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Unformatted text preview: Chpt 17 Treatment of Mental Disorders 88.1 Chapter 17: TREATMENT OF MENTAL DISORDERS. {pp 634-66“ BIOM EDICAL THERAPIES Pharmacotherapies from Gleitman: "Psychology“, 7th edition. 2007 *[Dear student, pay very close attention to the following table which lists some commonly used psychotropic medications. their functions. drug class, chemical name. and trade name. These drugs are referred to in the text and lecture by one or another of their names or classes. These are the ones on which I might test you.] Antidepressants MAO inhibitors Pheneizine Nardil Tricyciics lmipramine Tofranil SSRl's Fluoxetlne Prozac Atypicals Bupropion Wellbutrin Antipsychotics Classic Chlorpromazine Thorazine Atypicals Ciozapine Clozaril Antimanics -- Lithium carbonate Eskalith — Carbamazapine Tegretol Anxiolytics Benzodiazepines Diazepam Valium Atypicals Buspirone Buspar Drug Treatment of Schizophrenia: Antipsychotics *{In Chapter 16, we saw that one of the major arguments offered by adherents of a biochemical theory of schizophrenia is the effectiveness of certain drugs such as: (1} chlorpromazlne (its pharmaceutic name is Thorazine). which beiongs to a drug class called the phenothiazines and (2) halomridoi [its trade name is Haldoll which belong to the drug class the bu_tyroghenones. These drugs specifically reduce many of the maior symptoms of schizophrenia. such as thought disorder.wid1drawal, and hallucinations but have no effect on symptoms that are not specific to that disorder. These drugs bionkade synaptic receptors in pathways of the brain that are sensitive to dopamine. and it is this blockade that is generally thought to produce the therapeutic effects] | The social reality of treating schizQMrenics: Know something of the history of treating schizophrenics. the advances wrought by the discovery and use of the antipsychotic medications, the effect on deinstitutionalization of schizophrenics and some of the problems assooiated with deinstitutionalizatlon.] Drug Treatment of Depression: Antidepressants *[There are three classes of antidepressants: monoamine oxidase {MAO} inhibitors. trigycllcs, and selective serotonin reuptake inhibitors. The tricyclics. of which imlgamine (its pharmaceutical name is Tofranil) is a member, are the more widely used than MAO Inhibitors because they are more effective and have fewer side-effects. Both ciasses of antidepressants work by increasing the amount of the transmitters—notepineghrine and serotonin-available for synaptic transmission but they do this in different ways: The tricycilcs decrease the rate of removal of the transmitter from the synapse by slowing down its re-uptaite Into the presynaptic tenninai. The MAO Inhibitors decrease the rate of enzymatic breakdown of norepinephrlne andlor serotonin in the synapse. However, these drugs are eflective in about 85% of depressives. An often more successful class of antidepressants are the M serotonin retrain inhibitors such as Prozac. They have few side effects (mainly some reduced sexual desire). Many cases of obsessive-compulsive disorder, panic disorder, bulemia. etc. also respond well to these drugs} Drug Treatment of Bipolar Disorder: Antlmanics *[Ltthium carbonate (Eskalith) ls used to treat the manic phase of the bipolar mood disorder. The manic episodes subside within 5-10 days after lithium treabnent starts. Reducing the manic phase seems also to forestall the depressive episodes. The mechanisms of action are unknown but may involve restricting the availability of norepinephrine for release into the synapse during the manic phase} [Eskaiith works for 60% to 80% percent of the patients but does have unwanted side effects (weight gain, dry mouth, tremors] affecting compliance and must have its level in the blood carefully monitored because of deadly toxic effects if only a bit over the effective level. Therefore, several safer alternative anti-monies have been developed, a prominent example being carbamazine (Tegretol) Drug Treatment of Anxiety: Anxlolytics *{Valium and Xanax apparently work to decrease anxiety by increasing neurotransmlsslon at synapses containing the neurotransmitter GABA. They are useful as short-tom treatments for generalized anxiety disorder, post-traumatic stress disorder, alcohol withdrawal. Insomnia, muscle spasms and tension headaches. They, however. are highly addictive and thus unsuitable for long-term treab'nentl {Evaluating a Drug Treatment} [See “How Should Therapy Be Evaluated," at the end of this annotated chapter} ...
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