Drug therapy (man and cop)

• Drug therapy

  • BZs = benzodiazepines
  • BBs = beta blockers
• BZs act on CNS (BZs)

  • BZs (eg diazepam) reduce the anxiety associated with stress by reducing CNS arousal
  • They enhance one way the body naturally combats anxiety
• mode of action = GABA activity (BZs)

  • GABA = a neurotransmitter that inhibits activity of neurons (that are involved within arousal) in most brain areas
  • GABA achieves this during normal synaptic transmission by combining with receptors on the postsynaptic neuron
  • This makes it less likely that the postsynaptic neuron will fire, so signals are less likely to be passed on from one neuron to the next - the net effect is reduced activity in the CNS
• BZ drug molecules combine with GABA receptors (BZs)

  • BZ enhance this natural inhibition
  • Like GABA, BZ drug molecules combine with postsynaptic receptors, making the receptors more responsive to GABA
  • => neural activity is inhibited throughout the CNS, neurons cannot be stimulated by another neurotransmitters for a period and the individual feels less anxious
• Strength for BZs = high-quality research shows they are effective (BZs)

  • in a double-blind placebo-controlled trial, half the pps take a placebo (inactive version of the drug), but neither they nor the researcher knows who is taking it
  • Baldwin et al = review of these high-quality studies concluded that BZs are significantly better than placebo in reducing acute anxiety
  • this is strong evidence that BZs are a good choice of drug treatment for people wishing to reduce anxiety, at least in the short term
• BBs act on sympathetic nervous system (BBs)

  • BBs reduce anxiety by reducing arousal on the SNS
  • BBs (eg atenolol) are usually prescribed to reduce blood pressure and treat heart problems but are also useful for stress
• mode of action = involves adrenaline and noradrenaline (BBs)

  • Stress hormones adrenaline and noradrenaline are produced as part of the sympathomedullary (SAM) pathway
  • These hormones combine with beta-adrenergic receptors in the cardiovascular system (mainly in heart and blood vessels)
  • This is why heart rate and blood pressure increase during stress
• BBs block beta-adrenergic receptors (BBs)

  • BBs block beta-adrenergic receptors so these receptors are not stimulated by adrenaline and noradrenaline
  • So heart rate, blood pressure etc do not increase, heart does not need more oxygen
  • BBs reduce stress-related anxiety without altering the alertness because they don’t affect the brain
  • => ideal for people who want to eliminate physical symptoms of stress but remain alert (eg stage performers, surgeons)
• strength = research shows BBs are effective (and effective when combined with BZs)

  • Kelly = concluded that BBs reduce anxieties associated with exams, public speaking and civil disturbances of living in Northern Ireland in 1970s
  • Studies consistently demonstrate BBs may be even more effective when used with other drugs such as BZs
  • => drug combination therapy with BBs and BZs may be the best way to treat the physiological symptoms of stress for most people
• counterpoint to effectiveness of drugs

  • Drugs don’t remove causes of anxiety (usually long-term) so symptoms return when person stops taking the drug, may mask deeper problems
  • => drug therapy is not a long-term solution to stress-related anxiety
• limitation = drug therapy has side effects

  • BZs = can cause breathing problems and paradoxical reactions (opposite effects)
  • eg impulsive behaviours and uncontrollable emotions
  • BBs = may reduce heart rate and blood pressure too much in some people
  • not suitable for people with diabetes or severe depression
  • => side effects are problematic because, as a consequence, a person may stop taking the drug making them ineffective
• extra evaluation = costs vs benefits

  • Costs of drugs = side effects, don’t offer a cure for anxiety/stress, dependency is an issue because BZs are addictive with long-term use
  • Benefits of drugs = give short-term relief which means psychological therapies can be used, cost-effective, non-disruptive
  • => benefits outweigh the costs as long as anti-anxiety drugs are only used to relieve short-term stress