Psychopharmacology of depression Flashcards
Why is psychopharmacology relevant for psychology students?
- many clients are on medication
- important to understand how drugs can influence psychotherapy responses as well as how psychotherapy can influence drug response (bi-directionality)
What are some of the statistics related to medication taking in depression patients?
43% of clients are on psychotropic medications (affect brain, used for psychiatric problems)
87% of practicing psychologists are involved in decision making of prescribing a drug for at least one of their clients on their caseloads
7% respondants have participated in decision making of taking the drug
What is one example of an SSRI?
Prozac
What is an SNRI? one example?
Serotonin norepinephrine reuptake inhibitor- Effexor
Acts similar to ssri, but If the dose is a bit higher, it actually works on the noradrenergic system
Not typically approved for children (only prozac is really approved, some others but not these)
Describe tricyclic medications?
Acts only on noradrenergic system
Old class of medications
Usually prescribed when other medications (ssri/snri) do not work
They have much more side effects compared to newer medications (ssri)
Describe MAOs?
They are also considered older generation of ant depressants
Much more side effect, which is why they are less prescribed
What is another alternative treatment for treatment-resistant depression?
Low dose of anti-psychotics could be given for those suffering depression- done usually in combination with an ssri (at a very small dose) helps remove the edge of irritability, also seen more in children now
Anti-convulsant are often used as well, especially for people with severe bi-polar disorder (lol, god help me) but they have a lot of side effects but it may be a trade off for some
When did SSRI’s come into the market?
SSRI came into the market in the 90’s and we see an increase of use it is the most widely prescribed anti-depressant
What’s the problem with treating depression with SSRI’s in children?
Bad reputation on ssri and kids evidence that it can increase suicide in children: SO THEY PUT A “BLACKBOX” WARNING: could lead to increased risk of suicide
some studies also show that it does not increase suicide in children, but the systematic reviews of published RCT data, indicated that newer AD by children DOES increase the risk of suicide so mixed evidence creating complex decision making
- as development of the serotonergic system is occurring, things are leveling out so some think it is not a good idea… however, if child is extremely depressed and it interferes with their normal development of life, perhaps then it may be a good option. Again, very complex decision to make.
What are some common causes of side effects?
- excessive doses
- pre-existing medical conditions
- polypharmacy
- drug x food interactions
- poor compliance
What is an adverse effect?
An uncommon and rare extreme effect of taking a medication (ex. severe allergic reaction)
- hinders efficacy
What is a side effect?
A common effect that goes hand in hand with the main effect (ex. dry mouth)
What’s the difference between an adverse effect and a side effect?
An adverse effect hinders the efficacy of a drug while a side effect does not
Why is compliance important?
Because it is relevant to pharmacokinetics/dynamics and can avoid adverse/side effects
When does compliance decrease, and with whom does it decrease more?
- after three months
- women and low SES have less compliance
