Abnormal Psychology

Foundations of Treatment 113

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Medications, particularly antidepressants,

are prescribed for an ever widening range

of conditions. By 2008, 11% of female

Americans and 5% of male Americans were

taking antidepressants (Barber, 2008).

Medications have helped many people, but

should personality traits (such as shyness

or grouchiness) long considered to be in the

normal range be treated with medication?

Reuptake inhibitors

Medications that partially block the process

by which a neurotransmitter is reabsorbed

into the terminal button, thus increasing

the amount of the neurotransmitter in the

synaptic cleft.

Antipsychotic medications

Medications that reduce certain psychotic

symptoms; also called neuroleptic

medications.

• partially blocking reuptake (the process by which neurotransmitter molecules left

in the synapse are reabsorbed into the terminal button to be recycled for later

use), thereby increasing the amount of neurotransmitter in the synaptic cleft. Such

medications are referred to as reuptake inhibitors.

Just as imbalances of different neurotransmitters are associated with different

symptoms (see Chapter 2), different medications affect the various neurotransmit-

ters differently, which changes synaptic activity among only some sets of neurons.

That is, medications are selective in their effects. For instance, selective serotonin-

reuptake inhibitors (SSRIs, such as Prozac, Zoloft, and Celexa, taken for depression

or anxiety) affect serotonin activity. Similarly, noradrenaline reuptake inhibitors

(such as Strattera, taken for attention-deficit/hyperactivity disorder) affect nor-

adrenaline (also called norepinephrine) activity.

As more is learned about brain systems and neurotransmitters, researchers are

able to develop new medications to target symptoms more effectively and with

fewer side effects. Thus, for any given disorder, the number of medication options

is likely to increase over time. Next, we’ll take a brief look at the medications used

to treat key disorders. When we discuss specifi c disorders in later chapters, we will

address medications for treating them in more detail.

Schizophrenia

Mental health clinicians most commonly treat schizophrenia and other psychotic

disorders with a class of medications referred to as antipsychotic medications

(orneuroleptic medications); these medications reduce certain psychotic symp-

toms, such as hallucinations. However, they do not cure the disorder. The origi-

nal, or traditional, antipsychotics include Haldol and Thorazine. A newer group

of anti psychotics, called second-generation antipsychotics oratypical antipsy-

chotics, may reduce additional symptoms such as withdrawal, apathy, and lack

of interest and improve cognitive functioning (Keefe et al., 1999). However, as

we will discuss in Chapter 12, research has shown that atypical antipsychotics

are not necessarily superior to traditional an-

tipsychotics (Green, 2007; Kahn et al., 2008;

Keefe et al., 2006). Both traditional and a typi-

cal antipsychotics affect the neurotransmitter

dopamine, along with other neurotransmitters,

and can have considerable side effects (such as

signifi cant weight gain).

Depression

Depression is often treated with SSRIs, SNRIs,

tricyclic antidepressants (TCAs), or monoam-

ine oxidase inhibitors (MAOIs). TCAs have

been used since the 1950s, and until SSRIs were

available, were the most commonly used type of

medication to treat depression. MAOIs have the

drawback of possibly causing potentially fatal

changes in blood pressure if the person taking

them eats food that contains tyramine (a sub-

stance found in cheese and wine). These medica-

tions may also be prescribed for other types of

disorders, such as various anxiety disorders or

eating disorders (Rosenbaum et al., 2005).

Anxiety Disorders

For the long-term treatment of anxiety disorders, antidepressants such as tricyclics,

SSRIs, or SNRIs can be effective (Rosenbaum et al., 2005). The optimal dosage

for treating anxiety symptoms generally differs from the optimal dosage for treat-

ing depression (Gorman & Kent, 1999; Kasper & Resinger, 2001; Rivas-Vazques,