Disorders and therapies
By: Giulia Caramellino and Ashley Benhayoun
psychopharmacology
Psychopharmacology is the study of the use of medications in treating mental disorders such as anxiety, depression, OCD, schizophrenia, and much more. This field of psychology requires continuous study in order to be up to date with new advances and medical knowledge. Many research studies and experiments use the double blind method to properly evaluate a drug's effectiveness.
Double blind method
double blind study is an experiment designed to test the effect of a treatment or drug by using groups of experimental and control subjects in which neither the participants or the investigators know which substance is being administered to which group.
Double blind method in the study of drugs and other substances
Double blind studies are essential to psychopharmacology because they create a testing environment where results can not be influenced by a bias from the participant or tester. The double blind method is used to prevent the placebo effect and observer bias. The placebo effect occurs when a fake treatment (placebo) improves a patient's or participant's condition simply because the person has the expectation that it will be helpful. The observer bias happens when a researcher's bias causes them to subconsciously influence the participants of an experiment. Both the placebo effect and the observer bias can not occur because both participants and testers have no knowledge of which is the control group and which is the experimental group.
Charecteristics of antianxiety drugs
Both antidepressants and anti anxiety medications are used to treat anxiety disorders. The broad-spectrum of most antidepressants provides effectiveness in anxiety disorders as well as depression. Anti anxiety medications include the benzodiazepines. Benzodiazepines enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA receptor. The effects are similar to sedatives and have hypnotic (sleep inducing), anxiolytic (anti anxiety), and muscle relaxant properties. High doses of shorter acting benzodiazepines may cause anterograde amnesia (loss of ability to create new memories) and dissociation. Benzodiazepines have relatively few side effects including, drowsiness, loss of coordination, fatigue, and mental slowing or confusion. People taking benzodiazepines for a couple weeks may develop a tolerance for them and start to depend on these drugs. Drug abuse is not uncommon so the medications are generally prescribed for brief periods of time (days or weeks). However, some patients may need long-term treatment.
Disorders treated by antianxiety drugs
Insomnia
Benzodiazepines can be useful for short-term treatment of insomnia. However, they do not necessarily improve sleep quality because they increase light sleep, therefore decreasing deep REM sleep. It is recommended that benzodiazepines be taken at the lowest effective dose and their use beyond 2 to 4 weeks is not safe due to the risk of dependence.
Generalized anxiety disorder (GAD)
Benzodiazepines are very effective in the short-term management of a generalized anxiety disorder (GAD) but were not shown to be effective in long-term improvement. Benzodiazepines can be used in the immediate management of GAD, if needed. However, they should not usually be given for longer than 2–4 weeks. The only medications most medical professionals recommend for the longer term management of GAD are antidepressants.
Acute anxiety
Benzodiazepines are sometimes used in the treatment of acute anxiety. They cause rapid or moderate relief of symptoms in most individuals, however, they are not recommended beyond 2–4 weeks and do not provide long term treatment. Antidepressants are safer and more effective in the short and long term treatment of most anxiety disorders.
Panic disorders
The most often used medicines to treat panic attacks include: Selective serotonin reuptake inhibitors or Benzodiazepines, such as Ativan, Valium, Xanax, Prozac, or Zoloft. Patients with panic disorders and preexisting depression who are treated with benzodiazepines have poorer outcomes than patients taking antidepressants.
Electroconvulsive therapy (ECT)
Electroconvulsive therapy is used when severe depression is unresponsive to other forms of therapy or medication. ECT can also be used when patients pose a threat to themselves or others and can not wait until medications take effect.
ECT is one of the safest and most effective treatments for depression. During ECT electrodes are placed on the patient's scalp and controlled electric current is applied while the patient is under anesthesia. The electric current causes a brief seizure in the brain. Typically, patients go in for 10 sessions.
ECT is a quick and safe way to relieve symptoms in severely depressed and suicidal patients. It's also very effective for patients who suffer from severe phobia, mania, or other mental illnesses.
Alternatives to ECT
There are many alternatives to ECT, the most common is transcranial magnetic stimulation (TMS). During TMS, a magnetic field is used to induce a small electric current in a specific part of the brain without causing seizure or loss of consciousness. TMS uses magnetic coils to create the electrical currents that stimulate the brain. A patient will usually have 20-30 treatments.