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Jamie Rusch
Psychiatric Medications
› Always been a part of mental health care – Legal or illegal , prescribed or self-administered
› Sedatives played a large role inside institutions› Illegal drugs played a role outside of institutions› Specific drugs became reality after WWII
History
Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPgeMental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› 1940s and early 1950s, French company explored sedatives› Discovered chlorpromazine– Relaxed patients but did not make them tired
› Psychiatrists claimed this “straightened out disordered thinking”› Quickly caught on in North America and Europe– Less dangerous than lobotomies or electroconvulsive therapy
History Continued
Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPgeMental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Concept of a “magic bullet” drove research› Laboratory research led to drug boom– Minor tranquilizers for anxiety– Anti-psychotics– Antidepressants– Mood stabilizers– Attention Deficit Disorder medication
History Continued
Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPgeMental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Medications affected how mental illness was treated› Medication availability helped closure of mental institutions› Social impact– Awareness prompted discussion and reduced stigma– Thought of as chemical imbalance– In turn, increased psychiatric drug market
History continued
Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPgeMental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Schizophrenia› Depression› Bipolar Disorder› ADHD
Most Common Disorders at Cherokee Mental Health Institute
› Neurotransmitters- chemicals in the brain that transmit messages to a receiving neuron in the brain
› Too much dopamine in subcortical part (cognition and emotion) of brain
› Not enough dopamine in prefrontal (organization, attention and motivation)
› Abnormal Serotonin, GABA, and glutamate
Schizophrenia-What’s different?
Hoeksema, S. (2013). Abnormal psychology (5th ed). New York, N.Y.: McGrawHill.McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral pharmacology. (7th ed.). Boston: Pearson.
› Typical antipsychotics (available since 1950s)– Haloperidol– Chlorpromazine– Perphenazine
› Rebalance dopamine,› Improves thinking, mood, organization, hallucinations, and
delusions
Schizophrenia-Medications
Hoeksema, S. (2013). Abnormal psychology (5th ed). New York, N.Y.: McGrawHill. McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral pharmacology. (7th ed.). Boston: Pearson.Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPgeMental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Atypical antipsychotics (available since 1990s)– Risperidone (Risperdal)– Olanzapine (Zyprexa)– Quetiapine (Seroquel)
› Rebalances dopamine AND serotonin› Improves thinking, mood, behavior, delusions, hallucinations,
motivation
Schizophrenia: Medications
McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral pharmacology. (7th ed.). Boston: Pearson.Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPge.Mental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Weight gain› Drowsiness› Blurred vision› Rapid heartbeat› Tremors and muscles spasms› Long-term kidney damage and tardive dyskinesia
(uncontrollable muscle movement)
Schizophrenia: Medication Side Effects
Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPgeMental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Inadequate amounts of– Norepinephrine (attention, motivation, pleasure, reward)– Serotonin – Dopamine (Alertness, energy)
Depression
Hoeksema, S. (2013). Abnormal psychology (5th ed). New York, N.Y.: McGrawHill. McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral pharmacology. (7th ed.). Boston: Pearson.
› Selective serotonin reuptake inhibitors (SSRIs)– Fluoxetine (Prozac)– Sertraline (Zoloft)– Excitalopram (Lexapro)
› Enhance the action of serotonin› Improve sadness, feelings of helplessness and hopelessness,
loss of interest
Depression: Medications (Antidepressants)
McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral pharmacology. (7th ed.). Boston: Pearson.Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPgeMental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Serotonin and norepinephrine reuptake inhibitors (SNRIs)– Duloxetine (Cymbalta)– Bupropion (Wellbutrin)
› Enhance action of serotonin and norepinephrine› Used less commonly by CMHI medical providers
Depression: Medications (Antidepressants)
McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral pharmacology. (7th ed.). Boston: Pearson.Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPge.Mental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Headache› Nausea› Sleeplessness› Weight gain› Agitation
Side effects
Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPgeMental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› May involve norepinephrine, serotonin, and many others› Lie dormant and then be activated by a life event
Bipolar Disorder
Hoeksema, S. (2013). Abnormal psychology (5th ed). New York, N.Y.: McGrawHill. McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral pharmacology. (7th ed.). Boston: Pearson.Thase, M., & Sachs, G. (2000). Bipolar depression: pharmacotherapy. Biological Psychiatry, 48(6), 558-572.
› Mood stabilizers– Lithium (manic and depressive episodes)– Depakote
› Antipsychotics› Antidepressants– Controversial
DISCLAIMER: Bipolar is difficult to treat and takes experimenting and different combinations for everyone!!
Bipolar Disorder: Medications
McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral pharmacology. (7th ed.). Boston: Pearson.Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPge.Mental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.Thase, M., & Sachs, G. (2000). Bipolar depression: pharmacotherapy. Biological Psychiatry, 48(6), 558-572.
› Dry mouth› Slurred speech› Blackouts› Frequent urination› Hallucinations
Bipolar: Medication Side Effects
Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPge.Mental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› High amounts of serotonin in the brain– Affects impulsivity
› Dopamine and norepinephrine function abnormally
Attention Deficit Hyperactivity Disorder (ADHD)
Hoeksema, S. (2013). Abnormal psychology (5th ed). New York, N.Y.: McGrawHill.
› Stimulants– Methylphenidate (Ritalin)– Amphetamine (Adderall)
› Nonstimulants– Atomoxetine (Strattera)
› Improve attention through heightened focus› Do the same thing but without addiction risk
ADHD: Medications
McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral pharmacology. (7th ed.). Boston: Pearson.Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from http://www.nami.org/Template.cfm?Section=About_Medications&Template=/TaggedPge.
Mental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014, from http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Treating mental illness is tricky› It is not like a virus or an infection› Difficult deciding what medications to use› Takes educated trials as well as trial and error› Medications only work when taken properly
Conclusion
› Craighead, W., & Dunlop, B. W. (2014). Combination Psychotherapy and Antidepressant Medication Treatment for Depression: For Whom, When, and How. Annual Review Of Psychology, 65(1), 267-300. doi:10.1146/annurev.psych.121208.131653
› Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association
› Hoeksema, S. (2013). Abnormal psychology (5th ed). New York, N.Y.: McGrawHill. › McKim, W. A., & Hancock, S. D. (2012). Drugs and behavior: an introduction to behavioral
pharmacology. (7th ed.). Boston: Pearson.› Medications. (n.d.). National Alliance on Mental Illness. Retrieved March 14, 2014, from
http://www.nami.org/Template.cfm?Section=About_Medications&Template=/Ta ggedPge› Mental Health Medications. (2008, July 8). National Institute of Mental Health. Retrieved March 13, 2014,
from http://www.nimh.nih.gov/health/publications/mental-health- medications/index.shtml?utm_source=twitterfeed&utm_medium=twitter.
› Moncrieff, J., Cohen, D., & Porter, S. (2013). The Psychoactive Effects of Psychiatric Medication: The Elephant in the Room. Journal Of Psychoactive Drugs, 45(5), 409-415. doi:10.1080/02791072.2013.845328
› Thase, M., & Sachs, G. (2000). Bipolar depression: pharmacotherapy. Biological Psychiatry, 48(6), 558-572.
References