APPSYCHUnit13.3BiomedicalTherapies

• Prescribedmedicationsormedicalproceduresthatactdirectlyonthepatient’snervoussystem.– Drugsthatalterbrainchemistry– Affectingbraincircuitry withelectric shock,magneticimpulses,orpsychosurgery.

– Psychologists– psychotherapy, butPsychiatrists(MD)canprescribebiomedical therapy

DrugTherapies

• Psychopharmacology -studyoftheeffectsofdrugsonmindandbehavior.– Drugshaveminimizedinvoluntaryhospitalization.• Whyisthisagoodthing?• Whyisthisabadthing?

AntipsychoticDrugs• Usedtotreatpeoplewithpsychoses(schizo)

– Psychoses=breakinrealitywherepeopleexperiencehallucinationsordelusions.

– Dampenresponsivenesstoirrelevantstimuli.– AntagonistforDopamine– Cancausesluggishness,tremors,andtwitchesbecauseofthelowdopamine levels.

– Chlorpromazine

AntipsychoticDrugs• Negativesideeffects– Nausea– Headaches– Exacerbationofothermedicalproblems

– TardiveDyskinesia - Involuntarymovementsofthefacialmusclestongueandlimbs.

• AtypicalAntipsychotics–clozapine,alleviatenegativesymptomsofschizophrenia(catatonia)(Awakenings)

AntianxietyDrugs• Drugsusedtocontrolanxietyand

agitation,PTSD,OCD• Depresscentralnervoussystemactivity,

eliminatelearnedfears• Can’ttakew/alcohol• Xanax,Ativan• Enhanceseffectsofexposuretherapy• Canbecomephysiologicallydependent.• Reducesymptomswithoutaddressing

rootcauseofproblem

AntidepressantDrugs• Drugsusedtotreatdepressionoranxiety.• Alteringthelevelsofvarious

neurotransmitters.– IncreaseavailabilityofNorepinephrineorSerotonin• Selective-Serotonin-Reuptake-Inhibitors:Prozac,Zoloft,Paxil

• Canhaveserioussideeffects– Drymouth,weightgain,hypertension,dizzyspells,weaksexdrive

• Fulleffectofthedrugmaytakeuptofourweeks(neurogenesis)

AntidepressantDrugs

AntidepressantDrugs• Exercise&CognitiveTherapy– maybe

aspowerfulonmilddepressionaspills• 75%ofantidepressantseffectscanbe

contributedtotheplaceboeffect.• Butlessforseveredepression.• 1in4peopledonotrespondtoa

particularantidepressantandswitchingtoanotherusuallybringsrelief.

• Whatarethenegativesideeffects?Anylongtermdamage?

Mood-StabilizingMedications• Lithium – (asalt)moodstabilizingdrugforupsanddownsofbipolar

disorder• Effectivelytreats7in10withbipolar• Greatlyreducessuiciderisk• Depakote – originallyforepilepsybuteffective incontrollingmanic

episodes

BrainStimulation• ElectroconvulsiveTherapy (ECT):Severely depressedpatients• Briefelectric current sentthroughbrainofanesthetizedpatient• Electrocuting people intoconvulsions (Shock treatment)• Patientsusedtobeawakewhenfirstusedin1938• 100voltsofelectricity for30-60seconds.• Somememorylossiscommon.• Wedonotknowwhyorhowitworks– maybesimilarto

rebootingacomputer• Reducessuiciderisk

AlternativeNeurostimulationTherapies

• Chestimplantthatstimulatesvagusnerve(messagetolimbicsystem)

• MagneticStimulationorRepetitiveTransductionMagneticStimulation (rTMS)involvestheapplicationofrepeatedpulsesofmagneticenergytothebrain;usedtostimulateorsuppressbrainactivity.– Surfaceofbrain,nottoodeep– Nottoomanynegativesideeffects– Stimulatesleftfrontallobe

• DeepBrainStimulation– overactiveareaofbrainbridgingfrontallobetolimbicsystemisexcited– Experimentaltechnique– SurgicalImplant

Psychosurgery• Surgerythatremovesordestroysbraintissueinanefforttochangebehavior.

• Lobotomy - Aprocedurethatcutthenervesconnectingthefrontallobestotheemotion-controllingcentersoftheinnerbrain.– Nowrare– Createdpermanentlylethargicpersonality.

TherapeuticLife-StyleChange• AerobicExercisehelpstocalmthosewith

anxietydisordersandenergizethosewhofeeldepressed.

• Adequate sleep(7-8hoursaday)canincreaseenergyandalertness.

• Lightexposureamplifiesarousalandinfluenceshormones.

• Socialconnectionshelpstosatisfythehumanneedtobelong.

• PositiveThinking• Nutritionalsupplements helpswith

healthybrainfunctioning.

PreventingPsychologicalDisorders• Resilience – personalstrengththathelpsmostpeoplecopewith

stressandrecoverfromadversityandeventrauma– Canresiliencepreventpsychologicaldisorders?– Developcopingcompetency

• Upstreamanalogy(savingdrowningpeopleoverandoverorgoupstreamandfixthe initialcauseoftheproblem)– Poverty,meaninglesswork,constantcriticism,unemployment,racism,sexism

• Wecanpreventbyalleviatingdemoralizingsituations