Biological therapies: Drugs and ECT

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  • Created on: 28-04-14 19:04
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Biological treatments
Antipsychotic drugs:
Conventional antipsychotics e.g. chlorpromazine used to combat against +e signs of schizophrenia.
Drugs will block dopamine neurotransmitter in brain by binding to receptors (not stimulating).
An atypical antipsychotic drug e.g. clozapine will temporarily occupy dopamine receptor then rapidly dissociate to
allow normal dopamine transmission.
May explain why atypical antipsychotics have lower levels of side effects compared to conventional
Antidepressant drugs:
Depression is due to lack of neurotransmitters e.g. serotonin.
Normal brains: neurotransmitters constantly released from nerve endings to stimulate neighbouring neurones; to
terminate their action they're either re-absorbed into nerve ending/broken down by enzymes.
Antidepressants work either by reducing rate of reabsorption or blocking enzyme that breaks neurotransmitter
Most common = SSRI's blocks transporter mechanism that reabsorbs serotonin into presynaptic cell after it had
fired, thus leaving more serotonin in synapse so its activity is prolonged and its transmission of the next impulse is
World Health Org. in 2001 found relapse rates were 55% when schizophrenics were treated with placebo, 25%
with chlorpromazine and 2-23% with chlorpromazine + family intervention.
Requires little effort from user.
Placebo effects may be reason for its effectiveness as Kirsch et al reviewed 38 studies of antidepressants and
found that patients who received placebos coped the best.
Tackles symptoms rather than problem as they offer temporary alleviation of symptoms.
Side effects of SSRI's include sexual dysfunction and suicidal thoughts e.g. Donald Schell killed his family after 2
days of taking Paxil.
Used in severely depressed people for whom psychotherapy and medication hasn't worked.
Used when there's a risk of suicide because it has quicker results than antidepressants.
Works by either a) placing electrode above temple of non-dominant side of brain and second in centre of
forehead OR b) place botch electrodes above each temple.
Patient injected with barbiturate (makes them unconscious whilst before shock given) and nerve-blocking agent
(muscles are paralysed to prevent them from contracting and causing fractures) and oxygen given to
compensate for their inability to breathe.
Small amount of electric current is passed through brain; short (0.5 seconds); produces 1-minute seizure, which
affects the entire brain.
ECT given 3x times a week; patient requires 3-15 sessions.
Abrams concluded that we couldn't understand why ECT works; some suggest it's because ECT alters the way
neurotransmitters are acting in brain so helps bring recovery.
Can save lives.
Comer states that 60-70% ECT patients improve after treatment.
Some patients who received sham treatment recovered too, suggesting that attention received plays an
important role in recovery,
Possible side effects include impaired memory and headaches according to Datto. The DOH report fund that 30%
of those receiving ECT within the last two years had permanent anxiety and fear.


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