Title: Psychopharmacology for Therapists
1Psychopharmacology for Therapists
- Antioch University
- Tina Panteleakos, M.A.
- Guest Lecturer
- 10/6/04
2A 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
3Starter 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!)
4Ill 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
5A 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.
6Hypothetical 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.
7Congratulations!!!
- 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?
9Psychodynamic 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
10THE BRAIN
11Frontal 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
12Parietal 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).
13Occipital Lobe
- The occipital lobes are the center of our visual
perception system.
14Temporal 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)
15Cerebellum
- Involved in the coordination of voluntary motor
movement, balance and equilibrium and muscle
tone.
16Brain 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
17The Limbic System
18A 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.)
19THE NEURON
20What happens when a neurotransmitter falls in
love with a receptor? - You get a binding
relationship!
21Some 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)