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Chapter 15

Drugs for Treating Schizophrenia and

Mood Disorders

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Psychiatric Drugs

• The development of psychiatric drugs to treat major mental illnesses such as schizophrenia and mood disorders has both revolutionized the field of mental health and provided insights into the biochemical basis for mental illness.

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Psychiatric Drugs

• As effective as psychiatric drugs might be for the mentally ill, none is without side effects.

• The perfect drug has yet to appear on the scene.

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The Biomedical Model

• The biomedical model, the prevailing viewpoint among mental-health professionals, asserts that abnormal thoughts and behaviors result from faulty biochemical processes in the brain.

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Antipsychotic Drugsand Schizophrenia

• Therapeutic medications for schizophrenia patients are classified as first-generation, second-generation, and third-generation antipsychotic drugs.

• First-generation drugs include chlorpromazine (brand name: Thorazine) and haloperidol (brand name: Haldol).

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Antipsychotic Drugsand Schizophrenia

• Second-generation drugs include clozapine (brand name: Clozaril) and risperidone (brand name: Risperdal).

• The newest third-generation drugs include apiprazadole (brand name: Abilify).

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Table 15.1

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Antipsychotic Drugsand Schizophrenia

• First-generation antipsychotic drugs have been effective in reducing symptoms for many patients, but they also carry the potential for the development of severe movement-related motor problems.

• Second-generation and third-generation antipsychotic medications do not produce this particular side effect.

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Antipsychotic Drugsand Schizophrenia

• Antipsychotic medications are believed to be clinically effective, and to involve the least number of adverse side effects, by virtue of a combination of actions upon subtypes of dopamine and serotonin receptors in the brain.

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Drugs Used toTreat Depression

• First-generation antidepressant drugs can be divided into two groups: MAO inhibitors and tricyclic antidepressants.

• The MAO inhibitors were the first group to be developed for the treatment of depression.

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Drugs Used toTreat Depression

• Although they are effective, patients need to be on a restricted diet to avoid serious adverse side effects.

• Tricyclic antidepressants do not require dietary restrictions, but their effects on the cardiovascular system make them undesirable for certain patients.

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Drugs Used toTreat Depression

• Second-generation antidepressants include the well-known drug fluoxetine (brand name: Prozac) and similar drugs that slow the reuptake of serotonin.

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Drugs Used toTreat Depression

• Collectively, they are referred to as selective serotonin reuptake inhibitors (SSRIs).

• Third-generation antidepressants slow the reuptake of both serotonin and norepinephrine in the brain.

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Drugs for Other Typesof Mental Disorders

• Mania and extreme mood swings between mania and depression (bipolar disorder) are two mood disorders that have been treated successfully with lithium carbonate or valproate (brand name: Depakote).

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Drugs for Other Typesof Mental Disorders

• Also used are antipsychotic medications such as risperidone (brand name: Risperdal) and ziprasidone (brand name: Geodon), or a combination of antipsychotic and antidepressant medications (brand name: Symbyax).

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Drugs for Other Typesof Mental Disorders

• Risperidone (brand name: Risperdal) has been approved as a treatment for symptoms of autism in children and adolescents.

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Psychiatric Drugs, Social Policy, and Deinstitutionalization

• Since the 1960s, a growing number of psychiatric patients have been treated outside a centralized hospital or institution and placed in treatment-care clinics in the community.

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Psychiatric Drugs, Social Policy, and Deinstitutionalization

• Although the policy of deinstitutionalization has sparked great debate and significant social problems remain, there is a growing consensus that mental-care treatment implemented in this manner is superior to institutionalization.