420 Chapter 12 Approaches to Treatment and Therapy
treatment of schizophrenia and other psychoses.
However, antipsychotic drugs are increasingly be-
ing prescribed off label for people with nonpsy-
chotic disorders, such as major depression, bipolar
disorder, posttraumatic stress disorder (PTSD),
autism, attention deficit disorder, and dementia.
Most antipsychotic drugs are designed to
block or reduce the sensitivity of brain receptors
that respond to dopamine; some also block recep-
tors for serotonin. Antipsychotic drugs can reduce
agitation, delusions, and hallucinations, and they
can shorten schizophrenic episodes. But they offer
little relief from other symptoms of schizophrenia,
such as jumbled thoughts, difficulty concentrat-
ing, apathy, emotional flatness, or inability to in-
teract with others.
Antipsychotics often cause troubling side ef-
fects, especially muscle rigidity, hand tremors,
and other involuntary muscle movements that
can develop into a neurological disorder. In addi-
tion, Zyprexa, Risperdal, and other antipsychotics,
which manufacturers have been targeting for chil-
dren and the elderly, often carry unacceptable risks
for these very groups. The immediate side effect is
extreme weight gain, anywhere from 24 to 100 ex-
tra pounds a year. Other risks include strokes and
death from sudden heart failure (Masand, 2000;
Ray et al., 2009; Wallace-Wells, 2009).the skull, disease, or bad environments. Today,
biological explanations and treatments are domi-
nant, partly because of evidence that some dis-
orders have a genetic component or involve a
biochemical or neurological abnormality, and
partly because physicians and pharmaceutical
companies have been aggressively promoting bio-
medical solutions.Medications for Mental
Disorders LO 12.1
The most commonly used biological treatment
is medication that alters the production of or re-
sponse to neurotransmitters in the brain. Because
drugs are so widely advertised and prescribed
these days, both for severe disorders such as
schizophrenia and for more common problems
such as anxiety and depression, consumers need
to understand what these drugs are, how they can
best be used, and their limitations.
The main classes of drugs used in the treat-
ment of mental and emotional disorders are these:1
Antipsychotic drugs, also called neuroleptics—
older ones such as Thorazine and Haldol and
second-generation ones such as Clozaril, Risperdal,
Zyprexa, and Seroquel—are used primarily in theantipsychotic drugs
(neuroleptics) Drugs
used primarily in the
treatment of schizo-
phrenia and other psy-
chotic disorders; they
are often used off label
and inappropriately for
other disorders such as
dementia and impulsive
aggressiveness.
Antipsychotic drugs can help some people with schizophrenia live normal lives. At left, Danny Dunn (seated)
poses with her mother. Danny was diagnosed as having schizophrenia and bipolar disorder when she was 17,
but medication, therapy, and family support help her function. “I still have challenges and problems,” Danny
says, “but life is so much better than it used to be.” The photo on the right shows USC law professor Elyn
Saks, who also benefited from medication and therapy, and wrote a memoir of her “journey through madness.”
She received a MacArthur Foundation “genius grant” for her contributions to mental health law.