Depression: Biological Therapies

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What are the full names of the 3 types of anti-depressants?
Monoamine-oxidase inhibitors (MAOIs), Tricyclic antidepressants (TCAs), Selective seretonin reuptake inhibitors (SSRIs).
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How do MAOIs work?
they block the enzyme that deactivates noradrenaline and seretonin.
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How effective are MAOIs?
50% effective- less effective than TCAs and SSRIs.
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What are the side effects of MAOIs?
Eating amine rich foods (e.g. cheese) when on MAOIs can cause high blood pressure and cerebral haemorrhage. Lethal if overdosed. Tiredness, dry mouth, blurred vision.
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How do TCA's work?
They block the re-uptake of noradrenaline and seretonin by the neurons that released them.
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How effective are TCAs?
60-65% effective.
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What are the side effects of TCAs?
Lethal if overdosed. Good for mild depression but 50% relapse with in a year. Tiredness, dry mouth and blurred vision.
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How do SSRIs work?
they block the re-uptake of seretonin.
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How effective are SSRIs?
65% effective. Most widely prescribed anti-depressant.
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What are the side effects of SSRIs?
Few side effects except potential impaired sexual functioning and increased aggression. Virtually impossible to overdose on.
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Evaluate drug therapy in general.
+more effective than placebos. - unethical to test. not 100% effective, 3 weeks to feel change, dependency/withdrawal, doesn't change env., returns when drugs stop, side-effects like tiredness can incr low mood, od ability not good for depressives.
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What does ECT stand for?
Electro-convulsive therapy.
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Who initiated ECT and what did he find in his research?
Sakel- found that injecting insulin into a schizophrenic inducing convulsions and a coma made some of them improve.
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What is the process of ECT?
Given muscle relaxant and anaesthetic, electrodes placed on temples and electric current of 70-150v is passed through brain for 0.04-1 second. Causes 1 minute convulsion. 2-3 treatments given a week for 3-4 weeks.
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What are the two types of ECT and what is the difference?
Bilateral (current passed through both hemispheres) and unilateral (current passed through only one hemisphere).
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What is the most popular explanation on how ECT works?
Believed that ECT increases the availability of serotonin in the brain.
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In what ways is ECT effective?
Fink did a meta-analysis of a range of studies and found that ECT is effective in over 60% of severe depressives. Janicak found 80% of his patients responded well to ECT but only 64% responded to drug treatment. ECT is quick: good for suicidal ppl.
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In what ways is ECT ineffective?
Sackheim found that there was a high relapse rate within a year- it only gives temporary relief and not a permanent cure.
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What is one major criticism of ECT?
Nobody knows exactly how it works, however, there are 3 main hypotheses.
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What is the first hypothesis?
Patients see it as a punishment for their behaviour and so ECT encourages them to reduce their depressed behaviour.
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What disproves this theory?
The use of sub-convulsive shocks are equally unpleasant but don't produce same positive effects: for ect to work there must be a convulsion or fit.
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What is the second hypothesis?
Works because of the amnesia that accompanies it as a side effect.
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What disproves this theory?
Unilateral ECT doesn't cause much memory loss but is as effective as bilateral ECT: memory loss is irrelevant- it's the convulsion that's important.
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What is the third, and most likely, hypothesis?
ECT causes biochemical changes- it increases levels of noradrenaline and seretonin.
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What is the other main criticism?
The ethics: it's inappropriate to put someone through such unpleasant therapy, people used to break bones with convulsions. Seen as abuse that a patient is encouraged to go through when they're vulnerable and can't stand up for themselves.
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How has the ethics of the situation improved?
The treatment is administered with an anaesthetic and a muscle relaxant: this way the patient is unconscious and doesn't hurt themselves.
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What are the issues and debates surrounding biological therapies?
Nature v Nurture (ignores environmental causes), Use of Animals (many drug therapies developed using animals), Reductionist (ignores psychological explanations for depression), Deterministic (no control over whether it will work or not).
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How do MAOIs work?


they block the enzyme that deactivates noradrenaline and seretonin.

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How effective are MAOIs?


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Card 4


What are the side effects of MAOIs?


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How do TCA's work?


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