Drug therapy is the main treatment for mental disorders and is based on the assumption that chemical imbalance is at the root of the problem. One type of drug is anti-anxiety drugs (e. g. , minor tranquillizers called BZs such as Valium. These have a calming effect by inhibiting the nervous system and causing muscles to relax. BZs work by enhancing the action of the chemical messenger GABA, which acts to calm brain activity. Another type of drug is anti-depressant drugs (e. g. MAOIs, TCAs and SSRIs. These improve mood by increasing the availability of neurotransmitters such as serotonin. For example, MAOIs block the action of an enzyme that breaks down serotonin, so increasing its availability in the nervous system. The last type of drug is anti-psychotic drugs (e. g. major tranquillizers such as the phenothiazines).
These sedate and alleviate symptoms such as hallucinations, of the person suffering from psychotic disorders such as schizophrenia. They seem to work by blocking the D2 receptor for dopamine.
Another type of therapy is ECT (Electro-convulsive therapy). This is when a patient lies on a bed, in loose clothes, and receives an anaesthetic and muscle relaxant before treatment. ECT involves passing a current (70-130 volts) through the brain for approximately half a second. This is done by fixing electrodes to the patient’s temples. This is now mainly used to treat people with severe depression and treatments are given typically two or three times a week for three r four weeks.
Over 11,000 patients in England and Wales were given ECT in 1999 (Johnstone 2003) and two thirds of these patients were women. Drug treatment has been found to be effective in relieving the symptoms of mental disorders in many people. Despite the claims made for some modern drug treatment, however, there are critics and the use of drugs remains controversial. Fisher and Greenberg (1989) believe they have limited beneficial effects. Others, (e. g. Kirsch and Sapirstein 1998) assert that beneficial effects are caused in large part by the placebo effect.
They argue that therapy produces beneficial effects often because of the attention given and because the patient develops an expectation of success when treatment is offered. Drugs may also have side effects that may be considered worse than the original symptoms of the disorder. Nevertheless, there is an expectation that patients will comply with medication, despite the fact that most medication carries side effects and often long-term dependency upon the drugs.
Also, psychologists have criticised psychiatry for focusing on symptoms and assuming that relieving symptoms with drugs cures the problem. Unfortunately, in many cases when drug treatment is ceased, the symptoms recur, suggesting that drugs are not addressing the true cause of the problem or helping patients learn to cope with experiences in their lives that may have contributed to the disorder in the first place. Furthermore, ECT is a quick form of treatment compared with drugs or psychological therapies.
It can be effective short-term treatment for depression with 60-70% of patients showing improvements, (Sackheim 1988). However, ECT should only be administered if anti-depressant drugs have no effect and if there is a risk that the person will commit suicide. Some psychiatrists argue that the prevention of suicide is sufficient justification for its use. Also, when ECT was first introduced there were serious effects including bone fractures and memory loss. Side effects have been reduced but opinions are divided regarding the severity of cognitive and emotional impairments following treatment.