Drug Craving Can Be LearnedAbused Drugs Have Reinforcing Properties : Self-AdministrationAbused Drugs Serve as Discriminative StimuliAlcohol Dependence Can Be Treated With Naltrexone or DisulfiramOpioids Mimic the Action of our Normal Biological EnvironmentChorpromazine (Thorazine): First AntipsychoticAustralian Psychiatrist Introduces Lithium to Treat Manic Depression (Bipolar Disorder)Amphetamine: First Report That Hyperactivity Can Be Reduced in ChildrenFluoxetine (Prozac) Introduced as Antidepressant Treatment for DepressionBenzodiazepines (BZD) Introduced, Class of Drugs that has Anxiolytic Effects (i.e., Antianxiety)Top Ten Discoveries in Psychopharmacology Abused Substances and Psychotherapeutic DrugsEach discovery created a shift in paradigm, could not be explained by current models (paradigms) and opened the door to a new line of study by opening the door to new paradigms5 substance and abuse5 psychotherapeutic drugsDrug Craving Can Be Learned- When confronted with cues that, in the past, have been paired with the drug, people (and non-human animals) dependent on drugs display evidence of craving (intense urge to take drug) and heightened drug withdrawal symptoms - Opened up the study of: Role of learning and experience in drug abuse Role of drug-anticipatory responses in drug abuse tolerance and dependence Role of dopamine and other neurotransmitters in drug craving and withdrawal(Shephard Siegel 1985)Abused Drugs Have Reinforcing Properties : Self-Administration - A variety of abused drugs have reinforcing effects, i.e., animals will press a lever in order to receive an injection of drug into the blood or into the brain (drug-induced self administration behavior)- Opened up the study of: Predictability of abuse potential of a drug in humans through its ability to produce self-administration reinforcing effects The role of specific neurotransmitters (dopamine) and anatomical substrates (nucleus accumbens) in the self-administration reinforcing effects of abused drugs(Weeks 1962)Abused Drugs Serve as Discriminative Stimuli- Animals can learn to press a lever in the presence of a specific abused drug (e.g., when heroin actsas the reinforced cue) and withhold pressing the lever in a non-drugged state or in the presence of a different drug state (e.g., in the presence of amphetamine as the non-reinforced cue).- Opened up the study of: Comparing drugs with similar and dissimilar subjective effects in studies of cross tolerance amongabused and non-abused drugs Identifying and examining the neurochemical basis among similar and dissimilar drugs with abuse potentialAlcohol Dependence Can Be Treated With Naltrexone or Disulfiram - Pharmacological treatment is effective in alcohol-dependent individuals by decreasing alcohol consumption, reducing craving, maintaining abstinence or preventing relapse- Opened up the study of: Comprehensive, integrated approach to alcohol abuse. In most cases, medications should be used to augment psychosocial therapies. Treatment for alcohol abuse/dependence should includeboth behavioral/psychosocial approaches and the use of various medications. Management of acute alcohol withdrawal or detoxification by either reducing glutamate activity or increasing GABA activity Pharmacotherapies to help treat comorbid psychological disorders (anxiety, depression, insomnia)w/ alcohol abuseOpioids Mimic the Action of our Normal Biological Environment (i.e., Endorphins)- Morphine and morphine-like drugs belong to the class of drugs called opioids; they interact w/ opioid receptors in the brain; Opioids are agonists at highly specific receptor sites and the analgesic potency of the agonist correlates w/ the affinity of the agonist for the opioid receptor- Opened up the study of: Genes that encode the different opioid receptors Classification of different kinds of opioid analgesics based on their receptor affinity Tolerance/dependence and rebound withdrawal symptoms opioid drugs incluing morphine Study of pharmacotherapy (e.g., methadone) of opioid dependence Chorpromazine (Thorazine): First Antipsychotic - Discovered by French Researchers - CPZ seemed to act on psychotic process—did not produce sedation or loss of consciousness; made pts more indifferent to, less anxious to upcoming surgery, more reactive/more interactive- Opened up the study of: Community mental health treatment where outpt programs were set up to treat pts closer to home in a more natural environment at less cost; CPZ changed the fabric of mental health treatment—thousands of pts were freed from long term hospitalization Alternative first generation antipsychotics (e.g., haloperidol—haldol), second-generation atypical antipsychotics (e.g., clozaril—clozapine Research into the serious side effects of chronic antipsychotic use on involuntary motor movements (tardive dyskinesias)  Neurotransmitter (dopamine) basis of antipsychotic effects(Pierre Deniker, Henri Leborit and Jean Delay, 1952) Australian Psychiatrist Introduces Lithium to Treat Manic Depression (Bipolar Disorder) - In the 1960s, Li gained widespread acceptance for treatment of mania (improvement in manic symptoms) w/ little or no effect on unipolar depression- Opened up the study of: Other mood stabilizing therapeutic agents for bipolar that do not require blood level monitoring (e.g., valproic acid-depakote, carbamezapine-tegretol, lamotrigine-lamictal) Research into other uses for mood stabilizers such as treatment of neuropathic pain, anxiety disorders, BPD and aggression Research into the combination of pharmacologic and psychotherapeutic-psychosocial treatments in bipolar and other disorders(John Cade, 1949)Amphetamine: First Report That Hyperactivity Can Be Reduced in Children - Amphetamine elevates mood, induces euphoria, increases alertness, reduces fatigue, reduces boredom and improves task performance—Methylphenidate, an amphetamine that augments the synaptic action of DA and NE in the nucleus accumbens, accounts for nearly 90% of medications given to children w/ ADHD.- Opened up the study of: Research into psychostimulants as a treatment for aggressive and conduct disorders, even in the absence of ADHD Research into alternative medications for ADHD (e.g, antidepressants, dopamine agonists, NE reuptake inhibitors)  Research into the neurobiology of ADHD Studies of early intervention, multifaceted combined therapies in ADHD