Biotherapies

Modified: 2024-07-28 8:34 PM CDST

• Biotherapies are the oldest of psychotherapies.
  • Biotherapies include psychosurgery, electroconvulsive therapy, and drug therapy.
    • Psychosurgery, primarily in the form of prefrontal lobotomies, became very common in the early part of the 20th century.
      • Because the effects of lobotomy were so variable, its use was discontinued.
      • Today, very little surgery is done for psychotherapeutic reasons.
      • Basically, the surgical means at hand are yet too crude and the brain is simply too complex.
      • Electroconvulsive therapy (ECT) followed a similar path, but ECT is still performed, especially in cases of severe depression.
    • Drug therapy has flourished and has become the main type of biotherapy.
      • Four main classes of psychoactive drugs exist:
        • antipsychotics,
        • antidepressants,
        • antianxiety drugs,
        • lithium.
    • The treatment of severe psychopathologies (i.e., those formerly called psychoses) was completely changed by the introduction of antipsychotic drugs.
      • Before, those patients literally had to be tied down (restrained).
      • After, the antipsychotic drugs made it possible to manage such patients safely.
    • The most common antipsychotic drugs are the phenothiazines (i.e., Thorazine and Haldol).
      • Both are dopamine blockers and are used on schizophrenics.
      • Most respond but many have side effects such as dry mouth, tremors, and jerkiness of movement.
      • The drugs must be used in conjunction with some other form of therapy.
    • Antidepressants increase serotin and norepinephrine.
      • Older antidepressants are trycyclics and monoamine inhibitors.
      • Prozac is a newer antidepressant.
      • Because depressed patients are at risk of suicide, the use of such drugs is important.
      • Fortunately, many patients respond positively to the antidepressants.
    • Drugs to reduce anxiety are among the largest category prescribed today.
      • Formerly barbiturates were prescribed, but their addictiveness and toxicity led to their discontinued use.
      • Today muscle relaxants (i.e., Miltown and Equanil) and benzodiazepines (i.e., Librium and Valium) are used instead.
      • Both may be overprescribed and some find their use habit forming.
    • Lithium (lithium chloride, a salt) has been successful in treating bipolar disorder.
      • Highly effective, its mode of action is unknown.
      • But its effect is one of the main sources of evidence for the classification of bipolar disorder as distinct from unipolar depression.
      • Bipolar disorder is successfully treated with Lithium (a salt, lithium chloride).
      • Its mode of action is a mystery still.
      • Patients must monitor their lithium levels as high levels may be toxic.