[16.3] Biomedical Therapies

Question 1

Psychopharmacotherapy

Answer 1

• psychopharmacotherapy: the use of drugs to attempt to manage or reduce clients’ symptoms

Question 2

Drug Treatments

Answer 2

• psychotropic drugs: medications designed to alter psychological functioning
• drug treatments have become mainstream practice for many people experiencing even relatively mild psychological problems and symptoms
• all psychotropic drugs are designed to cross the blood–brain barrier: a network of tightly packed cells that only allow specific types of substances to move from the bloodstream to the brain in order to protect delicate brain cells against harmful infections and other substances

Question 3

Antidepressants

Answer 3

• antidepressant drugs: medications designed to elevate mood and reduce other symptoms of depressio
• target areas of the brain that, when functioning normally, are rich in monoamine neurotransmitters—serotonin, norepinephrine, and dopamine
• monoamine oxidase inhibitors (MAOIs): were the first type of antidepressant that was developed and widely used
  
  • work by deactivating monoamine oxidase (MAO), an enzyme that breaks down serotonin, dopamine, and norepinephrine at the synaptic clefts of nerve cells
  • used less frequently than other antidepressants, in part because they can have dangerous interactions with fermented foods and other medications, causing severely high blood pressure
• tricyclic antidepressants: among the earliest types of antidepressants on the market and appear to work by blocking the reuptake of serotonin and norepinephrine
  
  • many side effects are associated with tricyclic antidepressants, including nausea, weight gain, sexual dysfunction and, in some cases, seizures
• selective serotonin reuptake inhibitors (SSRIs): a class of antidepressant drugs that block the reuptake of the neurotransmitter serotonin
  
  • among the most common of these are Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine)

Question 4

Mood Stabilizers

Answer 4

• drugs used to prevent or reduce the severity of mood swings experienced by people with bipolar disorder
• lithium was one of the first mood stabilizers to be prescribed regularly in psychiatry, and from the 1950s to the 1980s, was the standard drug treatment for depression and bipolar disorder
• lithium, a salt compound, can be quite eff ective, but it can also be toxic to the kidneys and endocrine system

Question 5

Antianxiety Drugs

Answer 5

• sometimes referred to as tranquilizers, antianxiety drugs: prescribed to alleviate nervousness and tension, and to prevent and reduce panic attacks
• these drugs aff ect the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that reduces neural activity
• their side eff ects include drowsiness, tiredness, and impaired attention, especially when they are taken at high doses
• more serious side eff ects include memory impairments, depression, decreased sex drive, and many other possible effects
• these drugs also have the potential to induce abuse and withdrawal symptoms

Question 6

Antipsychotic Drugs

Answer 6

• antipsychotic drugs are generally used to treat symptoms of psychosis, including delusions, hallucinations, and severely disturbed or disorganized thought
• the first generation of antipsychotic medications was designed to block dopamine receptors
• however, these drugs had significant side effects, such as seizures, anxiety, nausea, and impotence
• one of the more severe and often permanent side effects, tardive dyskinesia: a movement disorder involving involuntary movements and facial tics
• the newer generation of medications is referred to as atypical antipsychotics (or second-generation antipsychotics)
• makers of atypical antipsychotics claim that these drugs are less likely to produce extrapyramidal side effects including movement disorders that commonly occur when first-generation antipsychotics are prescribed
• they primarily seem to reduce dopamine and serotonin activity

Question 7

Evaluating Drug Therapies

Answer 7

• drugs are not more effective than psychological therapies in many cases
• e.g. depression; the use of antidepressants has become increasingly accepted among the general public, in part due to the pervasive marketing campaigns from drug companies
• however, these drugs are not as effective as they are widely believed to be
• research generally shows that drugs are more effective when combined with other types of therapy

Question 8

Frontal Lobotomy

Answer 8

• frontal lobotomy: surgically removing regions of the cortex
• Antonio Moniz developed leucotomy, the surgical destruction of brain tissues in the prefrontal cortex
• drilling small holes into the skull, Moniz would typically insert a small wire loop, a leucotome, through the holes and into the brain matter, and with a few flips of the wrist the damage is done and the patient is left to “recover”
• Dr. Walter Freeman further developed the “lobotomy” (as he called the procedure) for about a decade, until he learned of a new method, developed in Italy, for getting into the brain through the eye sockets, thereby avoiding drilling into the skull

Question 9

Focal Lesions

Answer 9

• one set of techniques involves performing focal lesions: small areas of brain tissue that are surgically destroyed
• these brain lesions are only used in some severe cases, when all other treatments have not worked to satisfaction
• this procedure, which is called an anterior cingulotomy, has no more risks or side effects than do many of the drugs used to treat these disorders, and it can reduce symptoms successfully despite other treatments being ineffective

Question 10

Electroconvulsive Therapy

Answer 10

• electroconvulsive therapy (ECT): involves passing an electrical current through the brain in order to induce a temporary seizure
• ECT has gone from being viewed as a torturous “shock treatment” to a relatively safe procedure, although it is still reserved for the most severe cases of disorders such as depression and bipolar disorder
• the side effects are relatively mild, typically consisting of some amnesia, but only for events occurring around the time of the treatment
• people don’t know why ECT works

Question 11

Transcranial Magnetic Stimulation

Answer 11

• transcranial magnetic stimulation (TMS): is a therapeutic technique in which a focal area of the brain is exposed to a powerful magnetic field
• stimulating parts of the frontal lobes of the cortex reduces depressive symptoms and may hold considerable promise for reducing symptoms of other mental disorders, such as schizophrenia

Question 12

Deep Brain Stimulation

Answer 12

• deep brain stimulation (DBS): is a technique that involves electrically stimulating specific regions of the brain
• the procedure involves inserting thin electrode-tipped wires into the brain and carefully routing them to the targeted brain regions
• s small battery connected to the wires is then inserted just beneath the skin surface
• DBS produces instantaneous results, and seems to work on even severe cases of depression that have been unresponsive to other treatments
• side effects such as internal bleeding and infection from the surgical insertion of the wires
• can cause relatively benign experiences such as spontaneous laughter and penile erections, but it can also trigger more troublesome states of depression or aggression