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VI. Biomedical Therapy Chapter 16 Biomedical therapy works by physically changing the brain’s functioning by altering its chemistry with drugs, or affecting its circuitry with electroconvulsive shock, magnetic impulses, or psychosurgery. A. Drug Therapy This is the most widely used biological treatment It has revolutionized the treatment of people with severe disorders—keeping thousands of people from hospital confinement. a. Antipsychotic Drugs Antipsychotic drugs are major tranquilizers used to treat patients with schizophrenia because they are effective at reducing agitation, delusions, and hallucinations ◦ Ex—Thorazine; Risperdal; Zyprexa They are thought to work by blocking the activity of dopamine in the brain, which is thought to contribute to schizophrenia Antipsychotics have powerful side effects. Some produce sluggishness, tremors, and twitches similar to those of Parkinson’s disease. Long term use of antipsychotics can produce tardive dyskinesia, with involuntary movements of the facial muscles, tongue, and limbs. b. Antianxiety Drugs Antianxiety drugs, which are mild tranquilizers, are used as an outpatient treatment to help people with anxiety disorders or panic attacks ◦ Ex—Xanax; Ativan They work by depressing the activity of the nervous system The longer a person takes an antianxiety medication, the less effective the drug may become Antianxiety drugs can also cause psychological dependence. After heavy use, people who stop taking them may suffer withdrawal symptoms. Many psychiatric patients are now receiving treatment for anxiety disorders by being prescribed antidepressants. c. Antidepressant Drugs People who suffer from major depression are often treated with antidepressant drugs. More recently, these are being used in the treatment of eating and anxiety disorders. Antidepressants work by increasing the amount of neurotransmitters— norepinephrine and serotonin ◦ Ex—Prozac; Zoloft; Paxil In order to work effectively, antidepressant medications must build up in the body to a certain level—usually 4 weeks Antidepressant drugs aren’t the only way to boost your mood. Aerobic exercise and cognitive therapy (by helping people reverse their habitual negative thinking style) can help. People with depression often improve after a month on antidepressants. d. Lithium Salt lithium is given in tablet form to help people with bipolar disorder. It is a mood-stabilizing drug. No one is completely sure how or why it works The drug Depakote, a drug originally used to treat epilepsy, also has proven effective. Side effects may include shakiness, memory impairment, and excessive thirst. B. Electroconvulsive Therapy Electroconvulsive therapy (ECT) occurs when an electric current is passed through a person’s brain. The current produces convulsions. Anesthesia is administered so that the person is unconscious The shock lasts 30-60 seconds and within 30 minutes, the patient wakes up. After 3 sessions per week for 2-4 weeks, 80% or more of people improved. It is an effective treatment for people with severe depression who don’t respond to antidepressant drugs Very controversial treatment. About 4 in 10 ECT-treated patients relapse into depression within 6 months. It also has some serious side effects such as memory loss, headaches, or seizures. However, many psychiatrists and patients believe that ECT is a lesser evil than severe depression’s misery. D. Magnetic Stimulation Repetitive transcranial magnetic stimulation (rTMS) is the application of repeated pulses of magnetic energy to the brain. It is used to stimulate or suppress brain activity. It is performed on wide-awake patients over several weeks. Unlike ECT, the rTMS procedure produces no side effects. Researchers are unclear on exactly how this procedure works. E. Psychosurgery Psychosurgery is brain surgery that removes or destroys brain tissue in an effort to change behavior. The best known technique was a lobotomy, which involved cutting nerve pathways to the brain between the frontal lobes and the emotion-controlling centers of the brain. This was used to reduce the uncontrollable agitation and violence of people with severe psychological disorders However, the treatment produced several serious side effects—the person was permanently lethargic, immature, and uncreative. The procedure was so controversial that it has been abandoned. Today, more precise, microscale psychosurgery is sometimes used in extreme cases. ◦ Ex—if a person suffers from uncontrollable seizures, surgeons can deactivate the specific nerve clusters that cause or transmit the convulsions. Because these procedures are irreversible, neurosurgeons perform them only as a last result.