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Biological Perspective

Works Cited

  • http://en.wikipedia.org/wiki/Psychopharmacology
  • http://en.wikipedia.org/wiki/Neuroleptics
  • http://en.wikipedia.org/wiki/Typical_antipsychotic
  • http://en.wikipedia.org/wiki/Atypical_antipsychotic
  • http://en.wikipedia.org/wiki/Extrapyramidal_system
  • http://en.wikipedia.org/wiki/Extrapyramidal_symptoms
  • http://en.wikipedia.org/wiki/Pseudoparkinsonism
  • http://en.wikipedia.org/wiki/Neuroleptic_malignant_syndrome
  • http://en.wikipedia.org/wiki/Monoamine_oxidase_inhibitors
  • http://en.wikipedia.org/wiki/Tricyclic_antidepressants
  • http://en.wikipedia.org/wiki/Antidepressant
  • http://en.wikipedia.org/wiki/Neuropathic_pain
  • http://en.wikipedia.org/wiki/Serotonin-norepinephrine_reuptake_inhibitors

Psychopharmacology

Psychosurgery

The scientific study of the effects drugs have on the mind: mood, sensation, thinking, behavior. Or, the use of drugs to control or relieve the symptoms of psychological disorders. There are four basic categories of drugs: those used to treat psychotic disorders, anxiety disorders, the manic phase of mood disorders and depression.

Also called neurosurgery for mental disorder (NMD), pyschosurgery is the neurosurgical treatment of mental disorder.

Electroconvulsive Therapy

Antidepressants

Antipsychotic Drugs

  • Antidepressants are drugs used for the treatment of major depressive disorder, but some have been shown to treat disorders such as dysthymia, anxiety disorders, obsessive compulsive disorder, eating disorders, chronic pain, neuropathic pain and, in some cases, dysmenorrhoea, snoring, migraines, ADHD substance abuse and sleep disorders.
  • Antipsychotics are a class of psychiatric medication, of which there are three classes: typical neuroleptics, atypical neuroleptics and partial dopamine agents. Also generally called major tranquillizers or neuropleptics, although the latter term is generally reserved for typical neuroleptics.
  • These are primarily used to manage psychosis: delusions, hallucinations, bizarre behavior, disordered thought, particularly the psychological disorders of schizophrenia and bipolar disorder, but are being increasingly used to manage non-psychotic behavior,
  • These work by blocking certain dopamine receptors of the brain, thereby reducing the effect dopamine has in synaptic transmission

SSRIs

MAOIs

Prefrontal Lobotomy

  • Made with the intent to more specifically target the critical neural activity present in depression with fewer side effects
  • Selective serotonin re-uptake inhibitors (SSRIs) are a class of compounds which inhibit only the reuptake of serotonin.
  • There exists also SNRIs: serotonin-norepinephrine reuptake inhibitors, which are used to treat depression but also anxiety disorder, OCD, ADHD, chronic neuropathic pain and fibromyalgia syndrome
  • These are typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders.
  • SSRIs are believed to increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin in the synaptic cleft available to bind to the postsynaptic receptor
  • Side effects: nausea, nervousness, insomnia, diarrhea, rash, agitation, some sexual arousal problems
  • These drugs cause fewer side effects, is comparatively safer than older forms of antidepressants
  • Examples: fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil)

Bilateral Cingulotomy

Typical neuroleptics

Partial Dopamine Agonists

  • Monoamine Oxidase Inhibitors are chemicals which inhibit the monoamine oxidase family, which break down the neurotransmitters norepinephrine, dopamine and serotonin, the three neurotransmitters most responsible for changes in mood.
  • These treat major depression, but can also be used to treat Parkinson's Disease, panic disorder with agoraphobia, social phobia, bulimia, post-traumatic stress disorder, borderline personality disorder, and particularly effective against bipolar depression
  • Side Effects: weight gain, constipation, dry mouth, dizziness, headache, drowsiness, insomnia, sexual arousal disorders
  • Examples: iproniazid, isocarboxazid (Marplan), phenelzine sulfite (Nardil), tranylcypromine sulfate (Parnate),
  • Long term use of neuroleptics, particularly those of the typical class, has been linked to reduced cognitive functioning.
  • A subclass of atypical antipsychotic drugs which affects the release of dopamine, rather than blocking its receptors in the brain.
  • The intent is to produce less negative side effects to the brain and its cognitive functioning.
  • Examples: by 2005, the only FDA-approved drug was aripiprazole, that is, Abilify.
  • Also named typical antipsychotics, classical neuropleptics or major tranquilizers.
  • These treat the positive symptoms of schizophrenia, such as delusions and hallucinations.
  • These may also treat acute mania, agitation and other minor conditions.
  • Their side effects may include motor problems and tardive dyskinesia, as these drugs affect the extrapyramidal system and the dopamine system
  • extrapyramidal system: an evolutionarily old (thus, near the medulla and reticular formation) neural network causing involuntary reflexes and movement, and effecting coordination
  • tardive dyskinesia: a syndrome causing one to make repetitive, involuntary jerks and movements of the body
  • extrapyramidal symptoms: any of various movement disorders such as tardive dyskinesia, akathisia (inability to remain still), and parkinsonism (tremor, hypokinesia (decreased bodily movement), ridigidy and postural instability) had after taking dopamine antagonists
  • Examples: chlorpromazine, droperidol, haloperidol (the most widely used typical antipsychotic)

TCAs

Atypical Neuroleptics

  • These treat positive and some negative symptoms of psychoses; these treat schizophrenia, bipolar disorder, autism and it may be used as an adjunct in the treatment of major depression.
  • These suppress dopamine to a much greater degree in the singular dopamine pathway responsible for psychosis, the nigrostriatal pathway. These also block or partially block certain serotonin receptors, begetting fewer negative side effects, maybe even improvement in the negative symptoms of schizophrenia e.g. withdrawal, apathy, reduced communication, etc.
  • A recent study showed schizophrenics receiving atypical neuroleptics through community-based treatement centers were less likely to enact violent behavior than those using other medication.
  • The main difference between typical and atypical neuroleptics is that atypical neuroleptics generally have fewer instances of extrapyramidal motor disorders. Few have been shown to be superior in this regard to lesser used, low potency typical antipsychotics. In fact, there are similar side effects:
  • tardive dyskinesia
  • neuroleptic malignant syndrome: muscle rigidity, fever, autonomic instability, cognitive changes e.g. delirium; life threatening; treatment: supportive care and removal of offending drug
  • increased risk of stroke, sudden cardiac death, blood clots, diabetes, and possibly weight gain
  • Examples: risperidone, clozapine, aripripazole
  • There are some critics of the term typical and atypical, first-generation and second-generation, as the classes merit no distinction.
  • Tricyclic antidepressants (TCAs) are chemical compounds used primarily as antidepressants
  • The TCAs were first discovered in the early 1950s in an effort to treat schizophrenia and were subsequently introduced later in the decade
  • They are named after their chemical structure, which contains three rings of atoms.
  • The tetracyclic antidepressants (TeCAs), which contain four rings of atoms, are a closely related group of antidepressant compounds.
  • These increase the activity of serotonin and norepinephrine by inhibiting their reuptake
  • Side Effects: dry mouth, dry nose, blurry vision, lowered gastrointestinal motility or constipation, urinary retention, cognitive and/or memory impairment, increased body temperature, skin rashes, blurred vision, lowered blood pressure, weight loss
  • Examples: imipramine (Tofranil), desipramine (Norpramin, Pertofrane), amitiptyline (Elavil), doxepin (Sinequan, Adapin)
  • Introduced by Italian neuropsychiatrists Ugo Cerletti and Lucio Bini
  • A standard psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses
  • Used to treat:
  • Depression
  • Schizophrenia
  • Mania
  • Catatonia
  • Lobotomy is a neurosurgical procedure, a form of psychosurgery, also known as a leukotomy or leucotomy.
  • It consists of cutting or scraping away most of the connections to and from the prefrontal cortex, the anterior part of the frontal lobes of the brain. While the procedure, initially termed a leucotomy, has been controversial since its inception in 1935, it was a mainstream procedure for more than two decades, prescribed for psychiatric (and occasionally other) conditions – this despite general recognition of frequent and serious side-effects.
  • Bilateral cingulotomy is a form of psychosurgery, introduced in 1948 as an alternative to lobotomy. Today it is mainly used in the treatment of depression and obsessive-compulsive disorder. In the early years of the twenty-first century it was used in Russia to treat addiction
  • It is also, rarely, used in the treatment of chronic pain. The objective of this surgical procedure is the severing of the supracallosal fibres of the cingulum bundle, which pass through the anterior cingulate gyrus

Antimanic Drugs

Antianxiety Drugs

  • Antimanic drugs are used to modulate the swings of mood common to bipolar disorder, but can also be used to treat borderline personality disorder and schizoaffective disorder
  • schizoaffective disorder: a mental disorder characterized by disordered thought (psychosis) and abnormal emotions
  • Less common effects: blurred vision, a slight tremble in the hands, a feeling of being mildly ill
  • Examples:
  • An antianxiety agent (also antipanic or anxiolytic) is a medication used to treat and calm anxiety reactions.
  • These are usually minor tranquilizers or benzodiazepines, e.g., Xanax, Ativan, Valium, etc.
  • These drugs have the side effect of acting as sedatives, and while there may be many others depending on the particular drug, the main concern is that of their potential for addiction and abuse in form of taking ever larger doses to "escape", as it were.
  • As with any drug, there is an issue of possible tolerance and dependence

Anticonvulsants

Mineral

  • Lithium carbonate affects

the manner in which sodium ions in neuron and muscle cells are transported, although it is unclear how this affects mood as of now

  • Side effects: Lethargy, weight gain, toxic buildup
  • A class of drugs normally used to treat seizure disorders, but have been shown to act as mood stabilizers; also treats neuropathic pain
  • Their method of action is to inhibit either excitatory glutamate or excite inhibitory GABA
  • These can be as effective as lithium
  • Examples: carbamazepine, valproic acid (i.e. Depakote), lamotrigine

http://www.youtube.com/watch?v=IBqxiOgfunA#t=20

http://www.youtube.com/watch?v=W8Ypt-vKI2U#t=146

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