Drug Therapy (AQA A Level Psychology): Revision Note

Drug therapy

• Drug therapy is a biological approach to managing stress that involves the use of medication to reduce symptoms associated with the physiological stress response

• These drugs work by targeting the body's neurochemical systems, such as the central nervous system or autonomic nervous system, to help reduce anxiety and tension

• Rather than addressing the root cause of stress, drug therapy aims to alleviate the effects of stress on the body and mind, providing short-term relief and improving the individual's ability to function

• Different categories of drugs can be used to manage stress, including those that reduce activity in the sympathetic nervous system or influence neurotransmitters such as GABA or serotonin to produce calming effects

• Drug therapy is fast-acting, often effective in acute situations, and can be prescribed alongside other treatments such as CBT

Anti-anxiety drugs

• Benzodiazepines (BZs) such as diazepam (Valium) and alprazolam (Xanax) are very commonly prescribed drugs in the UK, which lessen the anxiety response by quickly reducing physiological arousal in the central nervous system

• BZs work by tapping into the way the body naturally combats anxiety

  • Gamma-aminobutyric acid (GABA) is the most important neurotransmitter for inhibiting the activity of neurons in most areas of the brain, and BZs enhance this natural inhibition so there is less neural activity

  • During synaptic transmission, GABA combines with GABA-A receptors on the postsynaptic neuron, opening channels that allow chloride ions to enter, which reduces activity in the post-synaptic neuron and makes it less likely that signals will be passed from one neuron to the next

• BZs bind with GABA receptors so that the channels are opened but without blocking them, and instead channels are opened more often for chloride ions to enter the neuron

  • This makes the neuron more responsive to the inhibitory effects of GABA and less responsive to other neurotransmitters

Beta blockers

• Beta-adrenergic blockers (beta blockers) act on the sympathetic nervous system to reduce sympathetic arousal, a key part of stress-related anxiety, working more directly on the brain itself than BZs do

• Adrenaline and noradrenaline are produced as part of the sympathomedullary pathway and combine with beta-adrenergic receptors located throughout the cardiovascular system accounting for the increased heart rate and blood pressure associated with stress

  • By blocking these receptors, beta blockers slow heart rate, reduce blood pressure and cause the heart to pump less intensely, which reduces its need for oxygen

• As a result, beta blockers help slow the heartbeat and reduce symptoms of stress

• Unlike benzodiazepines, they are less likely to cause dependence, though side effects may include

  • cold extremities

  • fatigue

  • nightmares

  • sleep disturbances

Research which investigates drug therapy

• Baldwin et al. (2013) reviewed studies of BZs and concluded that there is generally more effective than placebo in treating acute anxiety, but that some BZ drugs are more effective than others

• Kelly (1980) reviewed research and concluded that beta blockers were effective for treating everyday anxieties associated with public speaking and exam nerves

  • Beta blockers can be useful for people with social anxiety disorder, in which fear of speaking in public is a major stressor, as they reduce the acute physical arousal (such as racing heartbeat)

Evaluation of drug therapy

Strengths

• Drugs are easy to take, affordable and popular with patients due to the familiarity of taking pills for a multitude of uses, for stress and generally for anxiety-related conditions

• Drugs do not require people to change the way they think or behave (which people tend to find difficult to do) and can be used in conjunction with psychological methods

Limitations

• Well-known side effects of BZs are drowsiness, weight gain and respiration problems, and in some cases Gaind & Jacoby (1978) reported paradoxical reactions, including criminal behaviour such as shoplifting, other impulsive behaviours, and uncontrollable emotional responses such as weeping

  • Beta blockers can reduce heart rate and blood pressure too much in some patients, and are not considered suitable for people with diabetes or severe depression, so side effects may occur that mean the patient stops taking the drug and their symptoms of anxiety return

• Drugs like BZs and beta blockers focus on anxiety reduction and treat our own physiological stress response rather than the stressor itself, so while this gives short-term relief it is not an appropriate treatment for chronic stressors

  • Coupled with the risk of dependency, there comes a point where treatment for chronic stress may do more harm than good, and a psychological therapy might be more appropriate

Issues & Debates

• Drug treatment assumes a biologically determined response to stress (e.g., neurotransmitter imbalance), suggesting behaviour can be altered by medication

  • This undermines ideas of free will, as it implies stress-related behaviours can be ‘fixed’ without addressing conscious choices or thought processes

• Drug therapies take a biologically reductionist approach by focusing solely on chemical processes in the brain (e.g. GABA or adrenaline) to explain and treat stress

  • This overlooks important psychological, cognitive, and social factors (e.g., social support), providing only a partial explanation of how stress develops and is experienced. As a result, drug treatments may have limited long-term effectiveness