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Psyc 330 Chapter 13 Notes
This is a comprehensive and detailed note on Chapter 13; psychotherapeutic medications. *Essential Study Material!!
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CHAPTER 13: PSYCHOTHERAPEUTIC MEDICATIONS Fewer than a dozen countries (predominantly the U.S., Italy, Japan, Germany, France,
the United Kingdom, Brazil, Spain, and Canada) account for approximately 75% of the
world’s pharmaceutical sales.
In the United States alone, well over 250 million prescriptions are processed yearly for
the lawful use of psychotherapeutics.
Psychotherapeutic: exerting a special or unique action on psychological functioning.
Historical Overview
The roots of psychopharmacology are based in the 19th century, when a science of
chemistry was developing.
The actual coining of the term psychopharmacology in 1920 is attributed to David
Macht, an American pharmacist.
The Pre-Chlorpromazine Era
The 19th century had a very little understanding of mental illness. The proposed
remedies were mostly speculative with little scientific report.
Many of the approaches used were actually cruel, including bloodletting, hot irons,
flogging, revolving chairs, starvation, and sneezing powder.
Scientists Emil Kraepelin, Philippe Pinel, and J. E. Esquirol were involved in the
development of a classification system of mental illnesses.
One of the more systematically studied drugs during the 19th century was cannabis.
Manic: relating to mania, a mood disturbance that typically includes hyperactivity,
agitation, excessive elation, and pressured speech.
The first half of the 20th century brought further attempts to use drugs and other
therapies to treat mental illness.
Tests were conducted on the effectiveness of giving amphetamines to
depressed and narcoleptic patients.
Narcoleptic: a state characterized by brief but uncontrollable episodes of
sleep.
Carbon dioxide inhalation procedures were used in the treatment of illnesses
referred to as psychoses and neuroses
Neuroses: nonpsychotic emotional disturbance, pain, or discomfort
beyond what is appropriate in the conditions of one’s life.
Also used in the treatment of psychoses were antihistamines, insulin shock, and
psychosurgery, which entails the cutting of fibers connecting particular parts of
the brain or the removal or destruction of areas of brain tissue with the goal of
modifying severe behavioral or emotional disturbances.
Electroshock therapy was used to treat severe depression (a procedure still
used today).
Finally, in 1949, an Australian physician named John Cade discovered that the
alkali metal lithium successfully moderated manic conditions.
The Age of Chlorpromazine
Paul Charpentier synthesized chlorpromazine in 1950.
Chlorpromazine was used as an anesthetic; it decreased patients’ anxiety about
surgical preparations and prevented shock during surgery.
Since 1955, the number of hospitalized psychiatric patients in the U.S. has decreased
significantly. Of course, other factors have contributed to today’s lower figure, such as
, the development of other psychotherapeutic drugs, but the starting point was
chlorpromazine.
The next major event was the appearance of reserpine in 1954. This drug is very
similar to chlorpromazine.
Other advances in the field were antianxiety (anxiolytic) medications, such as
meprobamate, and antidepressant medications, such as monoamine oxidase
inhibitors (MAOIs) and tricyclic antidepressants.
Epidemiology
Approximately 25% of the U.S. adult population experience some form of mental
disorder in any given year. Most of these people are experiencing symptoms
associated with one of the three problems: anxiety states, depression, and affective
disorder. However, only a minority seeks clinical services for their disorders.
One in every four adults in the U.S. (26.2%) suffers from a diagnosable mental
disorder in a given year.
The symptoms associated with mental health disorders frequently are treated with
prescription medications, most commonly prescriptions for an antidepressant or anti-
anxiety agent.
There are important trends among people who use psychotherapeutic medications:
o First, the prevalence of psychotherapeutic medication use is about twice as high
among women as among men.
o Second, psychotherapeutic drug use increases with age, a trend seen more
dramatically among men.
o Third, greater use of the psychotherapeutics is found among those who live
alone, those with more education, and those with higher incomes.
The nonprescribed use and abuse of psychotherapeutic drugs are a significant
problem.
The drugs most often abused or misused in western cultures are depressants and
stimulants.
The misuse of drugs are especially noted among the elderly. The elderly use about
one third of the drugs taken yearly in the U.S., which accounting for a much smaller
proportion of the population.
Several information gathering networks have been established to monitor the
distribution and use of drugs overall. The largest of these is the Drug Abuse Warning
Network (DAWN).
Classes of Drugs and Their Actions
The most common classification of psychotherapeutic drugs is by therapeutic usage.
This classification yields four basic categories: antipsychotics, antidepressants,
antianxiety agents, and antimanic medications.
Antipsychotics
Antipsychotics are used in the treatment of severe psychiatric disorders, such as
schizophrenia.
Schizophrenia affects approximately 1% of people over a lifetime, and the rate
appears to be slightly higher among men than women.
To a lesser extent, antipsychotics also have been used in the treatment of mania,
agitated depression, toxic psychoses, emotionally unstable personalities, and
psychoses associated with old age.
o Agitated depression: depressed mood accompanied by a state of tension or
restlessness. People with agitated depression show excessive motor activity, as
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