Chapter 10 Psychotherapeutic Drugs

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