WK 8 MH Flashcards

BIOMEDICAL TREATMENTS FOR MENTAL DISTRESS

1
Q

Disease centred model of psychiatric drugs

A

correcting a defective/diseased brain or a chemical imbalance

makes brain more “normal”

Drugs as treatment for disease

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2
Q

Drug-centred model to psychiatric drugs

A

psychiatric drugs are psychoactive drugs and alter functioning of nervous system

Drugs Create an abnormal brain state -

Superimposes onto manifestations of distress. e,g, alcohol used to treat social anxiety is not targeting an alcohol deficiency

Useful effects are are a consequence of alterations to normal brain functioning

Drugs do not specifically target psychiatric symptoms

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3
Q

psychoactive drugs

A

Chemical compounds act on CNS to produce changes in perception, mood, consciousness, behaviour

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4
Q

Activation of brain systems is
dependent on activity of individual
neurons.
* This activity is mediated by

A

the amount of NT available at post synaptic site

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5
Q

The goal of drug therapies is to modify

A

the levels of neurotransmitters believed to be
involved in symptoms.

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6
Q

2 routes of drug therapies / drugs

A

Agonist drugs

Antagonist drugs

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7
Q

Agonist drugs

A

Increase the action of a neurotransmitter
by increasing its availability by
preventing re-uptake at the synapses,
preventing degradation within the
synaptic cleft or replacing low levels of a
particular neurotransmitter with its
pharmacological equivalent

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8
Q

Antagonist drugs

A

Inhibit the action of a neurotransmitter
by decreasing the availability of the
neurotransmitter or replacing the active
transmitters with an inert chemical

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9
Q

Antidepressants associated with serious adverse effects e.g.

A

, agitation, nausea, sickness,
increase in suicidality in young people (< 25 years old).

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10
Q

typical withdrawal effects of antidepressants

A
  • anxiety,
  • irritability
  • insomnia,
  • hyperarousal
  • sensory disturbances,
  • flu-like symptoms,
  • nausea
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11
Q

Antidepressants

__% experience withdrawal effects, of these __% describe them as severe.

¡ 40% report feeling ______.

A

56

46

addicted

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12
Q

Dopamine hypothesis of
schizophrenia:

A

increased dopamine receptor sites (D2 receptors) on post-synaptic terminal, making people “supersensitive” to normal levels of dopamine.

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13
Q

Side effects of antipsychotics

A

block dopamine D2 receptors, reducing dopamine signalling = reduced activity of dopamine in basal ganglia, which controls movement and influences thought, emotion and motivation

Transient Parkinsons-like symptoms (e.g. stiffness in arms and legs, flat facial expressions)
also tardive dyskinesia (repetititive involuntary purposeless movements)

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14
Q

side effects of atypical antipsychotics

A

less movement side effects but increase appetite/weight gain

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15
Q

Mood stabilisers prescribed to

A

diagnoses of Bipolar dosprder , but also intense and sustained mood swings (e.g. BPD)

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16
Q

MOOD STABILISERS

Patient studies indicate ______ rates higher in those who don’t take mood stabilisers,
but mechanism of action poorly understood.

17
Q

MOOD STABILISERS

. All have ____ effects
that likely impact on mania symptoms.
¡ Healthy volunteer studies show lithium…

A

sedative

impairs mental abilities/dulling.

18
Q

Side-effects of MOOD stabilisers

A

hypothyroidism, impaired renal function, lethargy, weight gain

19
Q

drugs for anxiety

A

ANXIOLYTICS

20
Q

Benzodiazepines (e.g., diazepam) – drugs that enhance the action of

A

gamma amino butyric acid (GABA - inhibitory neurotransmitter).

21
Q

Benzodiazepines Impact regions of the ______ ______, producing muscle relaxing effects, reduction of alertness/hypervigilance, and sedation (i.e., they counteract
physical/somatic signs of anxiety).

A

limbic system

22
Q

side effects of benzodiazephines/anxiolytics

A

drowsiness
memory loss
depression
acute rage
aggressive behaviour

23
Q

Reliance on medication: report on polymedication by Royal College of Psychiatrists
(2007):
__% of people accessing mental health services are prescribed two or more
medications.

24
Q

CRITICISMS OF DRUG THERAPIES

A

Withdrawal symptoms and relapse following drug discontinuation

Patients are offered no alternatives other than taking drugs

¡ There is little evidence for the disease-centred model:

Temporary fix, not a cure

25
Only __% offered psychological therapies that have been proved to be effective to improve severe mental health difficulties (mostly for schiz tho)
10
26
There is little evidence for the disease-centred model: e.g.
no consistant evidence that people with schizophrenia have specific abnormalities in dopamine or depressed people with serotonin no consistent evidence specific drugs work better for specific problems
27
Electroconvulsive therapy origins
It was assumed that seizures could prevent/cure schizophrenia, since many believed that those diagnosed with epilepsy were immune to the disorder (we know this is incorrect now…).
28
ELECTROCONVULSIVE THERAPY (ECT)
Brief discharge of an electric current through the brain with the aim of inducing a controlled epileptic convulsion. ¡ Used while patient was fully conscious, now used with general anaesthesia with muscle relaxants to prevent injury. ¡ 2 x week for 3-6 weeks (over 6-12 sessions in total).
29
ELECTROCONVULSIVE THERAPY (ECT) how many ppl in Uk
2500
30
NICE (National Institute for Health and Care Excellence) recommends its [ETC] use in
treatment-resistant depression, mania or catatonia, where there is a high risk of suicide
31
adverse effects of ECT
permanent memory loss, major adverse cardiac events
32