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Biomedical Therapies
Antipsychotic Drugs
• Antipsychotic drugs (like Thorazine, Mellaril, and
Haldol) are used to gradually reduce psychotic
symptoms, including hyperactivity, mental confusion,
hallucinations, and delusions.
• Antipsychotic drugs appear to decrease activity at
dopamine synapses, sometimes producing
unfortunate side-effects such as symptoms of
Parkinson’s disease and tardive dyskinesia, an
incurable neurological disorder marked by
involuntary writhing and tick-like movements of the
mouth, tongue, face, hands, or feet.
• • But: not risk-free; may cause seizures or blood
disorders in some, diabetes or weight-gain in other s
Classical vs. Atypical
Antipsychotics
• Classical antipsychotics [chlorpromazine (sold as Thorazine)]: Remove a
number of positive symptoms associated with schizophrenia such as
agitation, delusions, and hallucinations.
• Atypical antipsychotics [clozapine (sold as Clozaril)]: Blocks receptors for
dopamine and serotonin to remove the negative symptoms associated with
schizophrenia such as apathy, jumbled thoughts, concentration difficulties,
and difficulties in interacting with others. They enable “awakenings.”
– These newer drugs, which
have a different mechanism
of action, have fewer motor
side effects but are not risk
free. They may increase
the risk of obesity and
diabetes.
Anti-Anxiety Drugs
• Antianxiety drugs depress the central
nervous system and reduce anxiety,
apprehension, nervousness, and
tension by elevating
neurotransmitter levels.
• Most widely abused drugs.
Anti-Anxiety Drugs
• Traditional Antianxiety Drugs Best known =
benzodiazepine tranquilizers
• • Examples: Librium, Valium (diazepam), Xanax
(alprazolam) and Ativan
• These depressant drugs decrease anxiety
disorder symptoms and treat insomnia.
• But: can impair memory; interact with alcohol;
can cause dependency at higher doses or with
longer use
Usually takes a week to fully work but can work for
acute situations, like a panic attack
Antidepressant Drugs
• Antidepressants gradually elevate mood and help bring people out of a
depression. They improve the mood by elevating levels of serotonin by
inhibiting reuptake.
• The 3 major classes of antidepressant drugs include:
– Tricyclics – Elavil, Tofranil
– Mao inhibitors (MAOIs) – Nardil
– Selective serotonin reuptake inhibitors (SSRIs) – Prozac, Paxil, Zoloft
• Today, the SSRIs are the most frequently prescribed.
Figure 15.12: Antidepressant drugs’
mechanisms of action.
The three types of antidepressant drugs
all increase activity at serotonin
synapses, which is probably the principal
basis for their therapeutic effects.
However, they increase serotonin activity
in different ways, with different spillover
effects (Marangell et al. 1999). Tricyclics
and MAO inhibitors have effects at a
much greater variety of synapses, which
presumably explains why they have more
side effects. The more recently
developed SSRIs are more specific in
targeting serotonin synapses.
SSRIs – Prozac, Paxil, Zoloft
• SSRI’s are equally effective, less annoying side
effects, & almost suicide -proof
• Antidepressants take ~4-6 weeks to produce their
effects
• 65-70% show significant improvement
• These drugs can also improve anxiety disorders
Best when used with severely depressed patients
• Antidepressants are now also used to treat
anxiety, OCD, and PTSD
Mood-Stabilizing
Medications
• Lithium Carbonate, a common salt, has been used to
stabilize manic episodes in bipolar disorders.
• It moderates the levels of norepinephrine and glutamate
neurotransmitters.
• is used to treat patients with bipolar mood disorders to
control mood swings. The drug may have dangerous side
effects, however, such as kidney and thyroid damage.
• Best known treatment for bipolar disorder: Lithium
Surprisingly anticonvulsants are an effective
alternative.
• Sometimes a combination of meds is necessary.
Powerful side effects that vary but can be toxic if over
ingested.
Electroconvulsive Therapy (ECT)
• • ECT is used for severely depressed patients who do
not respond to drugs.
• The patient is anesthetized & given a muscle relaxant.
• Patients usually get 30-60 seconds of electrical current
that relieves them of depression.
• Side Effects: using today's methods of ECT, very
small/limited effect on memory
– YET…much of the public still worries about the safety of
ECT
• About 4 in 10 ECT-treated patients relapse into
depression within 6 months
Repetitive Transcranial Magnetic
Stimulation (rTMS)
• In rTMS, a pulsating magnetic coil is placed
over prefrontal regions of the brain to treat
depression with minimal side effects.
• How does it work? One possible explanation is that
the stimulation energizes depressed patients’
relatively inactive left frontal lobe
Lobotomy
Lobotomy is a procedure that cuts the nerves
connecting the frontal lobes to the thalamus
• Portuguese neurologist Egas Moniz
developed it in 1935 to help uncontrollably
emotional and violent patients
• • In 1945, American neurologist Walter
Freeman developed the transorbital lobotomy,
which used an ice pick through the eye socket
to damage the neural connections.