Biological therapies
- Created by: Hannah Jeffery
- Created on: 27-04-15 10:16
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- Biological therapies for depression
- Anti-depressants
- drugs that relive the symptoms of depression
- depression thought t be caused by neurotransmitters working insufficiently
- drugs work by blocking the enzyme which breaks down the neurotransmitter
- reducing the rate of re-absorption of neurotransmitters
- eg tricyclic anti- depressants
- block the transporter mechanism which re-absorbs both serotonin and noradrenaline
- leads to more neurotransmitters being left in the synapse
- prolongs their activity
- eg SSRI's
- work similarly to tricylics but mainly on blocking serotonin
- increase the quantity of serotonin available to excite neighbouring cells
- eg Prozac
- Kirsch et al
- reviewed clinical trials of SSRI's
- only provided advantages in the most sever forms of depression
- however, they also found a placebo to be effective
- psychological explanations
- ethical issues involved with placebo as it involves deception
- participants are unaware of their treatment
- prior general concent
- however, they also found a placebo to be effective
- only provided advantages in the most sever forms of depression
- reviewed clinical trials of SSRI's
- work similarly to tricylics but mainly on blocking serotonin
- three phases to treatment
- acute phase
- treating of symptoms
- continuation phase
- four to six months of taking drugs
- drugs are gradually withdrawn
- in order to prevent relapse
- Maintenance phase
- for individuals who have a history of recurrent depressive episodes
- monitoring of the patient
- acute phase
- age bias
- elderly are often misdiagnosed because symptoms appears as due to their changes in lifestyle or natural changes
- eg lack of sleep could be due to reduction in SWS sleep
- also less likely to seek help due to the fear of the stigma attached and that they will loose their independence
- elderly are often misdiagnosed because symptoms appears as due to their changes in lifestyle or natural changes
- children and adolescents
- hammen foud that they were less useful in children and adolescents
- Geller et al
- double blind studies
- meta-review
- placebo effect in children
- could be due to the behaviour approach
- operant conditioning
- less effective due to developmental differences in brain neurochemistry
- Risk of suicide
- fears that use of SSRI's may increase risks of suicidal thoughts
- Ferguson et al
- twice as more likely to commit suicide than with other conditions or a placebo
- risk reduced for adults
- publication bias
- results that exaggerated the benefits of treatments were more likely to be published
- type of chemotherapy
- drugs that relive the symptoms of depression
- ECT
- Electro-Convulsive Therapy
- first used in 1938 to treat schizophrenia and widespread during the 1940s.
- process
- A weak current is passed across the temples for 0.5 - 4 seconds
- The patient's body goes into convulsions that are reduced by muscle relaxants and anaesthetic (a mouth gag prevents the tongue being bitten)
- believed that seizure restores the brains ability to regulate mood
- eg by enhancing the transmission of neurochemicals or improving blood flow to the brain
- Ethical issues
- 59% had not consented to treatment
- those who had consented were not in the best mind of frame to consent fully
- Ethical issues
- eg by enhancing the transmission of neurochemicals or improving blood flow to the brain
- believed that seizure restores the brains ability to regulate mood
- Oxygen is given before and after treatment to aid recovery
- usually involves 3-15 sessions
- now only used in extreme cases such as extreme cases of depression
- considered life threatening
- other therapies have failed
- case study
- 37 year old woman
- severely depressed after the separation from her husband
- attempted to commit suicide four times
- psychotherapy and anti-depressants had little effect
- 8 sessions of ECT over 3 weeks
- by the last session showed considerable improvements in her depressive symptoms
- continued with further treatment of anti-depressants
- four months later showed normal social and occupational functioning
- 37 year old woman
- effectiveness
- Folkerts
- effective when patients are resistant to other treatments
- scott
- compared 18 studies
- ECT is more effective than drug therapy in the short term
- however the studies didn't include new drugs such as SSRI's
- Folkerts
- Appropriateness
- Datto
- side effects include impaired memory, cardiovascular changes and headaches
- Rose et al
- third of patients suffered from persistent memory loss
- The department of health report 2007
- 30% of the people who received ECT in the last 2 years reported permanent fear and anxiety
- Unilateral ECT has a smaller effect on cognitive impairment
- Datto
- Anti-depressants
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