Therapies for depression - Drug therapy

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  • Created by: Amy
  • Created on: 12-06-13 19:06

Drug Therapy

Drug therapy (also known as chemotherapy) is the most widely used treatment for depression.  Effective drugs were rapidly developed in the 1960s with 3 main groups of antidepressants proving successful:

• Monoamine-oxidase inhibitors (MAOIs)

• Tricyclic antidepressants

• Selective serotonin reuptake inhibitors (SSRI’s)

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Monoamine-oxidase inhibitors (MAOIs)

MONOAMINE-OXIDASE INHIBITORS (MAOIs) work by blocking the enzyme that deactivates noradrenaline and serotonin.

Effectiveness:

  • Elevated patients’ mood, without incidentally affecting the disease
  • Less effective than tricyclic to treat depression – 50% success rate
  • More recent reversible selective MAOIs developed to avoid these problems

Appropriateness:

  • Side effects -> raised blood pressure, cerebral haemorrhage (cause by eating yogurt, cheese, etc)
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TRICYCLIC ANTIDEPRESSANTS

TRICYCLIC ANTIDEPRESSANTS work by blocking the re-uptake of noradrenaline and serotonin by the neurons that released them

Effectiveness

  • Effective for mild and severe depression, 1st choice of treatment,60-65% who take tricyclics experience some improvement in symptoms
  • However many side effects on the cardiovascular system
  • Gradually replaced by modified tricyclics which cause fewer side effects 

Appropriateness:

  • Lethal overdose, dangerous to suicidal people
  • effective only after 2-3 weeks, the delay makes it more difficult to get them to keep taking it
  • 50% of users relapse they stop taking the drug prematurely

 

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SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI’s)

SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI’s) work by blocking the reuptake of serotonin.

Effectiveness:

  • Most commonly prescribed antidepressant, 38 million take it
  • Produces less side effects than tricyclics and is almost impossible to kill yourself with them
  • Some types are banned in the UK because of  risk

Appropriateness:

  • Disturbing accounts of violence and suicide victims and families have sued the manufacturer in 200 court cases
  • 250,000 worldwide have attempted suicide and 25,000 succeeded
  • Triggers strange agitated state of mind in some 
  • Impaired sexual functions
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GENERAL DRUG THERAPY

  • Quicker than talk therapies
  • Cheaper method
  • More familiar and less stigma attached
  • Effective when compared to placebos, suggesting that it does have an effect on biology

Effectiveness:

  • Treats the symptoms, not the underlying cause
  • Not 100% effective suggests biology is not the only cause and treatment
  • People often relapse after the drugs therefore not a permanent solution
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