Dit is een Engelstalige samenvatting van het vak Psychopharmacology. Deze bevat informatie uit de powerpoints, mijn notities en de meeste teksten (verplichte literatuur).
,Content
1 History of Psychopharmacology..........................................................................................................3
1.1 Ancient history..............................................................................................................................3
1.2 Influences from psychology..........................................................................................................4
1.2.1 Experimental psychology.......................................................................................................4
1.2.2 Behavioral Psychology...........................................................................................................5
1.2.3 Behavioral Pharmacology......................................................................................................6
1.2.4 Biological Psychology & Psychopharmacology.......................................................................6
1.2.5 Example: Hebbian learning....................................................................................................6
1.3 Influences from psychiatry...........................................................................................................9
1.3.1 Early pharmacotherapy (1860 – 1930)...................................................................................9
1.3.2 Hallucinogenic experiments (1880 – 1940)..........................................................................10
1.3.3 The revolutionary decade (1949 – 1958).............................................................................12
1.4 In conclusion...............................................................................................................................15
2 Neurobiological frameworks of Psychopharmacology.......................................................................16
2.1 Key concepts of behavioral neuroscience...................................................................................16
2.1.1 Anatomy & organization of the nervous system..................................................................16
2.1.2 Origin of signals...................................................................................................................19
2.1.3 Neural communication........................................................................................................20
2.2 Key concepts of Psychopharmacology: pharmacokinetics..........................................................29
2.2.1 General framework..............................................................................................................29
2.2.2 Routes of Administration.....................................................................................................29
2.2.3 Absorption & Distribution....................................................................................................31
2.2.4 Depot binding......................................................................................................................34
2.2.5 Inactivation & biotransformation........................................................................................34
2.2.6 Excretion..............................................................................................................................37
2.2.7 Overview..............................................................................................................................37
2.3 Key concepts of Psychopharmacology: pharmacodynamics.......................................................37
2.3.1 CNS-Behavioral Categorization of Drugs..............................................................................37
2.3.2 Influencing synaptic communication...................................................................................37
2.3.3 Drugs as ligands...................................................................................................................38
2.3.4 Physiological responses of receptors...................................................................................39
2.3.5 Dynamic reactions...............................................................................................................41
2.3.6 From drug actions to drug effects........................................................................................41
2.3.7 Dose Response Curves (DRCs)..............................................................................................42
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, 2.3.8 From selectivity problem to versatility?...............................................................................42
2.3.9 Tolerance ↔ sensitization..................................................................................................43
3 Psychosocietal discussions.................................................................................................................45
3.1 Topic 1: Psychopharmacological research & ethical challenges.................................................45
3.1.1 Research cycle.....................................................................................................................45
3.2 Topic 2: Therapy adherence & medicalization............................................................................53
3.2.1 Defining therapy (non)adherence........................................................................................53
3.2.2 Factors related to therapy (non)adherence.........................................................................53
3.2.3 Societal problems related to therapy (non)adherence........................................................56
3.2.4 The case of Scott Martin: introduction & instructions.........................................................57
3.2.5 How to improve therapy adherence....................................................................................58
3.3 Topic 3: Substance use disorders (SUDs) & societal issues.........................................................60
3.3.1 Drug abuse, addiction & dependency..................................................................................60
3.3.2 Drug policies & societal issues.............................................................................................66
3.4 Topic 4: Consequences of medicalization...................................................................................68
3.4.1 Ethical marketing.................................................................................................................69
3.4.2 Use, misuse & abuse............................................................................................................70
3.4.3 Homeopathy doesn’t work..................................................................................................72
2
, 1 History of Psychopharmacology
1.1 Ancient history
Before experimental psychology (19th century) – at the beginning of evidence-based medicine
3 men rose to the challenge of (self)experimenting with drugs:
1. Pièrre-Alexandre Charvet (1799 – 1879)
Opium crisis
Based on trade route between UK and China (Taiwan)
Sailors noticed that locals used a lot of opioids (inhaling, eating) for
its pain relieving properties and there was quite a lot of
recreational use
This caused conflict: recreational use = money!
Taiwan missed out on cash and they saw their locals turn into a criminalized society
Substance of interest: opium/heroin/morphine
First experimental pharmacological studies
Behavior > physiology: tranquillizing properties and euphoria with the right dose
Systematically animal testing (e.g. snails, fish, frogs, birds…) and himself
Observed behavioral effects
Self-experimentation of a psychoactive substance (= compound that influences our
behavior)
2. Moreau de Tours (1804 – 1884)
From angel-and-demons to humanistic approach
Mental issues = demons
Substance of interest: hasjisj
A little bit of progress in psychiatry
People suffering from mental issues were sent to prison during that time
One person (Pinel) removed the chackles and put them into a clinic (same rights, but at
least they got some specialized “treatment”)
First substance-based model of mental illnesses
Behavioral comparison (psychosis, dreams)
Hypothesized about central nervous system (CNS): there’s a link between the brain
3. Mantegazza (1831 – 1910)
Anthropological (he was an anthropologist) exploitations in South America
He saw the tribal use of coca leaves (Incas) for its energizing properties which caused
them to do horrible things such as human sacrifices
Substance of interest: cocaine/coca leaves
Self-experimentation
Uplifting (euphoric) properties of coca
He saw a clear link with “psychotic craziness” (= term for a lot of mood disorders; low
energy level)
Enthusiastic supporter of coca
First attempt at a classification system
Based on psychoactive plants and plant extracts
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