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Stimulants
Stimulantsare 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, are powerful medicines that lessen agitated behavior,
reduce tension, decrease hallucinations and delusions, improve social behavior, and produce
better sleep behavior, especially in schizophrenic patients. 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, 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 psychotic 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 depression is repetitive transcranial magnetic stimulation
(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 schizophrenic patients, especially violent ones, to reduce the intensity 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.Modes of Therapy
So far we have discussed therapies that are largely individual—in other words, one-on-one.
Another way that psychological services can be delivered is in groups.Group Therapy
The same types of therapies used in individual counseling can be used with a group of
patients. Typically, group therapy is more helpful than individual counseling in enablingTreatment of Psychological Disorders ❮ 235