BIOLOGICAL APPROACH: DRUG THERAPY

Question 1

describe the three main types of psychoactive drugs.

Answer 1

The three main types of psychoactive drugs are
1.antipsychotics,
2. antidepressants
3. antianxiety drugs.

Question 2

what do antipsychotics treat?

Answer 2

1) Antipsychotic drugs treat psychotic mental disorders.
2) They also control manic depression.

Question 3

give an example of a psychotic mental disorder + briefly explain what this constitutes.

Answer 3

1)like schizophrenia,
2) whereupon an individual has lost touch with reality.

Question 4

describe the etiology of these psychotic disorders.

Answer 4

Both of which are characterised by increased dopamine levels.

Question 5

how do antipsychotics aim to treat this?

Answer 5

thus antipsychotics aim to reduce dopamine levels in the brain.

Question 6

what are the two types of antipsychotics?

Answer 6

There are two types of antipsychotics;
1 typical
2 atypical.

Question 7

describe what typical antipsychotics DID, providing an example.

Answer 7

1)Typical antipsychotics
2) such as Loxapine
3) were first used primarily to combat positive symptoms of schizophrenia,

Question 8

how do typical antipsychotics work?

Answer 8

Typical antipsychotics work by:
1. binding to dopamine receptors
2. permanently blocking their action,
3. thus eliminating positive symptoms.

Question 9

there are two types of schizophrenic symptoms: positive and negative. what are positive symptoms, giving an example?

Answer 9

1)Positive symptoms are added to normal behaviour,
2)like delusions and hallucinations.

Question 10

what are negative symptoms, giving an example?

Answer 10

1)whereas negative symptoms remove from normal behaviour,
2)for example, lack of motivation in schizoids.

Question 11

describe when atypical antipsychotics developed, providing an example.

Answer 11

1) Atypical antipsychotic drugs developed more modernly in the 1990s.
2) such as Clozaril

Question 12

describe how antipsychotics work.

Answer 12

These act by
1)only temporarily occupying dopamine receptors,
2)then rapidly dissociating
to allow normal dopamine transmission.

Question 13

how are these atypical antipsychotics effective? provide empirical evidence.

Answer 13

1)This offers lower levels of side effects like tardive dyskinesia,
2)whilst allowing for the pleasurable effects of dopamine transmission
3) and concurrently reducing the risk of suicidal side effects compared with typical psychotics
(Meltzer & Gadaleta, 2021).

Question 14

secondly, antidepressants. What do antidepressants treat?

Answer 14

1)Secondly, antidepressants treat the symptoms of unipolar depression,
2)the most common form of depression. .

symptoms of, as a disdavantage of drug therapy = not treating cause

Question 15

what do antidepressants assume the etiology of depression is?

Answer 15

This acts by the assumption that
depression is
- caused by insufficient amounts of the serotonin neurotransmitter production
- into the synapse.

Question 16

give an example of one type of antidepressants.

Answer 16

Monoamine oxidase inhibitors (MAOIs)

monoamine oxidASE= enzyme, INHIBITors = prevent,

Question 17

how do MAOIs work?

Answer 17

1) work by blocking the enzymes that break down serotonin,
2) so that the amount of serotonin available to stimulate other neurons is increased.

Question 18

what is the function of serotonin? how does this enable the use of MAOIs?

Answer 18

1) Serotonin is responsible for mood regulation and is associated with happiness.
2) MAOIs thus allow the patient to feel happier.

inhibit break down of serotonin-> more in synapse -> more absorbed -> :)

Question 19

name the second type of antidepressant.

Answer 19

Additionally are selective serotonin reuptake inhibitors (SSRIs),

Question 20

describe SSRIs briefly with an example.

Answer 20

the most commonly prescribed antidepressants,
including Prozacs.

Question 21

think - inhibits reuptake of serotonin

how did SSRIs work?

Answer 21

These work by:
1. blocking the transport mechanism that reabsorbs serotonin into the presynaptic cell after it has fired,
2. leaving more of the serotonin in the synapse,
3. increasing ease of transmission of the next impulse,
4. so that ‘normal serotonin transmission can occur, lessening depressive symptoms.

Question 22

thirdly are anti-anxiety drugs. what do these treat?

Answer 22

Thirdly are anti anxiety drugs, used to treat anxiety and stress,

Question 23

give examples of anti-anxiety drugs.

Answer 23

most commonly:
1. benzodiazepines (BZs),
2. Librium
3. or Valium

Question 24

what do benzodiazepienes (BZs) do?

Answer 24

BZs slow down the activity of the central nervous system .

Question 25

how do BZs work?

Answer 25

BZs work by: *enhancing* the activity of **Gamma-aminobutyric acid (GABA)**, the *neurotransmitter* that is the **body’s natural form of anxiety relief**.

Question 26

what other modality treats anxiety?

Answer 26

**Beta blockers (BBs) ** are also used to reduce anxiety.

Question 27

how do BBs work?

Answer 27

They do so by: 1. reducing the activity of **adrenaline** and **noradrenaline**, which form the **bodily response to stress**. 2. BBs **bind to receptors** on the cells of the * heart + other somatic cells stimulated during **sympathetic arousal** – the ‘*fight or flight*’ response

Question 28

how are these BBs effective?

Answer 28

Blocking these receptors 1. makes it harder to stimulate cells in these parts of the body. 2. Consequently, placing less stress on the heart. 3. Ergo, the person feels calmer and less anxious.

Question 29

EVALUATING EFFECTIVENESS

Question 30

# methodology involves? have done? first advantage, provide empirical evidence to establish whether drug therapy has proven effective or not.

Answer 30

**Randomised control trials** have **provided considerable evidence** for the effectiveness of drug therapies.

Question 31

provide empirical evidence indicating the effectiveness of drug therapies (name, date), findings.

Answer 31

***Soomro et al (2008)** * 1. *reviewed* **17 studies **of the use of **SSRIs with OCD** patients, which has *depressive components* 2. finding that these were** more effective than placebos** in **reducing symptoms of OCD** up to *three months after treatment*.

Question 32

provide a second empirical study that supports Soomro et al's (2008) findings.

Answer 32

1. Similarly, **Kahn et al (1986) ** 2. followed **250 patients over 8 weeks** + 3. found **BZs to be significantly superior** to placebos. | kahn et al, 1986, 250 - 8wks, BZs>placebos

Question 33

what is a **methdological** disadvantage of these findings?

Answer 33

1. However, **most studies** are only of *three to four months duration* 2. –* little longitudinal data* exists **(Koran et al,2007)**, 3. thus **establishing long-term efficacy is more difficult**. | koran, DOB

Question 34

regarding **patients**, whats a second disdavantage of drug therapy? consider adavantage and add study, and give examples.

Answer 34

There again, * despite being *generally extremely effective* in treating psychological disorders **(Pies, 2012)**, * drugs can have ***severe side effects*,** like **hallucinations with tricyclic depressants**.

Question 35

state three side effects of **SSRIs**.

Answer 35

Side effects of SSRIs include 1. nausea, 2. headaches 3. + insomnia,

Question 36

what are the disadvantages of tricylic and SSRIs side effects?

Answer 36

All of which can deter patient compliance thus impeding the full effectiveness of the therapy

Question 37

a second disadvantage regarding patients is symptom substitution. describe what is meant by this.

Answer 37

1. In continuation, **drugs are effective in treating the symptoms** of psychological disorders, but **does not address the underlying cause(s)**. 2. Thus it is a **reductionist** therapeutic approach.

Question 38

explain this disadvantage by comparing it other therapies in an endogenous depressed patient.

Answer 38

For example, an individual suffering depression in adulthood because 1. of repressed childhood trauma 2. or maladaptive thinking may experience positive short-term benefits from effective antidepressant drug therapy.

Question 39

whats a disdavantage of this short-term benefit?

Answer 39

* However they will have no greater insight into their thought processes which are causing distress, * thus no means to improve them long-term.

Question 40

where is this long-term skill equipment offered in other therapies?

Answer 40

* This is offered in the cognitive restructuring component of cognitive behavioural therapy (CBT). * Or addressing repressed traumatic conflicts in psychotherapy.

Question 41

this absence of such in drug therapy can result in what?

Answer 41

* This results in “revolving door syndrome”; * the patient recurrently seeks treatment as their disorder is never truly cured.

Question 42

to be concluded, what can be said about drug therapies' effectiveness in treating mental health with a biological approach?

Answer 42

* In conclusion, whilst an **efficacious** therapeutic modality, * evidence suggests that the physical component of mental illness only forms part of a** holistic explanation**; * encompassing **more abstract, non-physical contributors**, including *emotional* or *internal psychic* conflict.

Question 43

how could this then relate to drug therapies efficacy as a treatment modality?

Answer 43

* Therefore drug therapy cannot be considered entirely effective in isolation. * It should be integrated with non-physical, psychological treatments, such as cognitive therapy.

Question 44

why should this be done?

Answer 44

to: account for individual differences in * exogenous experiences causes of psychic distresss * + avoid reductionism. This way, both physical symptoms and underlying causes can be treated.

Question 45

EVALUATING ETHICAL CONCERNS

Question 46

evaluate a methodological ethical concern arisen in drug therapy research.

Answer 46

* An ethical issue arises relating to the methodology of drug effectiveness research, pertaining to the **use of placebos**. * A *fundamental research ethic* is that **no patient should be given a treatment known to be inferior**. * *Existing effective treatments* exist should be **used as control conditions** testing for new treatments. * Substituting a placebo from an effective treatment **contradicts this duty**.

Question 47

# think DRIPP! there from this, is another ethical issue. what is it? | deception, right TW, informed consent, protection from harm, privacy

Answer 47

* it exposes them to a treatment known to be inferior, * which could risk further psychological or physical harm later on.

Question 48

a further issue is valid consent. evaluate this concern.

Answer 48

* A further ethical concern is the lack of valid consent. * Patients may find it difficult to remember all the facts regarding the potential side effects of the drug prescribed, * or they may not be in the right frame of mind to digest the information, * therefore obtaining informed consent is precluded.

Question 49

a further issue is working with vulnerable individuals. how is this a concern?

Answer 49

* Patients referred to drug therapy are usually vulnerable individuals, * for instance, a schizoid in a dissociative state.

Question 50

# 1 OF 2 firstly, how could this develop into an ethical issue , considering the role of medical professionals?

Answer 50

That said, medical professions may withhold some information about the drugs to the patients, such as 1. limited drug efficacy 2.or alternative therapeutic options.

Question 51

# 2 OF 2 firstly, how could this develop into an ethical issue , considering the role of medical professionals?

Answer 51

* Some medical professionals may also **exaggerate the benefits** of taking medication * in favour of the **cost-effective ‘quick fix’ **drug therapy offers. ‘

Question 52

# quick fix -> no alt options -> treatment of patient effects? how is this in comparison with other therapies?

Answer 52

* This is disadvantageous as psychological therapies, such as psychoanalysis, which, although longer in duration, * may effectively treat the root cause and thus avoid the risk of further psychological distress.

Question 53

to conclude, is drug therapy ethical?

Answer 53

* In all, drug therapy may not be entirely ethical. * It raises numerous ethical concerns that can compromise patient beneficence, if not prescribed by an ethical, trained psychiatrist.

Question 54

even if the psychiatrist is ethical and does not want to compromise patient benefiecence, what could happen?

Answer 54

Even then, systemic pressures within the health service may hinder ethical implementation. | could want to provide better -> lack of resources -> treat all patients

Question 55

concluding on the methodological ethical concern (research ethics, placebos)?

Answer 55

* Methodological ethical concerns, which, while they could be justified by a cost-benefit analysis, * challenge the integrity of the drug therapeutic approach.

Question 56

how can it be ensured this remains an ethically sound treatment?

Answer 56

* To ensure it remains ethically sound, a multidisciplinary approach, including psychologists and other health workers involved in the patient’s care, must be offered. * This must consider the best patient outcome contextualised to their condition.