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Biological Psychiatry: Psychopharmaceuticals and Imaging

Biological Psychiatry: Psychopharmaceuticals and Imaging. Contributing Factors to Rise of Biological Psychiatry. Renewed attention to needs of the psychotic in mental hospitals Genetic Studies (Kety, 1968): 10% higher incidence of disease in relatives of schizophrenics as compared to controls

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Biological Psychiatry: Psychopharmaceuticals and Imaging

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  1. Biological Psychiatry: Psychopharmaceuticals and Imaging

  2. Contributing Factors to Rise ofBiological Psychiatry • Renewed attention to needs of the psychotic in mental hospitals • Genetic Studies (Kety, 1968): 10% higher incidence of disease in relatives of schizophrenics as compared to controls • Rise of controlled clinical trials as the gold standard in medicine; importance of “criteria, control, and variables;” talk therapies didn’t measure up • Development of psychopharmaceuticals • New journal: Biological Psychiatry (1969)

  3. Neuroleptic, or Antipsychotic Class of Drugs

  4. Pierre Deniker & Jean Delay 1952—Testing of Chlorpromazine St. Anne Hospital Paris, France Side Effects: Tardive Dyskinesia

  5. Early Psychotropic Medications • Chlorpromazine (Thorazine), 1954 McLean Hospital study—used with schizophrenics • Reserpine, used as a tranquilizer • Haloperidol was developed in 1958 (better known as Haldol), for psychotics, but non-sedative.

  6. Smith, Kline & French Laboratories c. 1956 “…helping to dispel or modify delusions, hallucinations and confusion, while keeping the patient calm and approachable.”

  7. 1959

  8. “Patients hospitalized for many years have returned to society”

  9. “helping patients gain more from psychotherapy… reduce anxiety, agitation and tension in patients…”

  10. MEPROBAMATE or Miltown Anti-Anxiety Drug (1959)

  11. 1965

  12. Anti-Depressant TestingRoland Kuhn Nathan Kline Tested anti-depressant, Imipramine (tri-cyclic) at Münsterlingen asylum in Switzerland, published results 1957 Tested Iproniazid (Monoamine Oxidase inhibitor MAOI) Rockland State Hospital NY

  13. IMIPRAMINE tri-cyclic anti- depressant

  14. Neurotransmitter Theoriesof Mental Illness • Dopamine (in excess) caused psychotic disturbances • Acetylcholine linked to dementia • Serotonin linked to depression Popular from 1963-1980; recognition after this period that it was much more complex

  15. Newsweek (1990) Class of SSRI: selective serotonin- reuptake-inhibitor Time (1992)

  16. National Alliance for the Mentally Ill founded 1979 “Mental illnesses are biologically based brain disorders.  They cannot be overcome through ‘will power’ and are not related to a person's "character" or intelligence.”

  17. CT SCANNER

  18. From Dumit, 2004

  19. CT scan PET Scan MRI Scan (Magnetic Resonance Imaging) From Dumit, 2004

  20. PET (Positron Emission Tomography) Procedure Johns Hopkins U. Medical Center, 1995

  21. Constance Perchura and Joseph Martin (1991) Nancy Andreasen (1984)

  22. PET scans of Patient with Attention-Deficit Hyperactivity Disorder compared to normal control (right)

  23. PET scans, Buchsbaum, 1985

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