PS101 Lecture Notes - Electroconvulsive Therapy, Tricyclic Antidepressant, Tardive Dyskinesia

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PSYCHOLOGY LECTURE November 27,29 2012
FINAL EXAM:
- Dec 13th at 7:00pm
- 75 questions worth 25% based on the 8 chapters covered this term plus
appendix A
- 15 questions based on last 3 chapter 14, 15, 16 (5 each)
- Final is worth 38%
APPROACHES TO TREATMENT AND THERAPY
Types of therapy
Range from pills to psychodynamic
Some are less popular today
Not mutuality exclusive, some can be combined very effectively (some
cannot)
Three classes of therapies: Talk, Behaviour, Biology
FIGURE 14.2
Biological Treatment (in order)
- Drug treatment
- Electro convulsive shock
- Psychosurgery (last resort) a one way street, can do things to brain but
cannot undo them
Drug Treatment
- Psychoactive drugs have revolutionized the treatment of mental disorder
- The number of people in institutions dropped
Cautions:
- Placebo effect
The apparent success of a treatment that is due to the patients
expectation and hopes rather than to the drug or treatment itself
Meta-analysis (when you have a group of studies and you look at them
altogether) indicate that clinicians considered medication hopeful yet
patient ratings in treatment groups were no greater than patient
ratings in placebo groups
- High relapse and dropout rates
There may be short term success but many patients (50%-66%) stop
taking medication due to side effects
Individuals who take antidepressants without learning to cope with
problems are more likely to relapse
- Dosage problem
Finding the therapeutic window or the amount of medication that is
enough but not too much
Genetic differences
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Drugs may be metabolized differently in:
o Men and women, old and young, and in different ethnic groups
o Groups may differ in tolerable dosages due to variation in
metabolic rates, amount of body fat, number of type of drug
receptors in the brain, smoking and eating habits
- Long-term risks
Antipsychotic drugs can be dangerous, even fatal if taken for many
years
o Tardive dyskinesia
Antidepressants are assumed to be safe but no long term studies have
been conducted
Many doctors and the public overlook the possibility if long-term
dangers when a drug shows short run benefits
- Ease of use
Over prescription 200 million a year
Little harm
Cost effective
Drug treatments
o Do not cure the disorder
o Do not teach client coping & problem solving skills to deal with
stress
o Can bring symptoms under control & other therapeutic
o Techniques can be incorporated
FIGURE 17,18
Antipsychotic Drugs
- Many block or reduce sensitivity of brain receptors that respond to
dopamine
- Some increase evels of serotonin, a neurotransmitter that inhibits dopamine
activity
- Can relieve positive symptoms
Antidepressant Drugs
- Monoamine oxidase inhibitors (MAOIs)
Elevate norepinephrine and serotonin in brain by blocking an enzyme
that deactivates these neurotransmitters
- Tricyclic antidepressants
Boost norepinephrine and serotonin in brain by preventing normal
reuptake of theses substances
- Selective serotonin reuptake inhibitors
(e.g Prozac)
Problem for Drug therapy
- Time course of action
- Changes in brain have to change learned responses
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Document Summary

75 questions worth 25% based on the 8 chapters covered this term plus appendix a. 15 questions based on last 3 chapter 14, 15, 16 (5 each) Not mutuality exclusive, some can be combined very effectively (some cannot) Three classes of therapies: talk, behaviour, biology. Psychosurgery (last resort) a one way street, can do things to brain but cannot undo them. Psychoactive drugs have revolutionized the treatment of mental disorder. The number of people in institutions dropped. The apparent success of a treatment that is due to the patients expectation and hopes rather than to the drug or treatment itself. Meta-analysis (when you have a group of studies and you look at them altogether) indicate that clinicians considered medication hopeful yet patient ratings in treatment groups were no greater than patient ratings in placebo groups. There may be short term success but many patients (50%-66%) stop taking medication due to side effects.

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