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Psychiatric Medications. Jamie Rusch. History. 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.
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Psychiatric Medications Jamie Rusch
History • 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 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.
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=/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. • 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=/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. • 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=/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. • 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
Most Common Disorders at Cherokee Mental Health Institute Schizophrenia Depression Bipolar Disorder ADHD
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. 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-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=/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. • Typical antipsychotics (available since 1950s) • Haloperidol • Chlorpromazine • Perphenazine • Rebalance dopamine, • Improves thinking, mood, organization, hallucinations, and delusions
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. • Atypical antipsychotics (available since 1990s) • Risperidone (Risperdal) • Olanzapine (Zyprexa) • Quetiapine(Seroquel) • Rebalances dopamine AND serotonin • Improves thinking, mood, behavior, delusions, hallucinations, motivation
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=/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)
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. • Inadequate amounts of • Norepinephrine (attention, motivation, pleasure, reward) • Serotonin • Dopamine (Alertness, energy)
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. • 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=/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. • Serotonin and norepinephrine reuptake inhibitors (SNRIs) • Duloxetine (Cymbalta) • Bupropion (Wellbutrin) • Enhance action of serotonin and norepinephrine • Used less commonly by CMHI medical providers
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. Headache Nausea Sleeplessness Weight gain Agitation
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. May involve norepinephrine, serotonin, and many others Lie dormant and then be activated by a life event
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. • 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: 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. Dry mouth Slurred speech Blackouts Frequent urination Hallucinations
Attention Deficit Hyperactivity Disorder (ADHD) Hoeksema, S. (2013). Abnormal psychology (5th ed). New York, N.Y.: McGrawHill. • High amounts of serotonin in the brain • Affects impulsivity • Dopamine and norepinephrine function abnormally
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. • Stimulants • Methylphenidate (Ritalin) • Amphetamine (Adderall) • Nonstimulants • Atomoxetine (Strattera) • Improve attention through heightened focus • Do the same thing but without addiction risk
Conclusion 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
References 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.