250 ❯ Step 4. Review the Knowledge You Need to Score High
(Celexa, Lexapro), and fluvoxamine (Luvox). Non-SRRIs include bupropion (Wellbutrin)
and velafaxine HCL (Effexor XR). They have all been found effective for treating depressive
disorders, and some have also been found effective for treating obsessive-compulsive dis-
order, panic disorder, and post-traumatic stress disorder (PTSD). For treatment of bipolar
disorder, lithium has been widely used to stabilize mood, alone or with antidepressants.
Anti-seizure medicines used to treat epilepsy, such as valproic acid (Depakene), divalproex
(Depakote), and Topiramate (Topamax) have also been used. Stimulants
Stimulants are psychoactive drugs, such as Ritalin (methylphenidate) and Dexedrine
(dextroamphetamine), that activate motivational centers and reduce activity in inhibitory
centers of the central nervous system by increasing activity of serotonin, dopamine, and
norepinephrine neurotransmitter systems. They are used to treat people with narcolepsy
and people with attention-deficit/hyperactivity disorder.Antipsychotics
The last class of drugs, neuroleptics, is made up of powerful medicines that lessen agitated
behavior, reduce tension, decrease hallucinations and delusions, improve social behavior,
and produce better sleep behavior, especially in patients with schizophrenia. An excess
of dopamine is thought to be the cause of the schizophrenic symptoms; neuroleptics
block dopamine receptors. Neuroleptics include Thorazine (chlorpromazine), Haldol,
and Clozaril. Unfortunately, these drugs can have serious side effects, including tardive
dyskinesia, or problems with walking as well as drooling and involuntary muscle spasms,
which result from the blocking of dopamine at other sites. These problems cause some
patients to abandon the medication after hospitalization, which results in a return of psy-
chotic symptoms.Other Biological Treatments
Some patients do not respond well to antidepressant drugs or psychotherapy.
Electroconvulsive shock treatment (ECT) is used as a last resort to treat severely depressed
patients. ECT is administered humanely, with the patient under anesthetic and given a
muscle relaxant to prevent injury from convulsions. Then the patient receives a momentary
electric shock. Typically, the procedure is repeated about six times over 2 weeks. Just how
the procedure works is still unknown, but many depressed, suicidal patients are restored to
healthy functioning. The patient usually experiences some (often temporary) memory loss
immediately following the procedure, but no apparent brain damage. A promising new
painless treatment for severe depressive disorder is repetitive transcranial magnetic stimu-
lation (rTMS) in which repeated pulses surge through a magnetic coil positioned above
the right eyebrow of the patient. The treatment is administered daily for a few weeks. The
treatment may work by stimulating the depressed patient’s left frontal lobe.
Psychosurgery, or the removal of brain tissue, can also be used to treat certain organic
problems that lead to abnormal behavior. Psychosurgery is a treatment of last resort because
its effects are irreversible. From about 1935 to 1955, the prefrontal lobotomy, which cut
the main neural tracts connecting lower brain regions to the frontal lobes, was performed
on thousands of patients with schizophrenia, especially violent ones, to reduce the inten-
sity of their emotional responses. Unfortunately, following the lobotomies, many patients
were left as emotional zombies, with extensive brain damage. Today psychosurgery is very
limited. One successful procedure used for severe epilepsy is the corpus callosum transection,
or split brain surgery, in which only the corpus callosum between the left and right cerebral
hemispheres is cut.