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Outline and evaluate biological treatments of depression (15 marks)

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Introduction

Outline and evaluate biological treatments of depression (15 marks) I am going to discuss the use of antidepressant drugs and electroconvulsive therapy and their use in the treatment of depression. Both are broadly used in the UK and elsewhere in the world and are often used in psychiatric hospitals without the consent of the patient. The biological explanation is that depression is caused by insufficient levels of serotonin and noradrenaline. Antidepressant drugs are used for the treatment of moderate to sever depression and are usually taken for at least four months, usually longer. The two main types are tricylics and Selective Serotonin Re-Uptake Inhibitors (SSRIs). Tricylic drugs prolong the mood-lifting effects of noradrenaline and serotonin by preventing the re-absorption after they are released. It also means that the remittance of the neurotransmitters is easier and faster the next time. Similarly, SSRIs such as fluoxetine (Prozac) block the re-absorption of serotonin but not noradrenaline, prolonging the feeling of excitement and lowering depression. In 2008, Kirsch found that in moderately depressed patients, there was improvement in their conditions when using placebos as well as when using the real SSRI. (S)he also found that in severely depressed patients there was significant advantages to using the real drug when compared with the control placebo group. The study concluded that for moderately depressed patients, it was the hope of recovery which caused their improvement whereas in severe cases, the biological effects were what caused the improvement. ...read more.

Middle

drugs. However, the most prominent issue with placebo trials is that of ethics. Many studies are done without the consent of the patient and so they are not aware that they even might have a placebo which means that informed consent can never be given1. Also, if a placebo is given to patient at high risk of suicide and who clearly needs help and they do not respond to the placebo, it could result in a worsening of their condition or even their suicide. Furthermore, if a patient is told that they are being prescribed the drug but in reality it is a placebo, they are being deceived by the experimenter and may become worse because they feel helpless when the 'drug' does not work. When taking drugs to combat symptoms, there are often side effects such as increased suicidal thoughts, headaches and many others which can range from mild to severe. Drug treatment is often favoured by doctors and hospitals because it is relatively cheap and requires little supervision (unless in a psychiatric hospital) and requires very little effort on the patient's part and many drugs do not cause any severe adverse effects when taken many at a time (overdosing). On the other hand, the lack of supervision can lead to inappropriate amounts of the drug being taken which and prolonged use of the drug can lead to both a psychological and biological dependency upon it. ...read more.

Conclusion

The Department Of Health report in 2007, found that 30% of recent ECT patients complained of permanent fears and anxieties since having it. In an earlier DOH report from 1999, they found that out of seven hundred mental health patients who had been sectioned and consequently been given ECT, 59% of them had not given consent for the treatment. Further concerns about consent are that even where patients do submit to the treatment willingly, it is difficult, particularly when they have been sectioned, to fully inform them about the treatment especially since those who are sectioned are not considered mentally capable of giving informed consent. Finally, one major concern is that even the leading psychologists do not know exactly how ECT works. Since it is supported by the evidence that depression is less common in people who suffer from epileptic fits, it is assumed that it is the seizure and not the current which causes the improvement in condition. Since ECT is far more invasive and has a far worse reputation than drug treatment, it is the less frequently used therapy. However, as stated earlier, in cases where patients do not seem to respond to drug treatments, ECT is usually significantly more effective. 1 Unless participants are taken from psychiatric patients sectioned under the Mental Health Act in which case, consent may be given by their doctor or family but not them. 2 Where the patient is anaesthetised and is not aware that they are not given the ECT. Vicki Holland ...read more.

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