WK 8 MH Flashcards

BIOMEDICAL TREATMENTS FOR MENTAL DISTRESS

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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.

A

relapse

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.

A

90%

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
Q

Only __% offered psychological therapies that have
been proved to be effective to improve severe mental health difficulties (mostly for schiz tho)

A

10

26
Q

There is little evidence for the disease-centred model:

e.g.

A

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
Q

Electroconvulsive therapy

origins

A

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
Q

ELECTROCONVULSIVE THERAPY (ECT)

A

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
Q

ELECTROCONVULSIVE THERAPY (ECT)

how many ppl in Uk

A

2500

30
Q

NICE (National Institute for Health and Care Excellence)
recommends its [ETC] use in

A

treatment-resistant depression, mania or catatonia, where there is a high risk of suicide

31
Q

adverse effects of ECT

A

permanent memory loss, major adverse cardiac events

32
Q
A