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Psychopharmacology for Therapists

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Title: Psychopharmacology for Therapists


1
Psychopharmacology for Therapists
  • Antioch University
  • Tina Panteleakos, M.A.
  • Guest Lecturer
  • 10/6/04

2
A BRIEF History of Mental Illness
  • Out of individuals control (The demons ate my
    soul) Treatment?
  • EXORCISM
  • Within individuals control (Hes just criminally
    insane) Treatment?
  • INSTITUITIONALISM (aka the loony bin)
  • Biological-Psychological Interaction Treatment?
  • SCIENCE
  • Biological factors can affect psychological
    functioning (e.g., hyperthyroidism, steroidal tx
    for lupus, drug abuse)
  • Psychological factors can affect biological
    functioning (stress and the hippocampus)
  • Its a complex, enmeshed relationship - hopefully
    you would treat the person, not the disorder

3
Starter questions
  • Why is psychopharmacology important to you?
  • Not important (AU requirement)
  • General curiosity (Bio 1 was the best college
    class EVER)
  • Vested interest (grad school blues)
  • Competent therapists are a good thing (people are
    going to come to me for help? Ethics also
    include limitations)
  • Knowledgeable therapists are better (why is my
    client involuntarily sticking out his tongue and
    smacking his lips? Oh! Tardive Dyskinesia!)

4
Ill Never Tell...unless you sign this
coordination of care form.
  • Compliance issues stemming from side effects,
    mood disorders, or personality
  • Embarrassing side effects
  • Quitting the Xanax cold turkey
  • Late-onset side effects
  • Previously controlled symptoms re-emerge
  • Substance abuse
  • The meds just aint working

5
A Collaborative EffortWell
  • In a Perfect World
  • MDs, PAs, NPs would have time to return phone
    calls
  • Managed Care Organizations would relax their
    constricted, sphincter-like grip on treatment
    authorizations
  • Clients could afford to go to MDs, PAs, or NPs
  • Oh what a world we live in
  • Therapist. Collaborator. Student. Advocate. All
    before lunch.

6
Hypothetical Intake
  • 26-year-old, Greek-Mexican, single female prone
    to existential angst complains of insomnia,
    fatigue, and difficulty concentrating. WWUD
  • To what extent is there evidence that
    biochemical factors may be contributing to a
    her symptomatology.

7
Congratulations!!!
  • Youve just been nominated for the Therapist
    General for the U.S. The New York Times is
    requesting an in depth interview regarding your
    stance on therapy and psychotropic medication.
    The journalist kindly gave you a copy of her
    questions so you may prepare. Complete quick
    write answers for the following questions

8
  • Who uses (ingests) psychotropic medication?
  • Are there certain circumstances in which
    individuals should be required to take
    psychotropic medication? If yes, describe such
    situations. If no, why not?
  • Which is more effective to treat depression in
    adults medication or talk therapy?
  • Should children be prescribed psychotropic
    medication? Why or why not?
  • Are you comfortable recommending psychotropic
    medication youve never tried? Why or why not?

9
Psychodynamic thoughts on meds
  • Generic
  • Stigma I must be really sick and/or have no
    willpower
  • Therapy cant help
  • Meds are addictive (AA)
  • Personal
  • OCPD focus on the side effects
  • Anxiety feel better, but change causes
    anxiety/fear
  • Paranoid worried they are going to lose control
  • Depressed ability to cope with life is decreased
  • Narcissistic Ive never seen individuals with
    significant narcissism stay on meds for long

10
THE BRAIN
11
Frontal Lobe
  • The frontal lobe is considered our emotional
    control center and is tantamount to our
    personality, as well as performing logic
    reasoning
  • Left lobe is typically involved in controlling
    language related movement
  • Right lobe involved in non-verbal abilities

12
Parietal Lobe
  • Two main functions
  • Integrates sensory information to form a single
    perception (cognition).
  • Constructs a spatial coordinate system to
    represent the world around us (integrates visual
    input).

13
Occipital Lobe
  • The occipital lobes are the center of our visual
    perception system.

14
Temporal Lobe
  • The temporal lobes are involved in the primary
    organization of sensory input
  • The temporal lobes are highly associated with
    memory skills
  • Left verbal material
  • Right non-verbal matierical (music drawings)

15
Cerebellum
  • Involved in the coordination of voluntary motor
    movement, balance and equilibrium and muscle
    tone.

16
Brain Stem
  • Plays a vital role in basic attention, arousal,
    and consciousness. All information to and from
    our body passes through the brain stem on the way
    to or from the brain

17
The Limbic System
18
A few structures of the limbic system
  • Hippocampus - at the core of the temporal lobes
    and controls the more primitive pleasure stimuli
    and aversion stimuli pathways and associations,
    also involved in the formation of long-term
    memory
  • Amygdala - mediates both inborn and acquired
    emotional responses (such as fear and agression)
  • Fornix an axon tract that interconnects the
    hyptholamus and the hippocampus
  • Hypothalamus - controls the autonomic nervous
    system and regulates blood pressure, heart rate,
    hunger, thirst, and sexual arousal connected to
    the pituitary gland and thus regulates the
    endocrine system. (Not all authors regard the
    hypothalamus as part of limbic system.)

19
THE NEURON
20
What happens when a neurotransmitter falls in
love with a receptor? - You get a binding
relationship!
21
Some neurotransmitters
Transmitter Derived from Site of Synthesis
Acetylecholine Choline CNS, parasymp. nerves
Serotonin (5-HT) Tryptophan CNS, enteric cells, gut
GABA Glutomate CNS
Histamine Histidine hypothalamus
Epinephrine Tyrosine Adrenal medulla, CNS cells
Norepinephrine Tyrosine CNS, sympathetic nerves
Dopamine Tyrosine CNS, (limbic system)
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