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Unformatted text preview: Therapy Therapy I. I. II. Biomedical Therapies Psychological Therapies I. Biomedical Therapies I. Biomedical Therapies
A. Drug Therapies 1. Antipsychotics – used to treat psychotic 1. disorders through blockade of dopamine a. Traditional (typical) – only relieved positive symptoms through specific blockade of D2 receptors - antagonists of Cont. Cont. Other Effects – dizziness, nausea, blurred Other vision, sexual impotence, Parkinson’s symptoms, tardive dyskinesia symptoms, See motor side effects at about 70% receptor See occupancy occupancy Examples: chlorpromazine (Thorazine); Examples: haloperidol (Haldol) haloperidol Cont. Cont.
1. Atypical antipsychotics reduce both positive Atypical and negative symptoms without the motor side effects side a. Why? Antagonism of DA (not as great and a. more specific) and 5HT2 more b. Examples (6 on market) - clozapine (Clozaril) specific to D4 receptors, peaks in blood 1-4 hours; half-life 9-30 hours – can cause agranulocytosis 9-30 Cont. Cont.
- olanzapine (Zyprexa) - Aripiprazole (Abilify) – DA partial agonist Other Effects – sedation, weight gain, Other constipation constipation Warnings: 9-14% increase in risk of developing Warnings: Type II diabetes; elongation of QT interval (heart) (heart) Biomedical Biomedical
1. Antianxiety Drugs – reduce anxiety, most Antianxiety helpful for generalized anxiety disorder helpful a. Benzodiazepines – Valium, Xanax, a. Ativan Ativan Other Effects – lightheadedness, slurred speech, drowsiness, physical dependence DO NOT take with alcohol 3. Antidepressants 3. Antidepressants
a. SSRI’s (Selective Serotonin Reuptake a. Inhibitors) Inhibitors) - Prozac, Paxil, Zoloft - effect serotonin only, block presynaptic transporter of 5-HT reuptake transporter - most commonly prescribed class of most antidepressants antidepressants - Good for depression and anxiety Good SSRI’s cont. SSRI’s cont.
b. Prozac (fluoxetine) 5HT syndrome 5HT withdrawal – 60% of patients (flulike symptoms, sleep problems, sensory disturbances, anxiety, agitation, crying) Sexual dysfunction – 80% (orgasm, erection, desire, arousal) Pregnancy and breastfeeding? Increased risk of suicide in children/teens? SSRI’s cont. SSRI’s cont. Few anticholinergic and antihistaminic side effects (no sedation or cognitive impairments) Not fatal in overdose Side effects: anxiety, agitation, insomnia, sexual Long halflife – don’t need to take everyday Cont. Cont.
Concern with all antidepressants: Slow onset of action: 46 weeks Biomedical Biomedical
1. Lithium – used in treatment of bipolar Lithium disorder, helps to level manic and depressive episodes episodes Other Effects – works for 70-75%, toxic at Other high doses, weight gain high Biomedical Biomedical
A. Other Therapies 1. Electroconvulsive Shock Therapy (ECT) 1. – used to treat severe depression used a. Treatment occurs in a series (once every a. 2-3 days for two weeks) 2-3 Biomedical Biomedical
b. An electric current is run through the brain b. for 1-2 sec that produces a seizure for Temporary memory loss, some relapse Biomedical Biomedical
1. Psychosurgery–removal or destruction of Psychosurgery–removal brain tissue –can help with depression or OCD OCD a. Lobotomies – very rare now b. Corpus callosum – severed to lessen b. seizures seizures c. Cingulotomy – small part of limbic c. system destroyed system II. Psychological Therapies II. Psychological Therapies
A. Behavior Therapies – apply learning A. principles to eliminate unwanted behaviors - Does not deal with the underlying problem 1. Classical Conditioning – anxiety disorders Psychological Psychological
a. Systematic desensitization – an exposure a. therapy that associates a relaxed state with gradually increasing anxiety-triggering stimuli gradually Psychological Psychological
Aversive conditioning - replacing a positive Aversive response with a negative response - Antabuse and alcohol Antabuse 2. Operant Conditioning 2. a. Token economy – giving of rewards for desired behaviors desired
a. Psychological Psychological
A. Cognitive Therapies – teach people new, Cognitive more adaptive ways of thinking and acting more - negative thinking patterns influence your negative mental health (Albert Ellis – Rational Emotive Therapy) Emotive - “musterbating”, “awfulizing”, “musterbating”, “catastrophizing” “catastrophizing” Psychological Psychological
A. Cognitive-Behavior Therapies – change selfdefeating thinking and behavior (Aaron defeating Beck) Beck) - give homework (e.g. diaries, getting out of give the house, exercising, meeting people) the Psychological Psychological
A. Humanistic Therapies – focus on selffulfillment fulfillment 1. past is not important 1. 2. conscious 3. responsibility for one’s feelings 4. promote growth Psychological Psychological
Carl Rogers Client-Centered Therapy – nondirective 1. genuineness, acceptance, and empathy 2. Active-listening 3. Ideal and actual selves Psychological Psychological
A. Gestalt Therapy – (Fritz Perls) – mental Gestalt illness comes from lack of self-awareness of true feelings true - directive directive - body awareness body - empty-chair technique Psychological Psychological
A. B. B. Psychoanalysis – (Freud) – bring repressed Psychoanalysis childhood feelings into conscious awareness Psychodynamic – understanding of current Psychodynamic symptoms by exploring childhood symptoms - face-to-face, fewer sessions, deemphasizes face-to-face, sexual conflict Psychological Psychological
A. B. Eclectic Group and Family Therapy ...
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- Spring '08