Goal: To learn about and evaluate the value of various biologically-based methods in the treatment of different forms of psychopathology

Goal: To learn about and evaluate the value of various biologically-based methods in the treatment of different forms of psychopathology

The medical model and the search for underlying diseases that produce the symptoms of psychopathology If identified, such diseases would then be the focus of biologically-based treatments, especially drugs and/or surgeries But so far, very few such diseases have been found So biological treatments are focused on symptom-relief, not cure 2

Psychopharmacology/pharmacotherapy Drugs have been used in medicine to treat mental disorders for over 150 years Major advances in development of seemingly effective drugs over the past 60 years Studies suggest that 11% or more of Americans might be taking a prescription drug for hoped-for psychological benefit Closely related to/justified by the growing interest in the role of neurotransmitters 3

Drug treatment of fear, anxiety, and obsession Minor tranquilizers (also called anti-anxiety or anti-anxiolytic), especially benzodiazepines (Valium, Xanax) Often used in treatment of PTSD, phobias, GAD, social anxiety disorder Can provide short-term relief, but might be linked to long-term dependence, and can be abused More emphasis in recent years on use of antidepressants, especially with OCD Can also provide symptom-relief Little or no risk of abuse or dependence 4

Drug treatment of depression Many types of anti-depressants: MAOIs Tricyclics SSRIs and Atypicals (most widely used) Many studies show both safety and efficacy Side-effects can be problematic Relapse is common after cessation of use Placebo effects hard to rule out, and superiority of drugs often modest 5

Drug treatment of mania/bipolar disorder [not in text] Manic episodes, especially if psychotic, might require major tranquilizers Lithium and other mood-stabilizing drugs have become the treatment of choice in controlling mood swings, but mode of action not understood Depressive aspects usually require addition of anti-depressant drugs Non-compliance can be a problem 6

Drug treatment of substance use disorders Controversial, but increasingly emphasized Agonists are substitutes (e.g., methadone for heroin, nicotine patches) Antagonists block brain receptor sites, so drug has less psychoactive effect (e.g., Naltrexone with alcohol use disorder Aversives produce unpleasant effects when the drug is taken (e.g., antabuse and alcohol) Anti-depressants might reduce craving Non-compliance and/or abuse always possible 7

Drugs used to treat other impulsecontrol disorders Paraphilic disorders sometimes treated with drugs to disrupt sex hormones, suppress sexual urges SSRIs have shown some promise in treatment of bulimia SSRIs have also been used with gambling disorder and other possible behavioral addictions, but evidence is not extensive 8

Drug treatment for psychotic disorders Almost always the treatment of choice Wide range of drugs available to treat schizophrenia, other psychotic disorders, and psychotic features in depressive and bipolar disorders Effectiveness clearly established, but mostly with positive symptoms Side-effects can be very serious, sometimes irreversible Non-compliance a major challenge 9

Drugs used to treat other cognitive disorders None for dissociative disorders Tranquilizers used to control behavior problems sometimes seen in ID, ASD Stimulant medication widely prescribed in treatment of ADHD Many studies suggest effectiveness Concern about over-diagnosis, possible sideeffects, links to substance abuse 10

Drug treatment of health-related psychopathology SSRIs might have some value with symptomrelated disorders No drug has yet been shown to consistently improve sexual desire or arousal Many drugs available for ED and PE [not in text] No drugs yet to cure dementias, but some might slow its progression [not in text] Tranquilizers and sedatives can be used to control agitation in delirium and dementia 11

Coma and convulsive therapies Uncommon, mostly limited to severe depression Surgical procedures Rare, mostly experimental Prosthesis for ED, sex reassignment surgery for gender dysphoria Phototherapy for SAD Alternative therapies (diets, magnets, exercise, acupuncture, etc.) often popular, but scientific evidence either lacking or inconsistent, and hard to rule out placebo effects 12