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Name TCAs MAOIs SSRIs Lithium
Used to treat Unipolar Unipolar Unipolar Bipolar
How it works Stops noradrenaline Stops monoamine Stops the re-uptake of How it works is
and serotonin being oxidase from serotonin at neurones unknown
taken up by neurones breaking down
noradrenaline and
Problems/side effects Toxic ­ can cause dry Toxic ­ can react Rarely have side Can cause tremors,
mouth, weight gain, with certain foods to effects, but effects are blurred vision ad
constipation, blurred increase blood more severe i.e. confusion
vision and erectile pressure and cause insomnia, nausea,
dysfunction heart failure diarrhoea
How effective Delayed effect ­ 75% Less effective in Less effective than 80% of patients
of patients experience general than TCAs, other anti- experience complete
relieved symptoms in but work better for depressants, but are or partial recovery,
2-3 weeks (Cole et certain individuals easier to administer and it can reduce the
al), but not all and cause less side rick of relapse
respond effects…read more

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- The way in which anti-depressants work isn't fully understood
- Anti-depressants take a few weeks to kick in
- Medication treats the symptoms of depression, not the cause
- The effectiveness of antidepressants doesn't mean that there was a neurochemical cause
- Some individuals don't respond to anti-depressants alone, therefore neurochemicals can't be the
sole cause of depression…read more

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- After placing electrodes on the patients temple, a small electrical current is delivered across the
brain whilst the patient is under anaesthetic and a muscle relaxant to reduce risks
- The aim is to produce a seizure lasting up to a minute after which brain activity returns to normal
- Although ECT is much safer than it was, there are still a few side effects, including headaches,
stiffness, confusion and temporary memory loss
- In a few cases, the memory loss can be permanent and the spasms that occur during in the
seizure can cause fractured vertebrae and tooth damage…read more

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Beck's cognitive behavioural therapy (CBT)
- 20 sessions over 16 weeks ­ focuses dysfunctional thinking patterns
Phase one Education phase Teach patient origin of
depression and how
thoughts become
emotions which become
Phase two Behavioural activation Improving mood and
energy levels
Phase three Cognitive factors Identify, challenge and
change negative
automatic thoughts
Phase four Hypothesis testing Homework tasks
between sessions…read more

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Elkin et al (85)
- 250 depressed patients randomly assigned to one of three groups for 16 weeks including
CBT, drugs and the placebo group
- Initially, the most severely depressed fared best of medication (CBT=36%, which was higher
the placebo group).
- 18 months later, CBT group maintained their improvement about the medication and placebo
- However medication may have to be used alongside CBT for the most effective treatment…read more

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