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MODULE 53 PREVIEW Administration of antipsychotic, antianxiety, and antidepressant drugs constitutes the most widely used biomedical therapy. Electroconvulsive therapy, although controversial, continues to be an effective treatment for many severely depressed people who do not respond to drug therapy. Psychosurgery is rarely used to alleviate specific problems largely because the effects are irreversible and potentially drastic. GENERAL INSTRUCTIONAL OBJECTIVES 1. To describe the drug therapies. 3. To describe electroconvulsive therapy and psychosurgery, and to explore reasons for the controversy over these techniques. MODULE GUIDE Drug Therapies 1. Identify the common forms of drug therapy. Psychopharmacology has revolutionized the treatment of severely disordered people. Antipsychotic drugs, such as chlorpromazine, provide help to people experiencing the positive symptoms of auditory hallucinations and paranoia by dampening their responsiveness to irrelevant stimuli. A newer drug, clozapine, helps reanimate schizophrenia patients with the negative symptoms of apathy and withdrawal. Antianxiety drugs such as Valium and Librium reduce tension and anxiety without causing excessive sleepiness. For this reason they have been prescribed even for minor emotional stresses. Antidepressants aim to lift people up, typically by increasing the availability of the neurotransmitters norepinephrine and serotonin. For example, fluoxetine (Prozac) blocks the reabsorption and removal of serotonin from the synapses. The simple salt lithium is often an effective mood stabilizer for those suffering bipolar disorder. Lectures: Fluoxetine (Prozac); Cosmetic Psychopharmacology; A Pill for Stage Fright (Anxiety) Transparencies: 144 Biology of Antidepressants; 145 Comparing Treatments for Depression Videos: Module 33 of The Mind Series, 2nd ed.; Module 28 of The Brain series, 2nd ed. Electroconvulsive Therapy and Psychosurgery 2. Describe the use of electroconvulsive therapy and psychosurgery in the treatment of psychological disorders. Electroconvulsive therapy (ECT), or shock treatment, is a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient. Although ECT is credited with saving many from suicide, no one knows for sure how it works. Psychosurgery removes or destroys brain tissue in an effort to change behavior. For example, the lobotomy was once used to calm uncontrollably emotional or violent patients. In this now-rare procedure, the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain are cut. Other psychosurgery is used only in extreme cases. Lectures: Electroconvulsive Therapy; Cingulotomy Video: Module 34 of The Mind Series, 2nd ed.