PSY240: chapter 5 Treatments for abnormality
System of mental health services has four major sectors: speciality mental health
sector includes: psychiatrist, psychologist, psychiatric nurses, and psychiatric social
workers who are trained specifically to treat people with mental disorders.
General medical or primary care sector includes health care professionals, such as
internists, pediatricians and nurse practitioners, who may not be specifically trained in
mental health treatment, but are often the initial point of contact, or the only source of
mental health services, for people with mental health problems.
Human services sector includes: social services, school-based counseling services,
residential rehabilitation services, criminal justice services and religious professional
Voluntary network sector includes: self-help groups, such as alcoholics anonymous
(AA), is a growing component of the mental health treatment system.
In Canada, it is estimated that approximately 3% of the adult population has attended
an AA meeting.
37% of Canadians who suffer from mental disorders or substance dependence use some
type of health care or community resources.
However, most people who might benefit from treatment are getting no treatment at all.
Proponents of biological theories of mental disorders most often prescribe medication.
Psychotherapy: prescribed when psychological and some social approaches to
Psychotherapy can take many forms, but most involve a therapist (psychiatrist,
psychologist, clinical social worker, or marriage or family counselor) talking with the
person who has the disorder about his or her symptoms and what is contributing to
Drugs and psychotherapy may work on different aspects of a disorder, and they are
increasingly being used together in an integrated approached to disorders.
Antipsychotic drugs Reduce symptoms of psychosis (loss of reality testing, hallucinations,
Antidepressant Reduce symptoms of depression (sadness, loss of appetite, sleep
Lithium Reduce symptoms of mania (agitation, excitement, gradiosity)
Antianxiety drugs Reduce symptoms of anxiety (fearfulness, worry, tension)
Chlorpromazine: a drug to treat the symptoms of psychosis. Psychosis involves the
loss of touch with reality, hallucinations (unreal perceptual experiences) and delusions
(fantastic, unrealistic beliefs)
Chlorpromazine belongs to a group of chemical compounds called phenothiazines.
Which has a chemical structure very similar to that of synthetic violet and blue dye
products. They can act as antihistamines and thus were initially thought useful in the
treatment of allergies.
Phenothiazines also result in decrease in muscle tone, the reduction of nausea, and in
some cases either sedation or euphoria. PSY240: chapter 5 Treatments for abnormality
Physicians use phenothiazines to calm agitated patients, however, and to reduce
tremors in patients with parkinsons disease.
Can also reduce postsurgical shock, a neuroendocrine response to stress that can be
Pain was reduced so greatly in some patients that they did not require morphine.
Reduce hallucinations and delusions of some psychiatric patients.
Reduce agitation, excitation, confusion and paranoia in psychotic patients.
Labeled chlorpromazine as Neuroleptic: drug depresses the activity of the nervous
Butyrophenone: another class of drugs that can reduce psychotic symptoms.
However, phenothiazines and butyrophenone also produce a number of dangerous side
Side effects include: sedation, visual disturbances, tardive dykinesia, neurological
disorder characterized by involuntary movements of the tongue, face, mouth or jaw.
Drugs reduce levels of the neurotransmitter dopamine or influence receptors for
dopamine in the brain.
Drugs that relieve the symptoms of psychosis- led to a revolution in the treatment and
lives of people with psychosis, who had been locked away in psychiatric hospitals and
institutions, perhaps for life, often completely out of touch.
Side effects: euphoria.
Drugs are now called MAOIs. Inhibit the enzyme monoamine oxidase in the brain,
which results in higher levels of a number of neurotransmitters such as norepinephrine.
MAOIs has dangerous side effects include: throbbing headaches, jaundice, rise in blood
pressure, especially mixed with certain types of food.
Because of these side effects, other drugs are use more often.
Until 1980s, antidepressants most often used were tricyclic antidepressants,
energized patients and elevated their moods.
Side effects: sedation, dry mouth, blurred vision.
They work by inhibiting the reuptake of the neurotransmitters norepinephrine,
serotonin and perhaps dopamine in the brain.
Today more than 40 million people have taken Prozac. Antidepressant treatment rates
for those diagnosed with major depression in Canada have been increasing.
SSRIs, became popular that many people can tolerate the side effects of SSRIs, better
than the side effects of the tricyclics.
Side effects: nausea, diarrhea, headache, tremor, daytime sedation, failure to achieve
orgasm, nervousness and insomnia.
Newest antidepressants drugs are designed to target both serotonin and
norepinephrine. People with depression are often given combinations of
antidepressants drugs and lithium or antianxiety drugs.
Antidepressant Use and Suicidality:
Side effect from antidepressant use is increased suicidality, particularly in children and
Primary purpose of the label is to warn consumers of the heightened risk of suicidal
thinking and behaviours in children, adolescents and young adults taking
antidepressant medications, particularly in the first several months.PSY240: chapter 5 Treatments for abnormality
SSRI did increase the risk of completed or attempted suicide among adolescents (18 to
24 years old), however, the risk was decreased among adults (25 and older).
Among 65 and older, SSRI appeared to provide a protective effect.
SSRIs was associated with increased risk in adolescence but decreased risk among
adults and older people.
Antidepressants also help to reduce depression and suicidality in others.
Lithium and other mood stabilizers:
Lithium: metallic element that is present in the sea, in natural springs, and in animal
and plant tissue. It has been used to treat a number of medical disorders, with weak
results. In the middle of the nineteenth century, it was widely used to treat rheumatism
and gout. There was a relationship between these disorders and mania: a condition in
which people experience agitated, excited and grandiose ideas.
Lithium had a powerful calming effect. It could be used to treat mania. But it is a very
dangerous substance and can have many severe side effects, even death.
Anticonvulsants, and calcium channel blockers: are also being used in the treatment
of mania. These drugs have fewer side effects than lithium.
Anxiety and insomnia are the symptoms for which drugs are most often prescribed.
Barbiturates: suppress the central nervous system, decreasing the activity of a variety
of types of neurons. Although these drugs are effective for inducing relaxation and