Biomedical therapies

Psychotropic drugs

medications designed to alter psychological functioning

All psychotropic drugs were made to cross the BLOOD BRAIN BARRIER

A network of tightly packed cells taht only allow speciifc types of substances to move from the bloodstream to the brain in order to protect delicate brain cells against harmful infections and other substances.

• after crossing barrier psychotropics affect neurotransmitters

Different types of antidepressants

1. Monoamine oxidase inhibitors (MAOIS)

2. Tricyclic antidepressants

3. Selective serotonin reuptake inhibitor (SSRI)

Monoamine oxidase inhibitors (MAOIS)

deactivite monoamine oxidase, an enzyme that breaks down serotonin, dopamine, and norepinephrine at the synaptic cleft of nerve cells, leavinf more available at syanptic transmission

• not used often bc of bad side effects (severe reaction with tyramine in food, and drug interactions)

Tricyclic antidepressants

block the reuptake of serotonin and norepinephrine

• bad side effects, like weight gain, nausea, sex problems, seizures

Selective serotonin reuptake inhibitor (SSRI)

a class of antidepressant drugs that block the reuptake of serotonin (more serotonin in the synapse)

• safest and less drug interactions

• stimulate neurogenesis in hippocampus

• decreases amygdala activity

Herbal treatments

St. John's wort as an alternative to antidepressants. 

• Inhibits release of glutamate.

Mood stabalizers

used to prevent or reduce the severity of mood swings experienced by people with bipolar.

• most common back in the day —> Lithium

Lithium

one of the first mood stabalizers to be prescribed regularly in psychiatry, and in 1950s-1980s was the standard treatment for depression and bipolar

• effective but toxic to kidneys and endocrine system.

Anti-anxiety drugs

“tranquilizers”

affect the activity of GABA, an inhibitory neurotransmitter that reduces neural activity. 

• ex) xanax, valium

• Short lived effects

PTSD

Is a common psychological illness involving recurring thoughts, images, and nightmares, associated with traumatic event; it induces symptoms of tension and anxiety and can seriously interfere with many aspects of a person’s life

MDMA for PTSD (ecstasy)

• Dangerous and can lead to addiction. 

• Mdma enhances release of neurotransmitters.

Antipsychotic drugs

generally used to treat symptoms of psychosis, including delusions, hallucinatioms, and severely disorganized thoguhts.

• commone for schizophrenia and mood disorders

First and Second generation antispychotic drugs

first —> had bad symptoms like tardive dyskinesia

second —> atypical antipsychotics:

Tardive dyskenesia

a movement disorder involving involuntary movements and facial tics.

Atypical antipsychotics

less likely to prodyce side effects, inclduign tardive dyskenesia, that commonly occur with first gen antipsychotics

• generally affect dopamine and serotonin transmission, work for about half of users, and can lose effectiveness or negatively impact white blood cells over time.

What is diroder is lithium used for

bipolar disorder (mood stabalizer)

What disorder is clozapine used for

Schizophrenia (anti-psychotic)

Major limitation in drug therapy

neurotransmitters that are affected by psychotropic drugs are often found in a number of different brain areas.

Frontal Lobotomy

surgically severing the connections between different regions of the brain.

Moniz Leucotomy

the surgical destruction of brain tissues in the prefrontal cortex

• drill small holes in skull and enter loops

• alleveiate depression and anxious symptoms

Freeman lobotomy

Mortality rate for lobotomy was 5%, freeman would insert an icepick between eyelid and eyeball and tap with a hammer and move around until the frontal lobe is disconnected from the brain.

Focal lesions

small areas of brain tissue that are surgically destroyed.

Electroconvulsive therapy (ECT)

involves passing an electric current through the brain in order to induce a temporary seizure

• Depression and bipolar. Side effects can be mild like amnesia

Repetitive transcranial magnetic stimulation (rTMS)

a therapeutic technique in which a focal area of the brain is exposed to a powerful magnetic field across several treatment sessions.

• Stimulating the left prefrontal cortex improves depression symptoms. 

• 10-25 sessions to work.

Deep brain stimulation (DBS)

a technique that involves electrically stimulating specific regions of the brain

• instantaneous results

• Inserting electrode-tipped wires into the brain . 

• Risk of internal bleeding and infection from wires. 

• Side effects - spontaneous laughing and erections.

To activate a very specific brain region to alleviate symptoms use

deep brain stimulation.