PSYC340 Lecture Notes - Lecture 9: Atypical Antipsychotic, Valproate, Antipsychotic
9 Jun 2018
School
Department
Course
Professor
CHAPTER #9
anti-anxiety drugs: relieve tension, apprehension, and nervousness, most popular drugs are Valium
and Xanax (the proprietary names for diazepam and alprazolam) as well as other drugs in the
benzodiazepine family often called tranquillizers, drugs that exert their effects almost immediately
and can be fairly effective in alleviating feelings of anxiety, however, their effects are measured in
hours so their impact is relatively short-lived, routinely prescribed for people with anxiety disorders
but are also given to millions of people who simply suffer from chronic nervous tension, side
effects include drowsiness, depression, nausea, and confusion and have potential for abuse, drug
dependence, and overdose, as well as withdrawal symptoms when treatment is stopped
antidepressant drugs: gradually elevate mood and help bring people out of depression, reliance
has increased dramatically in the last 10-15 years, as they have become the most frequently
prescribed class of medication in North America, prior to 1987 there were two principal classes
(tricyclics such as Elavil and MAO inhibitors such as Nardil) which affect neurochemical activity in
different ways and tend to work with different patients, overall, they are beneficial for about 2/3 of
depressed patients, tricyclics have fewer problems with side-effects and complications than the
MAO inhibitors, today psychiatrists are more likely to prescribe a newer clsass of antidepressants
called serotonin reuptake inhibitors (SSRIs) which slow the reuptake process at serotonin synapses,
drugs include Prozac (fluoxetine), Paxil (paroxetine), and Zoloft (sertraline), which seem to yield
therapeutic gains similar to the tricyclics while producing fewer unpleasant/dangerous side effects,
SSRIs have also been proven valuable in treating OCD, panic disorders, and other anxiety
disorders, there is some doubt about how effective SSRIs are in relieving episodes of depression
among patients suffering from bipolar disorder, the variuous types of antidepressants exert their
effects gradually over a period of weeks but zbout 60% of patients’ improvement tends to occur in
the first two weeks, a major concern in recent years has been evidence from a number of studies
that SSRIs increase the risk for suicide primarily in adolescents and young adults, the increased
suicide risk appears to be a problem mainly in the first month of treatment, especially the first 9
days, thus, patients starting on SSRIs should be carefully monitored, a new class of antidepressants
known as SNRIs, which inhibirt reuptake at both serotonin and norepinephrine synapses, appear to
produce slightly stronger antidepressant effects than SSRIS (drugs known as venlafaxine called
Effexor, and duloxetine called Celexa), however targeting two neurotransmitter systems also leads
to a broader range of side effects such as troublesome elevations in blood pressure
antipsychotic drugs: used to gradually reduce psychotic symptoms of hyperactivity, mental
confusion, hallucinations, and delusions, primarily in the treatment of schizophrenia and also people
with severe mood disorders who become delusional, trade names are Thorazine (chlorpromazine),
Mellaril (thioridazine), and Haldol (haloperidol), traditional anti-psychotics appear to decrease
activity at dopamine synpases, although the exact relationship between their neurochemical and
clinical effects remains obscure, studies suggest antipsychotics reduce psychotic symptoms in about
70% of patients, patients usually begin to respond to treatment within 1-3 weeks, many patients are
placed on them indefinitely to avoid relapse into an active schizophrenic episode, side effects
include drowsiness, constipation, and dry mouth, as well as sympoms that resemble Parkinson’s
such as muscle tremors, muscular rigidity, and impaired motor coordination, often when patients are
discharged from the hospital they discontinue their treatment because of the side-effects and 70% of
patients relapse within a year, they may also cause a more severe and lasting problem called tardive
dyskinesia, seen in about 20-30% of patients who receive long-term treatment, atypical
antipsychotic drugs: a newer class of antipsychotic agents (clozapine, olanzapine, quetiapine) that
appear to be rouyghly similar to first-generation antipsychotics but offter some advantages, such as
find more resources at oneclass.com
find more resources at oneclass.com
helping some treatment-resistant patients who do not respond to traditional antipsychotics, they
produce fewer unpleasant side effects and carry less risk for tardive dyskinesia, but they also carry
some risks such as increasing a patients’ vulnerability to diabetes and cardiovascular problems
mood stabilizers: drugs used to control mood swings in patients with bipolar mood disorders,
lithium was the only effective drug in this category for many years and has proven valuable in
preventing future episodes of both mania and depression in patients with bipolar illness, lithium can
also be used in efforts to bring patients out of current manic/depressive episodes, however
antipsychotics and antidepressants are more frequently used for these purposes, lithium has some
dangerous side effects if it isn’t managed skilfully (lithium levels in the patients blood must be
monitored carefully because high concentrations can be toxic and even fatal), kidney and thyroid
gland complications are other major problems associated with lithium therapy, in recent years a
number of alternatives to lithium have been developed, the most popular is an anticonvulsant agent
called valproate and has become more widely used than lithium in the treatment of bipolar
disorders, Valproate appears to be roughly as effective as lithium in treating current manic episodes
and preventing future affective disturbances with fewer side effects, a combo of valproate and
lithium may be used in treatment in some cases
clinical psychologists: training emphasizes the treatment of full-fledged disorders
counselling psychologists: training is slanted towards the treatment of everyday adjustment
problems
psychiatrists: physicians who specialize in the diagnosis and treatment of psychological disorders,
many also treat everyday behavioural problems, however, in comparison to psychologists,
psychiatrists devote more time to relatively severe disorders (schizophrenia, mood disorders) and
less time to everyday marital, family, job, and school problems, have an M.D. degree and their
graduate training requires for years of course work in medical school and a four-year apprenticeship
in a residency at a hospital, increasingly emphasize drug therapy that the other, nonmedical helping
professions cannot provide, In comparison to psychologists, psychiatrists are more likely to use
psychoanalysis and less likely to use group or behaviour therapies
dream analysis: the therapist interprets the symbolic meaning of the client’s dreams, clients are
encouraged and trained to remember their dreams, which they describe in therapy and the therapist
then analyzes the symbolism in these dreams to interpret their meaning
free association: clients spontaneously express their thoughts and feelings exactly as they occur,
with as little censorship as possible, clients expound on anything that comes to mind regardless of
how trivial, silly, or embarrassing it might be and gradually, most clients begin to let everything
pour out without conscious censorship, the analyst studies these free associations for clues about
what is going on in the client’s unconscious
interpretation: the therapist’s attempts to explain the inner significance of the client’s thoughts,
feelings, memories, and behaviours, contrary to popular belief, analysts do not interpret everything
and they generally do not try to dazzle clients with startling revelations, instead, they move forward
inch by inch, offering interpretations that should be just out of the client’s own reach
mental hospital: both public and private mental hospitals that specialize in the care of people with
psychological disorders, many general hospitals have a psychiatric ward and those that do not
usually have psychiatrists/psychologists on staff/on call, tend to concentrate on inpatient treatment,
many provide outpatient therapy as well
deinstitutionalization: : transferring the treatment of mental illness from inpatient institutions to
community based facilities that emphasize outpatient care, made possible by the emergence of
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Mellaril (thioridazine), and haldol (haloperidol), traditional anti-psychotics appear to decrease activity at dopamine synpases, although the exact relationship between their neurochemical and clinical effects remains obscure, studies suggest antipsychotics reduce psychotic symptoms in about. Psychoanalysis includes the use of free association and the analysis and interpretation of dreams, resistances, and transferences: client-centred therapy is an insight therapy that emphasizes the provision of a supportive emotional climate for clients. The goal of therapy is to produce a change in maladaptive behaviours: couples and family therapy is an insight therapy that focuses on intimate and relationship issues, often via communication. Blended therapies: eclectic clinicians see value in using a combination of therapies, where warranted. This might include using therapies simultaneously or one-at-a-time, depending on the types of therapies used and the needs of the client. Double-blind method: to evaluate the effectiveness and safety of drug therapy, it is necessary to test all drugs before they are allowed to be used.
