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Western University
Psychology 1000

Treatment: Somatic Therapy Psychosurgery Electroconvulsive Therapy Drug Therapy What are the various options for somatic therapy? Why would you employ psychosurgery or ECT? How do psychoactive drugs work? Treatment  About 200 different forms of psychotherapy  Treatment of emotional or behavioral problems through psychological techniques  Note: Drugs… Somatic Therapy Somatic Therapy  Typically used in conjunction with some form of “Talking” Therapy  Patient may be too down to talk  May be suicidal  Psychosurgery  ECT  Drugs Psychosurgery  Brain surgery in the absence of obvious organic damage  Moniz (1935) reports a “calming effect” for prefrontal lobotomy  Simple, outpatient procedure  Separate pre-frontal lobes from the rest of the brain  Patients become more docile but… Refined procedure  Cingulectomy o Cut cingulum bundle o (Fibers connecting prefrontal lobes to limbic system) o Few side-effects (can influence strategy choice) o Seems effective for obsessive-compulsive disorder o Should be used only as a last resort o Never on patient who cannot consent o Irreversible ECT  Von Meduna (early 1900s) o Patients with epileptic seizures improved after attack  Cerletty (1937) uses electricity rather than drugs to induce seizure  Brief (less than 1 second) electrical current applied to head  Wild firing of neurons results in seizure and convulsions  Today, patients are anesthetized and partially paralyzed prior to treatment o Eliminates convulsion  Right hemisphere only o Less damage to verbal memory  3 to 12 sessions over several weeks  Only about 2.5% of patients treated  Can cause permanent brain damage even at low dosage  Why do this? o Increase monoamines o Antidepressant drugs are slow acting… may need to respond quickly  Note: was used for many disorders o E.g. schizophrenia o No useful effect o Last resort, consent required Drug Therapy  Useful psychoactive drugs introduced only about 50 years ago  Relieve symptoms by altering synaptic communication  Anti-Anxiety o Tranquilizers  Calming effect  Lower excitability  Heavily prescribed o Benzodiazepine (Diazepam, Valium)  Binds at specific receptor site and increases the sensitivity of GABA  Patients with neuroses prone to dependency  Occasional use can be beneficial  Can help reduce withdrawal symptoms  Chronic use not recommended  Should include some other therapy  Anti Depressants o Mood Elevators o Alter neurotransmitters o Tricyclic (Elavil)  Inhibit the re-uptake of serotonin and NE o MAO Inhibitor (Nardil)  Inhibits MAO… effectively leaving serotonin and NE in synapse  Need daily use  4 weeks for effectiveness  Tricyclics prescribed more often than MAO inhibitor  More side effects  Special diet  C
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