Lecture 29- Psychotherapeutics Flashcards
Final Exam!
What does it mean to be a “psychotherapeutic” drug?
- “Exert a special or unique effect on the mind or mental functioning”
- Key word: therapetic
What were some non-pharmacological treatments used throughout history to treat mental illness?
- Bloodletting (removing blood to “remain in proper balance”)
- hot irons
- flogging (hit w whip or stick)
- revolving chairs
- starvation
- sneezing powder
What was the goal of historical non-pharmacological treatments for mental illnesses?
- to “cleanse” those with mental illness
- was done without scientific report
What is a lobotomy?
- a discredited form of neurosurgical treatment for psychiatric disorder or neurological disorder that involves severing connections in the brain’s prefrontal cortex
- used in late 19th and early 20th centuries
What did Louis Pasteur invent/find?
- discovered the principles of vaccination
- pasteurization (the partial sterilization via mild heat of a product to make it safe to consume and imporve its keeping quality)
- germ theory (idea that cerain diseases are caused by the invasion of the body by microorganisms)
19th century (1800s)
What did Semon Waksman find/invent?
- antibiotics
- streptomycin (treats TB and other infections) and neomycin (treats and prevents infection in minor cuts, scrapes, or burns as well as hepatic coma)
WWII era
What did Emil Kraepelin, Phillip Pinel, and JE Esquirol do? When did this occur?
- developed a mental illness classification system
- believed scientific understanding was a prerequisite for treatment
pre-3rd revolution (pre-chlorpromazine era), 1800s-early 1900s
What was cannabis used for pre-3rd revolution (pre-chlorpromazine era)?
- Moreau used cannabis for treating depressin and manic patients
- Had temporary effects
- Replace disorder’s symtpoms with “good” effects of drugs
Historical overview
What were amphetamines used for?
narcolepsy
Historical overview
What was CO2 used for?
neuroses and psychoses
Historical overview
What were other historical methods for treating mental illness?
- antihistamines
- insulin shock
- psychosurgery (surgically disconnecting brain structures)
- electroshock therapy (still used today)
Lithium historical overview
- John Cade discovered lithium’s abilities to treat mania in the 1940s
- Not approved in the US until 1970 due to toxicity concerns
- Still used today for bipolar disorder
What is the National Comorbidity Survey Replication (NCS-R)?
- 9,000 adult household survey (age 18+)
- focused on anxiety (panic, PTSD), mood (depression, bipolar), impulse-control (ADHD), substance abuse
- didn’t include homeless, institutionalized, or prisoners
- didn’t access less common psychiatric disorders like schizophrenia and autism
done in 2005
National Comorbidity Survey Prelication (NCS-R) Findings:
According to this survey, how many adults are affected by mental illness?
- 1 in 4 US adults yearly
- of which 1 in 4 had a serious disorder that affects day to day
- around 50% of US adults meet criteria for mental illness at some point in lives
National Comorbidity Survey Prelication (NCS-R) Findings:
What were the percentages of various mental illness found in this survey?
- anxiety- 18%
- mood- 10%
- impulse- 9%
- substance- 15%
- comorbidity in about half
National Comorbidity Survey Prelication (NCS-R) Findings
According to this survey, did most people get treatment for their mental illness symptoms?
NO
National Comorbidity Survey Prelication (NCS-R) Findings:
According to this survey, when do symptoms appear?
- early
- 1/2 experienced symptoms by 14 years old
What is considered serious mental illness according to the NIMH?
mental, behavioral, or emotional disorder resulting in serious functional impairment, interfering with or limiting major life activites
Do men or women use more psychotherapeutics?
women’s psychotherapeutic usage is 2 times higher than men’s
How does psychotherapeutic use change with age?
use increases with age, most dramatically in men
In which types of individuals is higher psychotherapeutic use seen?
- living alone
- more education
- more income
Problems with psychotherapeutics
- criminal
- medical
- misuse (including non-intentional)… like w benzodiazepines that we previously discussed
Famous patients with schizophrenia
- John Nash- won the nobel prize in Economic Sciences (1994)
- Elyn Saks- professor of law, psychology, and behavioral sciences at University South Carolina
Famous patients with MDD
- Dwane Johnson
- Jim Carrey
Famous patients with bipolar disorder
- Demi Lovato
- Mariah Carey
What is psychosis?
- loss of contact with reality
- disorganized thinking and bizarre behavior
What are antipsychotics?
- Phenothiazines neuroleptic medication (neural depressants) or major tranquilizers
- beginning with Chlorpromazine
Historical Overview: Chlorpromazine Era
Who synthesized Chlorpromazine and when?
- Paul Charpentier
- 1950
Historical Overview: Chlorpromazine Era
What was chlorpromazine initially used for?
- Anesthesia
- decreased surgical anxiety and shock
- suggested for use in psychiatry
Historical Overview: Chlorpromazine Era
What was chlorpromazine’s use in Val-de Grace military hospital (in Paris)
- Calmed psychotic patients, made them less excited
- thoughts became less chaotic
- did not exprience loss of consciousness
Historical Overview: Chlorpromazine Era
What happened as a result of chlorpromazine spreading worldwide?
- After chlorpromazine spread worldwide, the number of hospitalized psychiatric patients in the US dropped
- Went from 600,000 (1955) to 150,000 (today) psychiatric patients’ hospitalized
- Outpatient treatment/facilities have become more popular, and other drugs have certainly contributed to this
Post Chlorpromazine Era
What was Reserprine used for and what happened?
- used starting in 1954, originally intended for arterial hypertension
- Side-effect of symptoms of indifference
- took several weeks for effectiveness to kick in
- patients often depressed so ultimately never took off
What has happened historically post-chlorpromazine era?
Advances in:
* anti-anxiety (as previously discussed)
* antidepressants (MAOIs, tricyclics, SSRIs)
* ketamine
Also:
* Use of LSD as a model psychosis but with limited success
