C16 Flashcards
Treatments for psychological disorders
Biological (drug therapy, psychosurgery, electric and magnetic therapies)
Psychological treatments (Psychodynamic, humanistic, behavioral, cognitive-behavioral, group)
Combined treatments (Drugs + psychotherapy, integrative therapies, mindfulness + psychotherapy)
Drug Therapies
Drugs can be used to treat, though not awlays cure, a wide variety of psychological disorders
Drug treatments for mood and anxiety disorders:
- Monoamine oxidase (MAO) inhibitors
- Tricylic antidepressants
- Selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, barbiturates, and lithium
Monoamine oxidase (MAO) inhibitors
One of the first in a class of drugs to treat depression. They slow down the action of the enzyme monoamine oxidase, which breaks down neurotransmitters in the brain (incl. others like norepinephrine, dopamine etc).
By INHIBITING the action, MAO allow more neurotransmitters to stay active in the synapse for a longer time, which presumably improves mood. Problem is that MAO inhibitors interact with food and when taken with common drugs like antihistamines, it produces very dangerous side effects, like dangerously high blood pressure, so not commonly prescribed for depression
Drug names include Nardil, Parnate.
Trycyclic antidepressants
Drugs used for treating depression as well as chronic pain, ADHD, and bedwetting.
Marketed under names like Elavil and Anafranil. They block the reuptake(absorption) of serotonin and norepinephrine almost equally, making these neurotransmitters more available in the brain. They produce unpleasant side effects like dry mouth, weight gain, irritability, confusion, and constipation
Many of these side effects are due to their impact on norepinephrine. People with depression have serotonin deficiencies so blocking both has its warts
Selective serotonin reuptake inhibtiors (SSRI)
Drugs prescribed primarily for depression and some anxiety disorders that work by making more serotonin available in the synapse
Introduced in the 90s. Better than trycyclic because it only targets serotonin, which causes fewer side effects. Common names is Prozac, Coloft, Paxil, and Celexa. Widely used today.
Very popular, even without the ill. Can be used to treat OCD, anxiety disorders, and compulsive gambling problems.
How do SSRI’s work?
Inhibits reuptake process so that more serotonin can bind with the postsynaptic neuron. By allowing more serotonin to be used, it alleviates some smyptoms of depression.
Drugs that affect both serotonin and norepinephrine can reduce depression, but produce side effects compared to those that just affect serotonin like SSRI
Side effects of SSRI
Agitation, insomnia, nausea, and difficulty in achieving orgasm (but can be used to treat premature cum)
Also a small infrequent side effect is that more teens commit suicide on SSRI. But a meaningless research since they are depressed and SSRI happens to be the most popular drug, they’d do it anyway
Bupropione (Wellburtin)
A widely used antidepressant that is unrelated to tricyclics, MAO inhibitors, and SSRIS. It inhibits the reuptake of norepinephrine and dopamine, both of which are excitatory neurotransmitters involved in arousal and positive emotion
Marketed under Zyban, as a smoking cessation/quitting aid. Wellburtin the name of antoher drug
Benzodiazepines and barbiturates
A class of anxiety reducing drugs.
Benzodiazepines can be addictive but less dangerous than barbiturates. Barbiturates has the higher risk of overdose. Both having calm effects and both can be addictive.
Drug names:
Benzodiazepines - Valium, Librium
Barbiturates - Pentobarbital
Lithium
A salt that is prescribed for its ability to stabilize the mania associated with bipolar disorder.
Influences glutamate, which plays a role in schizophrenia. Taking lithium can be dangerous and unpleasant. Side effects can be disarrhea, nausea, tremors, cognitive problems, kidney failure, briain damage, and adverse cardiac effects. It is difficult to determine an overdose amount. Some people become tolerant to it after a while, reducing its effectiveness. This drug requires regular blood tests by physicians. Doctors would rather use atypical antipsychotics to treat mania episodes instead of lithium, evidence of lithium helping is weak
Phenothiazines
Drugs used to treat schizophrenia. Help diminish hallucinations, confusion, agitation, and paranoia, but also has side effects
Since there is excess dopamine in people with schizophrenia, these drugs reduce dopamine in the brain.
Traditional antipsychotics
Historically the first medications used to manage psychotic symptoms.
Phenothiazines drugs such as chlorpromazine(Thorazine) or haloperidol(Haldol) are known as these. These drugs have many bad side effects. Include fatigue, visual impairments, and a condition called tardive dyskinesia (fcial spasms like grimacing and lip smacking) and body tremors
Atypical antipsychotics
Newer antipsychotic drugs that do not have side effects of creating tardive dyskinesia.
Clozaprine(Clozaril), Zyperexa, and Risperdal are examples of atypical antipsychotics. These are now considered first line of treatment for schizophrenia. These drugs preferentially block a different type of dopamine receptor than the traditional drugs do, which makes tardive dyskinesia less likely.
Some side effects can happen. In rare cases, excess of serotonin can happen which can lead to tremor, diarrhea, delirium, neuromuscular rigidity, and high body temperature. These medications can also produce weight gain, increased risk of diabetes, a reduction in white blood cells, and rarely a kind of cancer.
Prefrontal lobotomy
A form of psychosurgery in which the connections between the prefrontal cortex and lower portion of the brain are severed; no longer in use.
Since the prefrontal cortex is about thinking and the lower portion is for emotions, the thought was to modify behavior and possibly disengage disprutive thought patterns involved in halluciations and confused thinking
Produces profound problems and personality changes. Had the danger of leading to a vegetative state, listless, or subject to seizures
Rosemary kennedy, john’s younger sister, underwent this surgery to treat her erratic often violent mood swings. instead of reducing the effects, it left her mentally incapacitated. She would stare blankly at walls for hours and lost the ability to speak coherently.
Rare today, considered inhumane and cruel. Traditional psychotics would replace this old practice.
