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
Are all meds classified exclusively in one category?
No
26
What do names and classifications insinuate?
- the symptoms they alleviate - conditions (ex: depression) are concrete disease states
27
What are the 3 Frameworks of thinking about diagnosis and drug treatment?
Consensus statements, evidence based medicine, causal reasoning/pharmalogical reason
28
What is Consensus statements
- 'treatment guidelines' - developed by 'neutral' experts in an attempt to resolve controversial questions - produce guidelines for clinical treatment and care of particular conditions
29
What is evidence based medicine?
- ranks medical knowledge and research by level of evidence supporting the knowledge - large clinical trials
30
What is Causal Reasoning?
- physicians consider patient's response to med as a process of arriving at diagnosis - this can promote off label prescribing and poly pharmacy
31
What is off label prescribing
- use of meds for reasons not officially approved by drug regulators
32
What is Polypharmacy?
- simultaneous use of 5 or more prescription drugs
33
What is de-prescribing?
- term than began appearing in med journals partially due to concern about unforeseen adverse effects stemming from combinations
34
The assumptions underlying the use of psychiatric meds include...
- 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
What is the acute phase?
- direct response to personal trauma... drug treatment = brief, once symptoms resolved drug treatment stopped
36
What is Maintenance phase?
- remaining symptom free for more than 20 weeks deemed recovery
37
What is maintenance therapy?
- 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
What is the dual nature of psychopharmaceuticals?
Meds and commercial products - aggressively marketed, heavily shapes beliefs about mental illness and assumptions on how to respond to mental distress