1. Biological Psychiatry: Psychopharmaceuticals and Imaging

2. Contributing Factors to Rise of Biological Psychiatry Renewed attention to needs of the psychotic in mental hospitals Genetic Studies (Kety, 1968): 10% higher incidence of disease in relatives of schizophrenics as compared to controls Rise of controlled clinical trials as the gold standard in medicine; importance of “criteria, control, and variables;” talk therapies didn’t measure up Development of psychopharmaceuticals New journal: Biological Psychiatry (1969)

3. Neuroleptic, or Antipsychotic Class of Drugs

4. Pierre Deniker & Jean Delay 1952—Testing of Chlorpromazine St. Anne Hospital Paris, France Side Effects: Tardive Dyskinesia

5. Early Psychotropic Medications Chlorpromazine (Thorazine), 1954 McLean Hospital study—used with schizophrenics Reserpine, used as a tranquilizer Haloperidol was developed in 1958 (better known as Haldol), for psychotics, but non- sedative.

6. Smith, Kline & French Laboratories c. 1956 “…helping to dispel or modify delusions, hallucinations and confusion, while keeping the patient calm and approachable.”

7. 1959

8. “Patients hospitalized for many years have returned to society”

9. “helping patients gain more from psychotherapy… reduce anxiety, agitation and tension in patients…”

10. MEPROBAMATE or Miltown Anti-Anxiety Drug (1959)

11. 1965

12. Anti-Depressant Testing Roland Kuhn Nathan Kline Tested anti-depressant, Imipramine (tri-cyclic) at Münsterlingen asylum in Switzerland, published results 1957 Tested Iproniazid (Monoamine Oxidase inhibitor MAOI) Rockland State Hospital NY

13. IMIPRAMINE tri-cyclic anti- depressant

14. Neurotransmitter Theories of Mental Illness Dopamine (in excess) caused psychotic disturbances Acetylcholine linked to dementia Serotonin linked to depression Popular from 1963-1980; recognition after this period that it was much more complex

15. Newsweek (1990) Time (1992) Class of SSRI: selective serotonin- reuptake-inhibitor

16. “Mental illnesses are biologically based brain disorders. They cannot be overcome through ‘will power’ and are not related to a person's "character" or intelligence.” National Alliance for the Mentally Ill founded 1979

17. CT SCANNER

18. From Dumit, 2004

19. CT scan PET Scan MRI Scan (Magnetic Resonance Imaging) From Dumit, 2004

20. PET (Positron Emission Tomography) Procedure Johns Hopkins U. Medical Center, 1995

21. Nancy Andreasen (1984) Constance Perchura and Joseph Martin (1991)

23. PET scans of Patient with Attention-Deficit Hyperactivity Disorder compared to normal control (right)

24. PET scans, Buchsbaum, 1985