Psychotropics(“moving closer to a normal state”)

trop – to turn towardDrugs for treating schizophrenia and

Mood Disorders

THE BIOMEDICAL MODEL OF MENTAL ILLNESS

• Mental disorders are caused by abnormal biochemical processes in the brain.

• Genetic evidence for the biomedical model

SYMPTOMS OF SCHIZOPHRENIA

Schizophrenic patients are “split off” or “broken off” from a firm sense of reality.

positive symptoms of schizophrenia:delusional thinking, hallucinations (usually auditory), dulled emotions, inappropriate verbal expressions, odd body postures (catatonia).

ANTIPSYCHOTIC DRUG TREATMENT

• First-generation antipsychotic drugs:Thorazine, Haldol, Mellaril, Stelazine

• Second-generation antipsychotic drugs:Clozaril, Zyprexa, Risperdal

• Third-generation antipsychotic drugs:Abilify

SIDE EFFECTS OF ANTIPSYCHOTIC DRUGS

• First-generation drugs: Parkinson-like symptoms, tardive dyskinesia

• Clozaril: Agranulocytosis in 1-2 percent of patients

• Zyprexa and Risperdal: Significant weight gain and development of diabetes, dementia among elderly patients

ANTIPSYCHOTIC DRUGS AND THE BRAIN

• In general, antipsychotic drugs are altering the level of stimulation of dopamine-sensitive receptors in the brain.

• Subtypes of dopamine-sensitive receptors are differentially affected by various antipsychotic drugs.

• Third-generation antipsychotic drugs stabilize (modulate) the level of D2 receptors

Psychiatrists, Children and Drug Industry’s Role

“When Anya Bailey developed an eating disorder after her 12th birthday, her mother took her to a psychiatrist at the University of Minnesota who prescribed a powerful antipsychotic drug called Risperdal.”

By GARDINER HARRIS, BENEDICT CAREY and JANET ROBERTSPublished: May 10, 2007

http://www.nytimes.com/2007/05/10/health/10psyche.html?fta=y

“In 2006, the Food and Drug Administration received reports of at least 29 children dying and at least 165 more suffering serious side effects in which an antipsychotic was listed as the “primary suspect.” That was a substantial jump from 2000, when there were at least 10 deaths and 85 serious side effects among children linked to the drugs. Since reporting of bad drug effects is mostly voluntary, these numbers likely represent a fraction of the toll.”

http://www.nytimes.com/2007/05/10/health/10psyche.html?pagewanted=4&fta=y

Dr. Derek H. Suite, a psychiatrist in the Bronx, says he sees many children on antipsychotic drugs who do not need them.

Poor Children Likelier to Get Antipsychotics DUFF WILSONPublished: December 11, 2009

http://www.nytimes.com/2009/12/12/health/12medicaid.html?em

ANTIDEPRESSANT DRUGS

• First-generation antidepressant drugs:MAO-inhibitors (Nardil, Parnate), tricyclic drugs (Tofranil, Elavil)

• Second-generation antidepressant drugs:SSRIs (Prozac, Celexa, Paxil,

Zoloft)

• Third-generation antidepressant drugs:Cymbalta, Remeron, Effexor

ANTIDEPRESSANTS AND NEUROTRANSMITTERS

• MAO-inhibitors raise functioning levels of norepinephrine and serotonin.

• SSRIs raise functioning levels of serotonin.

• Third-generation antidepressants raise functioning levels of norepinephrine and serotonin.

DRUGS FOR OTHER TYPES OF MENTAL DISORDERS

Mania and bipolar disorders: Lithium, Depakote, Symbyax, Abilify

Autism: Risperdal

Mild depression: St. John’s wort

ISSUES IN MENTAL HEALTH TREATMENT

• Social effects of deinstitutionalization

• Psychiatric drugs and civil liberties

• Impact of health insurance coverage policy

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