1. Psychotherapeutic Drugs
Chapter 10
Psychotherapeutic Drugs

2. Understanding Mental Illness
Types of Disorders
Obsessive-compulsive behaviors,
psychosomatic ailments, panic
disorders
Psychosis: Person loses contact with reality
Examples: schizophrenia, bipolor affective disorder

3. Treatment Before 1950 Options very limited
Electroconvulsive therapy (ECT) used to treat depression and psychosis

4. Psychotherapeutic Drugs
Antidepressants
Major Tranquilizers

5. ANTIDEPRESSANTS Development began in the early 1950’s in TB Wards
Iproniazid
Tricyclics Developed

6. ANTIDEPRESSANTS TRICYCLICS: Similar to Phenothiazines
MECHANISM OF ACTION: BLOCKS REUPTAKE OF NOREPINEPHRINE AND SEROTONIN
MOOD REFLECTS A BALANCE BETWEEN NOREPINEPRINE AND SEROTONIN

7. EFFECTS OF TRICYCLICS ELEVATION IN MOOD INCREASED PHYSICAL ACTIVITY
INCREASED MENTAL ALERTNESS
INCREASED APPETITE
INCREASED ABILITY TO SLEEP

8. EXAMPLES OF TRICYCLICS
TOFRANIL
ELAVIL

9. IMPACT OF TRICYCLICS TREATS DEPRESSION 60-70% OF STUDIES
CLOSE IN EFFECT TO ECT

10. SELECTIVE SEROTONIN REUPTAKE INHIBITORS
NEWER ANTIDEPRESSANTS
INTRODUCED IN 1987
EFFECTS SEROTONIN

11. PROZAC SAFER THAN TRICYCLICS WEIGHT LOSS SIDE EFFECT
SOME REPORTS OF VIOLENT/SUICIDAL BEHAVIOR

12. Zoloft Most popular Antidepressant
Used for depression and obsessive-compulsive disorders, and panic disorders
Approved for use with children

13. PAXIL
The most heavily advertised antidepressant drug between
Excellent patient response
-59% believed that the
drug was beneficial

14. Paxil negtive responses include
-21% felt drowsiness or disorientation
-53% experienced decreased sexual interest
-22% gained weight
FDA has concerns that children taking Paxil are 3.2 times more likely to attempt suicide

15. PaxilCR
PaxilCR is a derivative of Paxil with a a positive patient response especially for social anxiety disorder, panic disorder and premenstrual syndrome.
PaxilCR is about 1/3 of the cost of Paxil

16. Lithium
Lithium is effective for acute mania and for preventing mania and depression from recurring
Lithium has multiple side effects including nausea, thirst, excessive perspiration and hand tremors
Few withdrawal symptoms

17. MAJOR TRANQUILIZERS “ANTI-PSYCHOTIC DRUGS” Phenothiazines (Thorazine)
MENTAL HOSPITAL ADMISSIONS DECREASED SIGNIFICANTLY AFTER THE INTRODUCTION OF MAJOR TRANQUILIZERS

18. MECHANISM OF ACTION BLOCK POSTSYNAPTIC DOPAMINE RECEPTORS IN THE BRAIN
BLOCK ACETYLCHOLINE

19. MEDICAL BENEFITS DECREASED ANXIETY DECREASED MANIA
DECREASED DEPRESSION
DECREASED STAY IN MENTAL HOSPITALS

20. MAJOR TRANQUILIZERS SIDE EFFECTS EXTRAPYRAMIDAL SYMPTOMS
TARDIVE DYSKINESIA

21. EXTRAPYRAMIDAL SYMPTOMS
FACIAL TICS
RIGIDITY
SHUFFLING WALK

22. TARDIVE DYSKINESIA
SLOW PROTRUSION OF TONGUE
LIP SMACKING

23. Summary
Psychotherapeutic drugs have been helpful in treating depression and other conditions
Antidepressants and Major Tranquilizers are two major categories of psychotherapeutic drugs
SSRIs are the most popular antidepressant drugs prescribed