Biological%20Therapies

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Biological Therapies
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Helping Professionals Who Can Administer
Biological Therapies

• Medical specialists
• Psychiatrists M.D.
• Neurosurgeon M.D.
• Other Medical Practitioners
• General practitioners M.D.
• Psychiatric nurses (M.S.N. M.S in
  psychopharmacology)
• Clinical psychologists Ph.D./Psy.D. ??

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Assumptions of Biological Therapies

• Psychological phenomena are associated with brain
  functions
• Psychopathology is associated with abnormality of
  brain functions
• Intervention lies in changing brain function
• Easiest way to change brain function is with
  drugs
• Influence rather than eliminating neural
  connections
• May be reversible

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Types of Biological Therapies

• Psychopharmacological
• Psychosurgical
• Other procedures (e.g. electroconvulsive therapy)

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PsychopharmacologySide Effects

• As with most biological therapies, psychoactive
  drugs have side effects
• Dont know enough about brain function
• Dont know enough about mechanics of the drugs
• Main effects, side effects, toxic effects
• therapeutic window of psychoactive drugs is
  very small
• State of the art for drug therapies is not cure
• Enhancing therapeutic effects
• Minimizing toxic effects

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Psychopharmocology Antipsychotics

• Dopamine receptor blockers
• Based on the dopamine hypothesis
• Overactive dopamine systems result in positive
  symptoms of schizophrenia
• Dopamine is involved in CNS control of behavioral
  attention and activation of movement
• Appears to be a correlation between positive
  symptoms of schizophrenia and attention to
  stimuli most can ignore
• Ongoing internal dialogue
• Aspects of the environment
• Unusual memory events
• Side effects of dopamine receptor blockers
• Tardive dyskinesia (involuntary muscle movement
  ex. mouth, lips, tongue)
• Parkinsonian tremors

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Psychopharmacology Antidepressants

• 3 major categories
• Similar functions
• Increase synaptic level of norepinephrine and/or
  serotonin
• Norepinephrine - ANS functions like
  bronchodilation and heart rate CNS control of
  arousal and vigilance
• Serotonin - CNS mechanisms of sleep and dreaming

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Psychopharmacology Antidepressants (cont.)

• Tricyclics
• Mechanism is unclear
• May sensitize monoamine receptors
• Block reuptake of norepinephrine and serotonin
  after fired
• 1-6 weeks for antidepressant effects
• MAO Inhibitors
• Prevent the breakdown of neurotransmitters
• Keeps more around for uptake
• Dangerous interaction with tyramine (natural
  enzyme)
• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Blocks reuptake of serotonin more serotonin
  available
• Not so selective
• Associated with increased sleep and sexual
  difficulties

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Next Generations of Antidepressants

• Wellbutrin
• Increases norepinephrine in synaptic cleft
• Reduces incidence of sexual dysfunction found in
  SSRIs
• May cause seizures
• Desyrel
• Counteracts some of the sleep difficulties found
  in SSRIs
• May cause constant erection
• Serzone
• Decreased sleep and sexual dysfunctions
• Other toxic effects unknown yet

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Alternative Treatment for Mood Disorders

• For Seasonal Affective Disorder (SAD) -Light
  therapy
• For SAD - Melatonin
• For Dysthymia St. Johns Wort (herb)

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Psychopharmacology Anxiety

• Anxiolytics
• Based on the assumption that anxiety disorders
  are the result of excessive activity in neural
  circuits of anxiety response/vigilance
• Too much GABA (Gamma Amino Butyric Acid)
• The central nervous systems primary inhibitory
  neurotransmitter keeps general levels of neural
  activity in check
• Benzodiazapines
• SSRIs
• Buspirone

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Psychopharmacology Psychostimulants

• Ritalin, Cylert, Dexedrine
• Used in the treatment of ADHD
• Stimulates the part of the brain that selectively
  attends

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Combined Therapies

• Debate is still on about whether psychotherapy
  alone may be effective and in the treatment of
  what disorders
• Many studies are showing that combination of
  psychotherapy and pharmacological therapy is more
  effective that drugs alone
• Meds used alone primarily for insurance reasons

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Psychosurgery

• Frontal lobotomy has been replaced with more
  precise targeting of specific areas of the brain
• Ex. Cingulotomy
• Disconnects the cingulate gyrus of the frontal
  lobe from the limbic areas of the temporal lobe
• Still very controversial
• Only used as experimental treatment for severe
  OCD that doesnt respond to behavioral and drug
  therapies

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Other Biological Procedures

• Electroconvulsive therapy (ECT)
• Used to be known as shock treatment
• Administered only as last resort only in severe,
  unrelenting major depression unresponsive to
  other therapies
• Treatment mechanics have improved still unclear
  about the mechanics of how it works
• Generally increases neurotransmitter turnover
• Requires several treatments to influence symptoms
• Side effects include memory loss
• Recent experimentation with unilateral ECT
  suggests that memory loss difficulties may be
  ameliorated with continuing sophistication in the
  administration of ECT