of 17 studies into studies of SSRI drugs compared to placebos. All 17 showed that SSRI’s were more effective than placebos.

Question 8

Benzodiazepines

Answer 8

• BZ drugs reduce anxiety
• Includes Valium and Xanax
• Reduces heart rate and blood pressure
• Increases Gamma-Amino Butyric Acid (GABA) which is a neurotransmitter that slows down the transferring of neurons and the person becomes calmer.
• BZ’s bind to where GABA binds to on the receiving synapse. This increases the flow of chloride ions into the neuron. Chloride ions reduce the excitability of the neurons. The person will feel more relaxed
• However, it also decreases serotonin. They are less happy and likely to get depressed.

Question 9

Strengths of Benzodiazepines

Answer 9

• Quite common and used by millions. Very effective
• Work very quickly, immediate relief
• Hardly any serious side effects compared to other drugs in the short term.

Question 10

Weaknesses of Benzodiazepines

Answer 10

• Ashton (1997)
• Stewart (2005)
• If BZ drugs are used long term they may result in unwanted side effects like drowsiness and depression. Not a good long term treatment

Question 11

Ashton (1997)

Answer 11

• Weakness of BZ drugs
• Ashton found that those who take BZ drugs in the long term become dependent and withdrawal can lead to returns in symptoms.
• Patients may also have drug escalation where their dose of BZ drugs increase in order to reduce their symptoms if they take it for long periods.

Question 12

Stewart (2005)

Answer 12

• Weakness of BZ drugs
• Meta analysis
• Criticised BZ drugs as they can impair processing and speed of verbal learning. They are temporary however.
• Cognitive ability reduces with BZ drugs, and once patients stop taking the drugs, cognitive ability seems to increase, but to a level below where they should be if they had never taken the drug in the first place.