Chapter 10 Psychotherapeutic Drugs



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Chapter 10

  • Psychotherapeutic Drugs


Classification of Mental Disorders

  • Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) provides criteria and classification

    • Anxiety disorders: unrealistic worries (i.e., phobias, OCD’s, PTSD, GAD)
    • Psychosis: major disturbance of intellectual and social functioning (two types)
      • Organic (known cause)
      • Functional (i.e., schizophrenia)


Classification of Mental Disorders, cont’d

  • Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) provides criteria and classification, cont’d

    • Mood disorder: depressed symptoms (i.e., dysthmia, bipolar disorder)


Treatment of Mental Disorders (Before 1950)

  • “Malaria Therapy” (1917)

  • “Narcosis Therapy” (1930’s)

  • Insulin shock therapy for schizophrenics (1930’s)



Treatment of Mental Disorders (Before 1950), cont’d

  • Induction of convulsions via drugs and electric shock [ECT] (1930-40’s)

  • Parahyde (sedative), a.k.a. “chemical straitjacket” (1950’s)



Treatment of Mental Disorders (After 1950)

  • Anti-psychotics (necroleptic)

    • Phenothiazines caused calmness without drowsiness
    • Shown to be more effective than placebos
    • Discontinuation lead to relapse 75-95% of patients within one year


Treatment of Mental Disorders (After 1950), cont’d

  • Anti-psychotics (necroleptic), cont’d

    • Mechanism of action results from blocking dopamine receptors and possibly seratonin
    • Are not addictive and extremely difficult to result in committing suicide


Anti-Depressants

  • Monoamine oxidase inhibitors (MAO’s), i.e., Nardil, Parnate

  • Tricyclic

  • Selective Seratonin Reuptake Inhibitors (SSRI), i.e., Prozac, Paxil



Mechanisms of Anti-Depressant Action

  • Works by increasing availability of seratonin or norepinephrine at respective synapses

  • “Lag period” exists resulting in a two-week window for improvements

  • Correct theories focus on the reaction of neurons to direct effects biochemically



Lithium

  • A salt (lithium chloride) substitute

  • Sedative properties identified in animal studies (1949)

  • Manic patients improved over depression and schizophrenia



Lithium, cont’d

  • Requires 10-15 days before symptoms decrease

  • Acts as a mood-normalizing agent for manic depression



Consequences of Drug Treatments for Mental Illness

  • Mental hospitals’ population has decreased since 1950

  • Liberation of mental patients to normal society

  • Prescription pad has replaced psychotherapy for many psychiatrists

  • 1/3 of homeless in the U.S. have some form of mental illness



Chapter 10

  • Psychotherapeutic Drugs





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