The Biological Treatment for Depression (Clinical Psychology) Flashcards
What is the main Biological Treatment of Depression?
Antidepressants
What are Agonists?
Agonists are drugs that mimic neurotransmitters
What are SSRIs, and how do they work?
Selective Serotonin Reuptake Inhibitors They block the reuptake of serotonin, by blocking the transporter cells e.g. Fluoxetine These are safer, and generally cause if you are negative side effects. Doctors often start by prescribing an SSRI
What are SNRIs, and how do they work?
Serotonin + Norepinephrine Reuptake Inhibitors They block the reuptake of both serotonin and norepinephrine e.g. Duloxetine For some, they may be the best choice for safety and tolerance issues
What are Tricyclic Antidepressants, and how do they work?
They block the reuptake of serotonin and noradrenaline, so they remain in the synapse for longer, and have a greater effect e.g. Imipramine These are older medications that have more severe side-effects, and more serious consequences if overdosed They aren’t normally prescribed as a first choice, but only when SSRIs are proven ineffective
What are MAOIs, and how do they work?
Monoamine Oxidase Inhibitors They stop the enzymes that break down amine neurotransmitters in the synapse, thus making them available for longer e.g. Tranylcypromine Using MAOIs requires a strict diet, because of dangerous (or deadly) interactions with foods that contain tyramine (e.g. certain cheeses, pickles and wines). They also must not be taken in combination with many common drugs/SSRIs
What are ECT, and how can it treat Depression?
Electroconvulsive Therapy Also known as electric shock therapy It is a treatment for depression, and often used as a treatment of last resort for those with severe depression who don’t respond to other medication
How do Antidepressants work?
They stop the reuptake (reabsorption) of receptors, and thus they stay in the synapse and get attached to the receptor
What are the Strengths of using Drug Therapy to treat Depression?
Research from the Royal College of Psychiatrists: They reported that 50%-65% of those treated with antidepressants showed improvement, compare to only 25%–30% of those treated with a placebo (however there is still a placebo effect) Geddes et al: Using drug treatment for depression showed a relapse rate of 18%, compared with 41% for a placebo group group - suggests treatments work Antidepressants provide relief from debilitating symptoms, which allows them to access other types of therapy (e.g. CBT) Antidepressants appear to treat the symptoms of depression
What Research evidence shows that using Drug Therapy to treat Depression is Ineffective?
- Holland longitudinal study: found that 76 per cent of depressed patients who did not take any antidepressant drugs recovered and never relapsed. 2. A Canadian study: found that people got better quicker without antidepressants. 3. NHS (2003- a major study): used meta-analysis to find that the difference between placebos and antidepressants is very small, for mild to moderate depression. 4. Kirsch (2009): conducted a meta-analysis; and found that All Groups Improved, including those who had psychotherapy, a placebo, and even no treatment. 5. Medical Research Council (1965): found that there was no difference in patient outcome between those who took imipramine (tricyclic) and those who took a placebo.
What are the Side Effects of using Drug Therapy to treat Depression?
Side effects that accompany drugs include nausea, insomnia, blurred vision, dizziness and sexual dysfunction. The older types of drug are dangerous if taken in overdose SSRIs have been linked to suicidal ideation in young people. The World Health Organisation found that non-medicated patients with depression enjoyed better heath than those who took antidepressants.
What is the problem with the cost of producing the Drug Therapy for Depression?
Drug trials are expensive and are often funded by drug companies with a vested interest in proving that a drug that has cost them millions of pounds to develop is an effective treatment.
How are Antidepressants Agonists?
Agonists are drugs that mimic neurotransmitters. They fit onto receptor sites, making the post synaptic dendrite believe the drug is a neurotransmitter. A substance that acts like another substance and therefore stimulates neural action; making the neuron fire about serotonin. They make the stimulation of one neurone by another much easier
What are the Similarities between the Treatments of Depression?
Drugs and CBT are both prescribed under NHS guidelines Both may have a time delay of a few weeks between treatments starting and symptoms alleviating. However some patients also report feeling better after only one week of both treatments Both have research that supports them Both have been criticised for not treating the root cause of the problem- drugs as they may mask symptoms, and CBT as it does not explore the past that might have influenced the onset of depression
What are the Differences between the Treatments of Depression?
Side Effects: Drugs have unpleasant side-effects and can cause death by overdose, where as CBT does not have dangerous or unpleasant consequences Type of Therapy: CBT is a talking therapy based on cognitive principles, whereas drugs are biological treatment based on the monoamine hypothesis Combining the two: Antidepressants might be necessary in order for those with severe depression to access CBT, but CBT is not needed for antidepressants to improve mood Empowerment: CBT tries to tech the patient skills to enable them to deal with their depression so empowers the patient, whereas drugs do not empower the patient but instead may cause them to feel dependent on them to feel okay
