- Pharmacotherapy (drug therapy) works by altering neurotransmitter levels, either blocking reuptake, increasing release, or blocking receptors.
- SSRIs (selective serotonin reuptake inhibitors) block serotonin reuptake at the synapse, increasing serotonin availability; used for depression and anxiety disorders.
- Antipsychotics act as dopamine antagonists, blocking dopamine receptors to reduce positive symptoms (hallucinations, delusions) in schizophrenia.
- Anxiolytics enhance GABA activity in the brain to reduce anxiety symptoms, typically benzodiazepines or buspirone.
- Electroconvulsive therapy (ECT) induces a controlled seizure under anaesthesia to reset neural circuits; used for severe, treatment-resistant depression.
- Kirsch et al. (2008) used meta-analysis of double-blind trials and found antidepressants only slightly more effective than placebo, suggesting placebo effect accounts for much improvement.
- SSRIs show moderate efficacy for depression and anxiety in placebo-controlled trials, but effectiveness varies by individual and severity.
- Antipsychotics are effective for positive symptoms of schizophrenia but less effective for negative symptoms (flat affect, withdrawal).
- ECT shows faster response than medication for severe depression, but effectiveness must be weighed against cognitive side effects.
- Drug therapy treats symptoms, not underlying causes (psychological, social, genetic factors remain); high relapse when medication stops.
- Side effects (sexual dysfunction, weight gain, tremor, sedation) can reduce treatment compliance and quality of life.
- ECT raises ethical concerns about informed consent (patients may not be fully competent to consent), cognitive harm (short-term memory loss), and mechanism remains poorly understood.
- Anxiolytics and benzodiazepines carry risk of psychological dependence and withdrawal symptoms, limiting long-term use.
- Global access varies: SSRIs and basic antipsychotics widely available in high-income countries; many low-income nations lack reliable supply or afford medications.
Biological treatments alone manage symptoms but do not address the psychological and social factors that sustain mental disorders. Combined approaches (e.g. medication plus cognitive-behavioural therapy) show better outcomes: medication reduces acute symptoms so patients can engage in therapy, while therapy builds coping skills and addresses underlying thought patterns.
- How do SSRIs and antipsychotics differ in their mechanism of action at the synapse?
- What did Kirsch et al. conclude about the effectiveness of antidepressants and why does the placebo effect matter for evaluation?
- What are three ethical concerns with biological treatments (side effects, informed consent, dependence)?
- Why is combining medication with CBT more effective than either treatment alone?
- What is the difference between treating symptoms and treating causes, and why does it matter for relapse?
