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mental illness > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

What are psychopharmaceuticals?

A

Medications that are psychoactive, impact mood, thoughts, or behaviour, prescribed for psychiatric reasons

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2
Q

What did psychopharmaceuticals do?

A
  1. impact on conceptualizing and categorizing illness
  2. highly prominent in modern treatment
  3. work alongside therapies, frontline position in treatment
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3
Q

What are different views on the role of psychopharmaceuticals?

A
  • cured mental illness and address chemical imbalance
  • aids recover process, allows progress and breakthroughs in therapy
  • placebo effect
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4
Q

What reshaped out thoughts about drugs?

A

Global consumer culture and psychopharmaceutical industry

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5
Q

What was the Patent Medicine sector of the market and what was on it?

A
  • unregulated, advertised directly to consumers without revealing all ingredients and used new substances, morphine and cocaine
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6
Q

What was Morphine and Cocatin sold and marketed by?

A

Morphine - relieve pain and nervous irritation, quiet restlessness, promote sleep
Cocaine - brain tonic and stimulant
- advertised as therapeutic

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7
Q

What did the unregulated sales of psychoactive substances associated with?

A
  • epidemic of addiction to opiates and cocaine in late 19th century
  • reformers advocated for control and regulations to manage distribution, reduce consumption, and health/social problems
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8
Q

What was the reform movement?

A
  • formalize and narrow what was deemed medicine and therapeutic to protect consumers
  • increased medical regulation of substances
  • sales of drugs by non physicians = criminalized
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9
Q

What was the US 1906 Food and Drug Act?

A

Requirement to disclose substances in labelling

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10
Q

What was the US 1914 Harrison Anti-Narcotic Act

A

physician prescription for sale of cocaine and opiates

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11
Q

What were implications from reform movement?

A
  • access to psychoactive drugs fully managed by physicians
  • substances were fully medicalized
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12
Q

What were Barbiturate and Amphetamines?

A
  • drugs used after decline in opiates and cocaine, widely prescribed, anxiety, insomnia, depression (not thought of as psychiatric drugs)
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13
Q

What did the large public appetite of barbiturates and amphetamines reveal?

A

-substances thought to be relatively safe, despite high rates of barbiturate overdose
- high prevalence of emotional and psychological suffering among people not institutionalized
- appetite for relief using psychopharmaceuticals
- perception of few side effects
- high barbiturates overdose rates = adverse public health effects of unrestricted psychopharmaceutical use

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14
Q

After WW2 what were two major reasons for psychoactive drugs to be understood as psychiatric medications?

A
  1. psychiatry expanding as a profession beyond asylums and into consumer realm, treating milder conditions
  2. new psychoactive meds became available (Thorazine - psychosis. Mood elevators - severely depressed. Miltown - anti anxiety)
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15
Q

What is Miltown?

A

first “blockbuster” Pharma drug with high consumption and large cultural impact, high demand = anxiety treatment legit, psychiatry was important by helping people, aggressively advertised towards women

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16
Q

What are some lessons from Miltown? (similar to barbiturates)

A
  • benefits overstated
  • risks/side effects harms understated (addiction and toxicity)
  • sales and profits
  • large consumer demand
17
Q

The field of psychiatry and new psychopharmaceuticals were partially shaped by…

A

commercial, professional, and cultural forces

18
Q

How did the political climate in the 1980’s boost biological psychiatry?

A
  • conservative
  • market driven policy
  • drug patents = profitable, more marketing and sales
  • health systems pressure on physicians to treat in shorter time = more prescribing (psychotherapy = time consuming)
19
Q

What does a drug need to do to be FDA approved?

A
  • needs to be more effective than a placebo (doesn’t need to be more effective than existing/competing meds)
20
Q

What is disease mongering and how did it impact pharmaceutical companies?

A
  • marketing strat
  • sell meds -> sell disease -> grow patient population -> develop markets -> increase prevalence and severity of mental illness and offer drug solutions
    -Pharma companies have great role in defining what is an illness, medicalize normal human experience and diversity
21
Q

What is Valium and how does it relate to feminism?

A
  • more American women overdose and dependence on Valium
  • feminists - valium prescribed to women for conditions that were social problems which stemmed from gender roles and relations rather than mental illness
  • led to changes in regulation and marketing of Valium
22
Q

What is the 3rd most common prescription among Americans 18-44

A

Antidepressants

23
Q

How much did antidepressant use increase in the US between 1988-2008?

A

400% (doubtful there was a 400% increase of depression)

24
Q

What are the three names drugs have?

A

chemical name, generic name, trade name(developed by Pharma companies, intentionally selected)

  • drug naming = often organized by families of diagnostic symptoms they alleviate or chemical structures of neuroreceptors targeted, or neurochemical mechanisms
25
Q

Are all meds classified exclusively in one category?

A

No

26
Q

What do names and classifications insinuate?

A
  • the symptoms they alleviate
  • conditions (ex: depression) are concrete disease states
27
Q

What are the 3 Frameworks of thinking about diagnosis and drug treatment?

A

Consensus statements, evidence based medicine, causal reasoning/pharmalogical reason

28
Q

What is Consensus statements

A
  • ‘treatment guidelines’
  • developed by ‘neutral’ experts in an attempt to resolve controversial questions
  • produce guidelines for clinical treatment and care of particular conditions
29
Q

What is evidence based medicine?

A
  • ranks medical knowledge and research by level of evidence supporting the knowledge
  • large clinical trials
30
Q

What is Causal Reasoning?

A
  • physicians consider patient’s response to med as a process of arriving at diagnosis
  • this can promote off label prescribing and poly pharmacy
31
Q

What is off label prescribing

A
  • use of meds for reasons not officially approved by drug regulators
32
Q

What is Polypharmacy?

A
  • simultaneous use of 5 or more prescription drugs
33
Q

What is de-prescribing?

A
  • term than began appearing in med journals partially due to concern about unforeseen adverse effects stemming from combinations
34
Q

The assumptions underlying the use of psychiatric meds include…

A
  • psychiatric illness “exist in nature” and have a natural course of illness (important to consider assumptions or the term “natural course of illness = biological and inherent)
35
Q

What is the acute phase?

A
  • direct response to personal trauma… drug treatment = brief, once symptoms resolved drug treatment stopped
36
Q

What is Maintenance phase?

A
  • remaining symptom free for more than 20 weeks deemed recovery
37
Q

What is maintenance therapy?

A
  • prescribing meds for extended periods or lifetime
  • disadvantage = labels people using these meds as chronically or permanently ill (chronic = stigma, persisting = less stigma)
  • discontinuation trials determine when and how people can stop using maintenance therapies
38
Q

What is the dual nature of psychopharmaceuticals?

A

Meds and commercial products

  • aggressively marketed, heavily shapes beliefs about mental illness and assumptions on how to respond to mental distress

mental illness (16 decks)

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