treatment before lobotomy, ect (shock), coma - now drugs change neurochemistry of brain change what...
Post on 19-Dec-2015
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TREATMENT
• BEFORE LOBOTOMY, ECT (SHOCK), COMA - NOW DRUGS
• CHANGE NEUROCHEMISTRY OF BRAIN
• CHANGE WHAT RECEPTORS ABSORB SO ELEVATE OR LOWER LEVELS OF NEUROTRANSMITTERS IN SYNAPSES
TREATMENTS
• ANTI-PSYCHOTICS
• LITHIUM FOR BIPOLAR
• PHENOTHIAZINES AND CLOZAPINE FOR SCHIZOPHRENIA
• ILLNESS SPECIFIC
SSRI’S
• UNLIKE OLDER DRUGS, SPECIFICALLY DESIGNED TO PREVENT REUPTAKE OF SEROTONIN
• NOT ILLNESS SPECIFIC (NOT “ANTI-DEPRESSANTS”)
Psychotropic Prescribing in USA (IMS - S Units)
0100000020000003000000400000050000006000000700000080000009000000
10000000
1990 1992 1994 1996 1998 2000 2001
AntidepressantAntipsychotic
HUGE GROWTH
• 10% OF ADULT POPULATION NOW TAKING AN SSRI
• 3 OF 7 BEST SELLING PRESCRIPTION DRUGS OF ANY KIND ARE SSRI’s
• 300% INCREASE IN PAST 10 YEARS IN NUMBER OF CHILDREN AND ADOLESCENTS TAKING MEDICATION
ARE SSRI’S BETTER?
• NOT MORE EFFECTIVE THAN OLDER DRUGS
• FEWER NEGATIVE SIDE EFFECTS
• NOT ADDICTING
• LESS RISK OF OVERDOSE
? ABOUT SSRI’S
• NOT MUCH BETTER THAN PLACEBOS FOR LESS SEVERE CONDITIONS
• LONG-TERM EFFECTS?
• ONLY ELIMINATE SYMPTOMS, NOT UNDERLYING PROBLEM?
• BETTER ALTERNATIVES?
• NOT GOOD FOR UNDER AGE 18?
STRENGTHS OF BIOLOGY
• BEST FOR PSYCHOTIC DISORDERS
• MORE KNOWLEDGE ABOUT BRAIN
• ADVANCES IN DRUG TREATMENTS FOR MANY CONDITIONS
1. OVERSTATEMENTS
• MOST CONVINCING FOR PSYCHOSES
• LESS EVIDENCE FOR OTHERS
• ARE BRAIN STATES CAUSES OR EFFECTS OF M.I.?
• CAUSES CAN BE SOCIAL OR PSYCH AS WELL AS BIOLOGICAL
2. GENES NOT DESTINY
• ONLY A MINORITY OF PEOPLE WITH GENETIC SUSCEPTIBILITY DEVELOP DISORDER
• OFTEN NEED ENVIRONMENTAL PRECIPITANT
• ENVIRONMENT CAN SUPPRESS - MORMONS AND ALCOHOLISM
3. WHAT DOES A GENE DO?
• DIFFERENCE OF GENOTYPE AND PHENOTYPE (APPEARANCE)
• CULTURE CAN SHAPE PHENOTYPE
• E.G. ANOREXIA
• GENES MAY HAVE GENERAL, NOT SPECIFIC, EFFECTS
4. MOST M.I. NOT GENETIC
• MOST PEOPLE WHO GET A DISORDER DO NOT HAVE GENETIC PROPENSITY TO THE DISORDER
SCHIZ. IN DENMARK
• THOSE WITH 1ST DEGREE RELATIVES HAVE 10x RATE OF SCHIZ
• BUT 90% OF PEOPLE WHO DO GET SCHIZ DON’T HAVE SCHIZ RELATIVES
• FAR MORE PEOPLE HAVE NO FAMILY HISTORY OF SCHIZ SO DESPITE LOWER % PRODUCE MORE CASES