WK 8 MH

Question 1

Disease centred model of psychiatric drugs

Answer 1

correcting a defective/diseased brain or a chemical imbalance

makes brain more “normal”

Drugs as treatment for disease

Question 2

Drug-centred model to psychiatric drugs

Answer 2

psychiatric drugs are psychoactive drugs and alter functioning of nervous system

Drugs Create an abnormal brain state -

Superimposes onto manifestations of distress. e,g, alcohol used to treat social anxiety is not targeting an alcohol deficiency

Useful effects are are a consequence of alterations to normal brain functioning

Drugs do not specifically target psychiatric symptoms

Question 3

psychoactive drugs

Answer 3

Chemical compounds act on CNS to produce changes in perception, mood, consciousness, behaviour

Question 4

Activation of brain systems is
dependent on activity of individual
neurons.
* This activity is mediated by

Answer 4

the amount of NT available at post synaptic site

Question 5

The goal of drug therapies is to modify

Answer 5

the levels of neurotransmitters believed to be
involved in symptoms.

Question 6

2 routes of drug therapies / drugs

Answer 6

Agonist drugs

Antagonist drugs

Question 7

Agonist drugs

Answer 7

Increase the action of a neurotransmitter
by increasing its availability by
preventing re-uptake at the synapses,
preventing degradation within the
synaptic cleft or replacing low levels of a
particular neurotransmitter with its
pharmacological equivalent

Question 8

Antagonist drugs

Answer 8

Inhibit the action of a neurotransmitter
by decreasing the availability of the
neurotransmitter or replacing the active
transmitters with an inert chemical

Question 9

Antidepressants associated with serious adverse effects e.g.

Answer 9

, agitation, nausea, sickness,
increase in suicidality in young people (< 25 years old).

Question 10

typical withdrawal effects of antidepressants

Answer 10

• anxiety,
• irritability
• insomnia,
• hyperarousal
• sensory disturbances,
• flu-like symptoms,
• nausea

Question 11

Antidepressants

__% experience withdrawal effects, of these __% describe them as severe.

¡ 40% report feeling ______.

Answer 11

56

46

addicted

Question 12

Dopamine hypothesis of
schizophrenia:

Answer 12

increased dopamine receptor sites (D2 receptors) on post-synaptic terminal, making people “supersensitive” to normal levels of dopamine.

Question 13

Side effects of antipsychotics

Answer 13

block dopamine D2 receptors, reducing dopamine signalling = reduced activity of dopamine in basal ganglia, which controls movement and influences thought, emotion and motivation

Transient Parkinsons-like symptoms (e.g. stiffness in arms and legs, flat facial expressions)
also tardive dyskinesia (repetititive involuntary purposeless movements)

Question 14

side effects of atypical antipsychotics

Answer 14

less movement side effects but increase appetite/weight gain

Question 15

Mood stabilisers prescribed to

Answer 15

diagnoses of Bipolar dosprder , but also intense and sustained mood swings (e.g. BPD)

Question 16

MOOD STABILISERS

Patient studies indicate ______ rates higher in those who don’t take mood stabilisers,
but mechanism of action poorly understood.

Answer 16

relapse

Question 17

MOOD STABILISERS

. All have ____ effects
that likely impact on mania symptoms.
¡ Healthy volunteer studies show lithium…

Answer 17

sedative

impairs mental abilities/dulling.

Question 18

Side-effects of MOOD stabilisers

Answer 18

hypothyroidism, impaired renal function, lethargy, weight gain

Question 19

drugs for anxiety

Answer 19

ANXIOLYTICS

Question 20

Benzodiazepines (e.g., diazepam) – drugs that enhance the action of

Answer 20

gamma amino butyric acid (GABA - inhibitory neurotransmitter).

Question 21

Benzodiazepines Impact regions of the ______ ______, producing muscle relaxing effects, reduction of alertness/hypervigilance, and sedation (i.e., they counteract
physical/somatic signs of anxiety).

Answer 21

limbic system

Question 22

side effects of benzodiazephines/anxiolytics

Answer 22

drowsiness
memory loss
depression
acute rage
aggressive behaviour

Question 23

Reliance on medication: report on polymedication by Royal College of Psychiatrists
(2007):
__% of people accessing mental health services are prescribed two or more
medications.

Answer 23

90%

Question 24

CRITICISMS OF DRUG THERAPIES

Answer 24

Withdrawal symptoms and relapse following drug discontinuation

Patients are offered no alternatives other than taking drugs

¡ There is little evidence for the disease-centred model:

Temporary fix, not a cure

Question 25

Only __% offered psychological therapies that have
been proved to be effective to improve severe mental health difficulties (mostly for schiz tho)

Answer 25

10

Question 26

There is little evidence for the disease-centred model:

e.g.

Answer 26

no consistant evidence that people with schizophrenia have specific abnormalities in dopamine or depressed people with serotonin

no consistent evidence specific drugs work better for specific problems

Question 27

Electroconvulsive therapy

origins

Answer 27

It was assumed that seizures could prevent/cure schizophrenia, since
many believed that those diagnosed with epilepsy were immune to the
disorder (we know this is incorrect now…).

Question 28

ELECTROCONVULSIVE THERAPY (ECT)

Answer 28

Brief discharge of an electric current
through the brain with the aim of
inducing a controlled epileptic
convulsion.
¡ Used while patient was fully conscious,
now used with general anaesthesia
with muscle relaxants to prevent injury.
¡ 2 x week for 3-6 weeks (over 6-12
sessions in total).

Question 29

ELECTROCONVULSIVE THERAPY (ECT)

how many ppl in Uk

Answer 29

2500

Question 30

NICE (National Institute for Health and Care Excellence)
recommends its [ETC] use in

Answer 30

treatment-resistant depression, mania or catatonia, where there is a high risk of suicide

Question 31

adverse effects of ECT

Answer 31

permanent memory loss, major adverse cardiac events