Mod 54 biomedical therapies

Mod 54 Biomedical Therapies
Obj 1 Goals

Biomedical therapy: prescribe medications or medical procedures that act directly on patient’s nervous system
Drug therapies
Psychopharmacology: study of effects of drugs on mind & behavior
Since 1950's treatment of choice for those w/severe disorders Deinstitutionalization: due to drug therapy, minimize hospitalization as an intervention & use community mental
**use double-blind studies to study the effects of medications
Obj 2 Antipsychotics
Chlorpromazine–Thorazine: “dampens” responsiveness to irrelevant stimuli works well for schizophrenia–auditory hallucinations & paranoia (positive symptoms) Negative symptoms–apathy, withdrawal do not respond well to these medications **need to take blood tests–very toxic effect on white blood cells mimics the effect on dopamine–blocks receptors sites **helps to reinforce the idea that overactive dopamine sites are a possible cause of schizophrenia Thorazine (works on D-2 receptor sites) causes sluggishness, tremors, twitches (Parkinson-like symptoms) Tardive dyskinesia: neurotoxic effect–involuntary movements of facial muscles: grimacing, tongue
Newer generation of drugs work on D-1 receptors–Clozapine, Risperidal, Zyprexa Fewer side effects but same effectiveness **for both types of drugs, dosage is VERY specific to person–be careful of overdose
***use in combination w/life skills programs & family support
Obj 3 Antianxiety Drugs
Xanax, Ativan–depress CNS activity DO NOT MIX W/ALCHOHOL!!
Help to cope with frightening situations & fearful stimuli Can produce psychological dependence–immediate relief reinforces a tendency to take the drugs when Withdrawal symptoms–increases anxiety & insomnia Rate of outpatient treatment for anxiety disorders has nearly doubled
Obj 4 Antidepressants
Also used to treat anxiety disorders like OCD
Boosts norepinephrine and/or serotonin–increases arousal & mood Fluoxetine–Prozac: blocks reabsorption & removal of serotonin (Zoloft, Paxil also SSRIs) Newer classes work on both serotonin & norepinephrine Side effects: dry mouth, weight gain, hypertension, dizzy spells Can be prescribed as a patch–bypasses the intestines & liver & reduces side effects In 2001, 89% of those diagnosed w/depression on medication (70% in 1987 which was 4 yrs before SSRIs were introduced) Delayed effect may be due to neurogenesis–birth of new brain cells Aerobic exercise: calm anxiety & bring energy Cognitive therapy: reverse negative thinking symptoms boost drug relief & reduce risk of relapse Cognitive therapy: top-down on frontal lobe Placebos in some studies seem to be just effective as drug treatments Also a question of whether or not using Prozac causes suicide Long term use in adolescence actually see a decline in suicide rates
Obj 5 Mood Stabilizing Meds
Lithium:
a salt used to treat mania & bi-polar disorder
Depakote: epileptic treatment also works very well to control mania

Obj 6 Brain Stimulation

ECT: used on severely depressed patients–brief electrical current is sent thru brain of an anesthetized (muscle
relaxers)
Generally receive 3 sessions a week for 2–4 weeks 80% improve remarkably, with some memory loss for treatment period Chest implant that stimulates the vagus nerve that sends signals to the limbic system reduces hyperactivity in the region for depression Also repetitive transcranial magnetic stimulation: (RTMS) repeated pulses of magnetic energy to the
brain–stimulates OR suppresses brain activity May be stimulating relatively inactive left frontal lobe
Obj 7 Psychosurgery
Remove or destroys brain tissue in effort to change behavior
lobotomy: very rare now–once used to calm uncontrollable emotion & violent patients
Cut nerves that connect frontal lobes to emotion-controlling centers of inner-brain hammer ice pick like instrument thru each eye socket into brain & wiggle it to sever connections running up to frontal lobe (barbaric isn’t it??) Inventor won the Nobel Peace Prize **now sever specific nerve clusters–severe OCD

Source: http://tigerappsych.wikispaces.com/file/view/NotesMod+54+Biomedical+Therapies.pdf

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research sarah m Dennis terry h Diamond MBBS, FAMAC, is Conjoint Lecturer, Department of MSc, PhD, is Senior Research Fellow, Centre for MBBCh, MRCP, FRACP, is Associate Professor Community Medicine, University of New South Wales, Primary Health Care and Equity, School of Public and a general practitioner, Sydney, New South Wales. Health and Community Medicine, University of New

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