Anorexia: Biological Treatment - Drug Treatments Flashcards
(17 cards)
Why would drug therapy be suggested as a biological treatment for anorexia?
If it is assumed that disorders occur biologically, then treatment should also originate biologically.
Who publish guidelines for treating mental illness?
National Institute for Health and Care Excellence (NICE).
What did NICE suggest about treatments for anorexia?
That drug therapy should be a last resort and to use other methods such as family therapy first. This is they do not help with the core symptoms, nor do they promote healthy weight gain.
What is the rationale of using drugs for anorexia?
- Low levels of neurotransmitters are found in anorexics
- Serotonin is associated with suppression of appetite and and mood
- Disruption to this leads to increased anxiety which can trigger anorexia
What is a co-morbid symptom?
A disorder that may result from the main diagnosis.
List 3 example of co-morbid symptoms.
1) Depression
2) Anxiety
3) OCD
What 2 types of drugs are used to treat anorexia and co-morbid symptoms?
1) Selective serotonin reuptake inhibitors (SSRIs)
2) Antipsychotics
Briefly explain how SSRIs work, using an example.
- Antidepressants that use natural neurotransmitters
- They block reuptake of serotonin in the presynaptic neurons
- This means more serotonin is available in the synapse for stimulation which increases levels
- They can help with co-morbid symptoms of anxiety and depression
- Citalopram is an example of an SSRI
Evaluate a supporting piece of evidence for SSRIs treating anorexia.
Fassino et al (2002) supports SSRIs treating co-morbid symptoms. He found that Citalopram didn’t help with weight gain but did help with depression and OCD. Therefore, this demonstrates that they can be used to treat co-morbid symptoms such as depression that may then lead to recovery
Briefly explain how antipsychotics work, using an example.
- Focus on dopamine due to the assumption that unusual dopamine functioning in the striatum may contribute to anorexia
- The striatum is associated with the reward pathway that corrects functioning of feeling satisfied after eating
- They bind to D2 receptors and block them to inhibit stimulation of dopamine receptors
- It also helps to reduce co-morbid symptoms such as anxiety due to dopamine being responsible for regulating emotional responses and so normal levels will allow normal emotional responses
- Olanzapine is an atypical antipsychotic drug
Evaluate a supporting piece of evidence for antipsychotics treating anorexia.
Silverstone et al found that patients who were prescribed olanzapine not only gained weight, but also reported less difficulty with eating as well as lower levels of anxiety, showing that drug therapy can be an effective treatment method in helping patients to recover from AN.
‘different treatment’
An alternative treatment method to drug therapy is Token economy as an alternative treatment method. It uses principles from operant conditioning to reinforce desirable behaviour of gaining weight for anorexics and rewarding them with tokens that can be exchanged for money or family visits. This is a long-term patient-centred process that allows the individual to find independence in their own improvement and so is better than the short-term improvement of drug treatment- so is a more effective treatment.
Using the acronym ‘DESSERT’, evaluate an ‘expense’ point.
A weakness of drug therapy is that it is Highly expensive. It can be very costly to buy the medication for this treatment especially if the patient would need to try different SSRIs or antipsychotics in order to see improvements. Therefore this renders the treatment ineffective as people may be deterred to complete treatment due to the price- reducing its overall efficacy.
Using the acronym ‘DESSERT’, evaluate a supporting and rejecting ‘studies’ point.
Kaye et al (2001) supports SSRIs treating anorexia. They used a double blind study to compare the outcomes of Fluoxetine and a placebo and found that those taking the SSRI were more likely to stay on medication and had much lower relapse rates, measure by body weight. This therefore demonstrates that SSRIs reduce relapses and increase time spent taking medication so improves anorexia.
Silverstone et al, fassino et al
Using the acronym ‘DESSERT’, evaluate a ‘side effects’ point.
A weakness of drug therapy is that antipsychotics such as olazapine have severe side effects. Patients have reported tardive dyskinesia as well as a decrease in emotional spontaneity and motivation. These may cause a patient to stop taking medication due to not wanting to experience the side effects and so may cause their disorder to worsen as it increases the risk of relapse and so is not a long term effective treatment method for anorexia.
Using the acronym ‘DESSERT’, evaluate an ‘ethics’ point.
Despite being seen as a positive in helping to stabilise a patients weight, weight gain can be unethical. The side effect of weight gain due to medication can cause psychological distress in patients who are considered a vulnerable group (due to their poor health, such as heart problems from low blood pressure). This reduces the effectiveness of drug treatments as they may cause a patient to stop medicating due to their extreme fear of weight gain, which would lead to a relapse but may also worsen co-morbid symptoms such as anxiety through gaining unwanted weight.
Using the acronym ‘DESSERT’, evaluate a ‘reason or mask’ point.
A weakness of drug therapy is that it merely masks the problem. Drugs mainly treat co-morbid symptoms such as depression and anxiety that can worsen the disorder and different types of anorexia (restricting and binging) will require different ways of being treated. Therefore does not get to the root of the problem that caused the disorder, only masks symptoms, and so is not effective.
