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ANTIPSYCHOTICS: PSYCHOTERAPEUTIC EDICATIONS – INTRODUCTION - Several medical revolutions that increased lifespan o Louis Pasteur (pasteurization, rabies vaccine, germ theory) o Selman Waksman (antibiotics) o Organ transplantation o 1950s psychopharmacology (ability to treat psychiatric illness through pharmacologic compounds) o Personalized medicine (genomic screening) – DNA screening to identify which forms of treatment will and won’t work to cut down on trial and error and time lost - In the 60s, there was an explosion of drug culture but markets were flooded with psychotherapeutics also - Psychotherapeutics are medications that exert a special or unique effect on the mind or mental functioning o Therapeutic key word – help someone overcome a mental illness o Antidepressant, antipsychotics o Antianxiety medications o Antimanic drugs/mood stabilizers - In the past, psychiatric treatment focused on subduing patients, not curing them o Families would drop off patients at centers and patients never re-enter society - Psychotherapeutic medications completely changed this o These medications only used in US, Europe, and Brazil (most forward thinking in recognizing mental illness as a disorder with biological reason) o In US alone, >250k prescriptions/year - The national comorbidity survey replication o 9,000 people (no kids, teens, prisoners, homeless) o Tells us prevalence and comorbidity (two illnesses at same time) of mental illness o Focuses on anxiety but includes mood and impulse control and substance use disorders 1 in 4 adults will have disorder that will affect day to day function Half adults will meet the criteria for some mental disorder in a lifetime 50% of people with substance use disorder also have comorbid anxiety/depression In most cases, individuals do not get treatment/professional help, mostly due to the stigma (even in this country) PSYCHIATRIC DISORDERS - In these types of affective disorder (mood disorders) symptoms tend to have early onset o About half of those diagnosed with depression or anxiety show signs in early adolescence 50% by age 14 75% by age 24 o This means that there is developmental origin of these disorders If symptoms show during adolescence, then they must be (at least in part) due to maturation process
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A lot of grey matter and synapses but not a lot of white matter as child with a lot of brain connectivity but few connections between brain regions (synthesize, logic, etc.) adult has less grey and synapses, but more white matter Adolescence: multiple processes to transition (pruning – shaping into personality, beliefs, etc., synaptic strengthening via stimulation “fire together wire together” when two neurons frequently fire simultaneously, they form synapses and strengthens learning and cohort together. Hardwiring of certain circuits via maturation.
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