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Chapter 16

PSYC 1200 Chapter 16: Chapter 15 - Treatment with drugs

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University of Manitoba
PSYC 1200
Dawson Clary

Treatment with Drugs:   Psychopharmacotherapy is the treatment of mental disorders with medication  Drug therapy   4 main categories: o Antianxiety drugs o Antipsychotic drugs o Antidepressant drugs o Mood-stabilizing drugs Antianxiety Drugs:   Antianxiety drugs relieve tension, apprehension, and nervousness  Most popular: Valium (diazepam), Xanax (alprazolam)    These drugs in the benzodiazepine family are called tranquilizers  Measured in hours so their impact is relatively short lived    Prescribed for anxiety disorders and people who suffer from chronic nervous tension  Side effects: drowsiness, depression, nausea, confusion   Also withdrawal treatment when drugs are stopped OSDP Antipsychotic Drugs:  Primarily in the treatment of schizophrenia    Also given to people with severe mood disorders who become delusional  Thorazine (chlorpromazine), Mellaril (thioridazine), Haldol (haloperidol)   Antipsychotic drugs are used to gradually reduce psychotic symptoms, including hyperactivity, mental confusion, hallucinations, and delusions   Decrease activity at dopamine synapses, although the exact relationship  between their neuro-chemical effects and their clinical effect remain unknown  Gradual – respond in 1-3 weeks    Several months – improvement  Unpleasant side effects: drowsiness, constipation, dry mouth are common    Produce effects that resemble the symptoms of Parkinson’s disease   May cause more severe and lasting problem called tardive dyskinesia  Tardive dyskinesia is a neurological disorder marked by involuntary writhing  and tic-like movements of the mouth, tongue, face, hands or feet o No cure   Newer class of antipsychotic agents called atypical antipsychotic drugs, such as clozapine, olanzapine, and quetispine   Similar to the first generation in therapeutic effectiveness, but they help some treatment resistant patients who do not respond to the normal treatment drugs, and have fewer side effects (also less risk for tardive dyskinesia) Antidepressant Drugs:  Antidepressant drugs gradually elevate mood and help bring people out  of depression   Prior to 1987, there were two principal classes of antidepressants: tricyclics and MAO inhibitors   Newer class of antidepressants called selective serotonin reuptake inhibitors (SSRI), which slow the reuptake process at serotonin synapses   Prozac, Paxil, Zoloft   SSRI’s have also proven valuable in the treatment of OCD, panic disorders and other anxiety disorders    Gradually over a period of weeks – improvement  Provided a relatively modest benefit for patients with mild to moderate depression    SSRI’s decrease risk of suicide, mostly in adolescences and young adults  First month after starting (first 9 days) – increased suicide risk   Patients should be carefully watched at the beginning OSDP  The newest class of antidepressants consists of medication that inhibit reuptake at both serotonin and norepinephrine synapses, referred to as SNRI’s    Venlafaxine, Duloxetine  Slightly stronger effects than SSRI’s Mood Stabilizers:  Mood Stabilizers are drugs used to control mood swings in patients with bipolar mood disorders    Lithium was the only effective drug many years ago  It prevents future episodes of both mania and depression   Lithium can also be used in effects to being patients with bipolar illness out of  current manic or depressive episodes  Toxic and even fatal – kidney and thyroid gland complications   Newer mood stabilizers in an anticonvulsant agent called valproate, which has become more widely used than lithium in the treatment of bipolar disorder   Fewer side effects   Combination of lithium and valproate may be used in treatment How Effective Are Drug Therapies?:  Some critics argue that drug therapies are not as effective as advertised and  that they often produce superficial, short-lived curative effects  Critics also argue that many drugs are overprescribed and many  patients overmedicated  Critics also argue that the side effects are underestimated and are often worse than the illness that the drug is supposed to cure Electroconvulsive Therapy (ECT):  1930’s thought that schizophrenia and epilepsy could not both exist in same body    Inaccurate – initially drug was used to activate the seizures  Safer now to elicit seizures with electric shock   Electroconvulsive therapy is a biomedical treatment in which electric shock is  used to produce a cortical seizure accompanied by convulsions  Electrodes are attached to the skill over the temporal lobes of the brain   Electric current is then applied either to the right side or to both sides of the brain for about a second   The current triggers a brief convulsive seizure (30 seconds)   Critics argue that E
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