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Biological Therapies: Drugs and ECT Approach proposed that disorder lies in physical processes so treatment is physical.

Targets hormones, parts of brain and neurotransmitters

Drug Treatments
Anti-psychotics- reduce levels of dopamine at synapses o e.g. chlorpromazine, clozapine (works also on serotonin pathways) o Used for schizophrenia, bipolar o Blocking action of dopamine in brain by binding to dopamine receptors makes brain less sensitive Antidepressants- increase levels of serotonin o Used for depression o Depression due to insufficient amounts of serotonin o MAOIs work by stopping enzyme breaking down noradrenaline which increased depression o SSRIs work by stopping nerve cells reabsorbing the serotonin they have released into the synapse, thereby increasing the amount of serotonin that is available making person in better mood Anti- anxiety like benzodiazepines o Slow down activity of CNS by slowing down nerve cell activity o Enhances action of GABA (neurotransmitter which is natural form of anxiety relief)

Evaluation of Drugs Convenient, relatively cheap, easy to take They do work! WHO (World Health Organisation) reported relapse rates lower when chlorpromazine taken (25%) compared to 55% when placebo taken Conflict of placebos: o Kirsch et al. reviewed 38 studies of antidepressants and found patients fared similar with placebo than real drug o Mulrow et al. compared use of tricyclics (antidepressant) and placebo. Success rate of 60% for tricyclic compared to 35% for placebo Tackles symptoms not problem Takes about 3 weeks to start working Side effects o SSRIs can cause anxiety, insomnia, nausea, suicidal thoughts o Clozapine lowers number of WBCs reducing immune defence system, respiratory and heart problems

Electroconvulsive Therapy (ECT)


Used for severely depressed patients at risk of suicide for whom medication and psychotherapy is ineffective How does it work? Electrode placed above temple of non-dominant side of brain and second electrode in middle of forehead (unilateral ECT) or one electrode either temple (bilateral ECT) Patient is anaesthetised and given muscle relaxant to prevent contraction, oxygen given 0.6 amps of electric current lasting half a second passed through brain Produces a seizure lasting up to a minute Usually given 3 times a week for 1-5 weeks

Not exactly sure how ECT works but that it changes the way the brain works. Evaluation of ECT Comer states that 60-70% of ECT patients improve after treatment Works when other treatments dont Sackheim et al. found 84% of patients had relapse within 6 months suggesting treatment not long term When therapy done without electric current, some patients recovered Side effects include impaired memory, cardiovascular changes, headaches o DOH report found those receiving ECT within last two years, 30% reported permanent fear and anxiety

Psychosurgery
Treatment that involves systematically damages the brain. Frontal lobotomy- treatment for schizophrenia- involved destroying areas of pre-frontal cortex. Made patients easier to control but didnt necessarily improve symptoms Nowadays, extremely rare unless severely depressed or OCD thats resistant to all other treatments

Evaluation of psychosurgery: Major ethic issues as irreversible and could have bad consequences Very rarely used so effectiveness not clearly known