PSYC 222 1st Edition Lecture 9Outline of Last Lecture Route Of administration i. Oral administrationii. Insufflationiii. Intravenous Injectioniv. Other types of injectionv. transport in the bloodvi. blood brain barriervii. mechanisms of drug actionviii.factors determining behavioral impacts of drugsOutline of Current Lecture Medication for mental disorders i. Mental disorders the medical modelii. classification of mental disordersiii. Early treatment of mental disordersiv. Antipsychoticsv. Antidepressantsvi. Selective Reuptake InhibitorsCurrent Lecturei. Modelsymptomsdiagnosisdetermination of causetreatmentcureUsually the only symptoms of mental disorders ar behavioral. Bhevaiors are varied and can have many causes. Models guide much of current thinking. Psychoactive drugs are used to control symptoms of mental illness. Researchersseek to identify chemical imbalances associated with specific mental disorders.ii. ii. Diagnostic and statistical Manuel of mental disorders (DSM-5). Anxiety disorders includes excessive worry,fears, or avoidance. DSM-5 Anxiety disorders: Specific Phobia, Social anxiety disorder, panic disorder, Agoraphobia, and generalized anxiety disorder. Psychosis include serious mental disorder involving loss of contact with reality. DSM-5 Schizophrenia: Chronic Pyschosis characterized by two of the following: Delusions, Hallucinations, disorganized speech, disorganized behavior, and lack of emotional response. These cause significant interference with social and or occupational functioning. DSM-5 Mooddisorders are characterized by depressed or manic symptoms. Major Depressive disorder, and bipolar disorder. At least one manic episode and possible alternating depression. Individuals dont always fit into diagnostic categories.iii. General Paresis: Syphilitic infection of the nervous system that causes psychosis. Malaria therapy: Fever associated with Malaria was thought to improve the condition. Later antibiotics were developed to cure syphilis. Early pharmacotherapy, "Narcosis Therapy" was depressants used to induce sleep for aweek or more. Intravenous thiopental sodium (truth serum), used during psychotherapy to help patients express repressed thoughts. Insulin shock therapyused to treat schizophrenia. Ineffective. Electroconvulsive therapy, ineffective to treat schizophrenia, still used to treat severe depression that doesnt respond to medication.iv. Penothiazines: an early group of drugs used to treat psychosis. Reduced psychotic symptoms without sedation. Initially caused tranquilizers or neuroleptics. Now called antipsychotics. Following intro of drug therapy for schizophrenia. Restraints and convulsive therapies were reduced or discontinued in psychiatric hospitals. Typical antipsychotics are dopamine antagonists, block D2 receptors, produce pseudoparkinson, and if there is a time delay in drug effects it indicates that the mechanism of action is probably more complex. Atypical antipsychotics are serotonin-dopanine antagonists, block both D2 dopamine and 5HT2A serotonin receptors and produce less pseudoparkinson. Antipsychotics are generally safe, do not produce drug dependence, difficult to use to commit suicide. The side effects are some allergic reactions; jaundice and skin rashes, photosensitivity, agranulocytosis; low white blood cell count, pseudoparkinson; tremors, muscle rigidity, shuffle walk, masklike face,and tardive dyskinesia; most serious complications of drug treatment. Long term effectiveness appears to be considerably lower than short term. 75% of patients discontinue use by 18 months. v. Monoamine oxidase inhibitors; (ex: phenelzine, tranylcypromine). Tricyclics; (ex: amitriptyline, doxepin, nortriptyline) Selective Reuptake inhibitors; (ex: fluoxtine, sertraline, paroxetine) Monomamine oxidase inhibitors elevate mood. They increase the availability of serotonin, norepinephrine, and dopamine in synapse by inhibiting enzymatic breakdown. Limited use due to side effects and toxicity; (ex: hypertension and "cheese reaction)vi. Types of selective reuptake inhibitors; SSRI (Serotonin reuptake inhibitors) and SSNRI (Serotonin and Norepinephrine reuptake inhibitors). These are safer than tricyclic antidepressants and less likely to lead to overdose deaths. However, FDA warning about increased risks of suicidal tendencies in children and