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Thursday, January 24, 2013

Medications for Mental Disorders - Understanding Addiction


  • The look and treatment of mental illness has changed over the years.  Currently the main method of therapy is drug therapy.
  • Using this approach: the patient shows symptoms, they are diagnosed, and then treated with drugs.  Others believe that this just covers the problem.
  • The Diagnostic and Statistical Manual of Mental Disorders provides criteria for classifying mental disorders to hundreds of specific diagnostics. The DSM V is expected in 2013.
  • Many insurance companies use these definitions. DSM sets the standards for health
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    professionals.
  • Anxiety disorders include:
    • panic disorders
    • specific phobias
    • generalized anxiety disorder
  • They are commonly treated with benzodiazepines and otherdepressants.
  • Psychosis is a major loss of contact with reality.  People suffering from a long-term psychotic condition with no known cause are diagnosed with Schizophrenia.
  • Malaria therapy” was used to treat general paresis when they say that the fever produced helped.  The introduction of antibiotics eliminated this treatment.
  • Thiopental sodium, “truth serum”, was used to help patients express repressed thoughts.
  • Insulin was used to shock schizophrenics but was seen to be not effective.
  • Electronvulsive therapyECT, was also used on schizophrenics but was found to only work in half the people and there was a high relapse rate.
  • Phenothiazines have special properties that did not by itself induce drowsiness or loss of consciousness.   First used to calm patients before surgery, it was then used to help calm mentally ill patients.Chlorpromazine was the first tranquilizer.
  • Phenothiazines are still used to treat acute schizophrenics.  It is understood that this is not a cure but it is better then the placebo treatments.
  • Pseudoparkinsonism is sometimes a side effect of those treated with Phenothiazines.
  • Antipsychotic drugs block D2 dopamine receptors.
  • Clozapine blocks D2 dopamine and 5HT2A serotonin receptors.
  • Clozapine produces less Pseudoparkinsonism then other antipsychotics. Another advantage is that some patients show improvement that did not on the other drugs.  The major negative side effect is that in some it suppresses white blood cell production.
  • With antipsychotic drugs, few are addictive.
  • Monoamine Oxidase Inhibitors (MAO) are limited due to side effects.
  • Tricyclic antidepressant had little effect on psychotic symptoms but improved the mood of depressed patients.
  • Selective Serotonin Reuptake Inhibitors changed how the class of drug was looked at and marketed.  Prozac, and other SSRIs drugs, are safer than tricyclic antidepressants because they are less likely to lead to overdose deaths.
  • Most antidepressants work by increasing the availability of norepinephrine or serotonin at the respective synapses.
  • Electroconvulsive therapy is the most effective treatment for depression.
  • If there is possibility of suicide then ECT is the best choice due to the fast results as compared to drug therapy.
  • Mood Stabilizers like Lithium show good results with manic individuals while showing little to no improvement in depressed individuals.
  • ValproicCarbamazepine and lamotrigine are not as effective on bipolar disorder but do help with patients that are susceptible to epileptic seizures.
  • One consequence of these drugs is the number of people in mental hospitals went down greatly.
  • The number of outpatient programs has increased dramatically as has the number of people onantidepressant drugs.
  • Psychiatrists are more likely to prescribe drug than do psychotherapy.

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