Psychopharmacology Lect 1 Overview

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  • These brain scans, made by positron emission tomography, show post-treatment increases (orange) and decreases (blue) in regional glucose metabolism. The subjects were depressed patients who responded to cognitive behavior therapy (CBT) or paroxetine, a serotonin-reuptake-inhibitor drug. CBT resulted in metabolic decreases in frontal and parietal cortex, and increases in hippocampus; paroxetine had the opposite effects. (From K. Goldapple et al., Arch Gen Psychiatry, 61:34–41, 2004.)Mayberg and colleagues at the University of Toronto recently published a PET paper detailing how cognitive-behavior therapy (CBT) affected depressed patients. Lasting several months, CBT uses homework assignments and guided practice to identify relationships between a patient's thoughts, feelings, and behaviors. The researchers found that when 14 subjects responded to CBT, glucose metabolism decreased in certain cortical regions and increased in the hippocampus.1 In an earlier study of 13 other depressed subjects, the SRI drug paroxetine (Paxil) had the opposite effects on those same areas. Several cortical areas affected by CBT, but not by the drug, involve "self-actualization, self-reference, and reappraisal of information," notes Mayberg.
  • Psychopharmacology Lect 1 Overview

    1. 1. PsychopharmachologyIntroduction and Overview
    2. 2. Vingette - IntroductionJoe is a 55 year old African American man. He quite smoking6 years ago but has moderate symptoms of COPD. He hasdifficulty cathcing his breath and is often fatigued.He comes into the clinic to address sleep problems. Hereports waking up in the early morning and having difficultygetting back to sleep. He also describes being highly irritablewith his wife and feeling like his job is pointless. He is havingdifficulty remembering things and reports being distractable.He has two boys 15 and 17. He reports that he is having moretrouble breathing lately so he has stopped coaching hisyoungest son’s baseball team. He likes to play sports butreports gaining weight over the last six years. He reports thathe feels hopeless about his future ability to be able to have a“normal life”.
    3. 3. Dr. Mary Bernheim, "Molly," wasborn Mary Hare in 1902 inGloucester, England. She spent herchildhood in India. She received aBA, MA, and PhD from Cambridgein England, the latter in 1928.Mary Hare, while a graduatestudent, also in 1928, discoveredthe enzyme tyramine oxidase. Theenzyme was eventually renamedmonoamine oxidase (MAO) and waslater found to play a significant rolein mood regulationDr. Mary Bernheims discovery,which Theodore Slotkin calls "oneof the seminal discoveries intwentieth century neurobiology."
    4. 4. Living With Half a Brain…• When Cameron Mott was three years old, she contracted a rare and deadly brain disorder; Rasmussens Encephalitis.• Her parents are desperate and have opted for the only available cure, a radical high-risk operation to remove the diseased half of her brain.• Cameron lives with her sister Caroline and her parents Casey and Shelley in Jamestown, North Carolina.http://today.msnbc.msn.com/id/36032653/ns/today-today_health/t/meet-girl-half-brain/#.UFAJEBjfMtc
    5. 5. Story of a Smile
    6. 6. Biopsychosocial Brain Biological Social Epigenetics EnvironmentalGenetics Psychological
    7. 7. Adverse GAD PTSD Childhood Life Coping Events Stress Chronic Style Pain Depression PersonalityPoor SocialSleep Support Inflammatory Cortisol Oxytocin ANS Balance Response And HRV Heart Disease
    8. 8. Depression Visualized
    9. 9. Depression TreatmentSSRI Compared with CBT
    10. 10. CBT and OCD
    11. 11. NeurotransmittersDopamine (DA): Five major transmiter systems.Motor function, appititive behaviors, reward, andworking memory.Serotonin (5-HT): Feeling satisfied, pain reduction,mood, basic okness, body temp and mood.GABA: Inhabitory neurotransmitter.Glutamate (Glu): Excititory neurotransmitter. 80-90% of all synapses.Acytalcholine (ACh): Learning, memory, arousallevels and concentraition.Norepinephrine (NE): Arousal, reward, and mentalfilter.Oxytocin: Social bonding, romantic love, andsexual intamacy.Histomine: Activation and arousal.Melatonin: Sleep and nacturnal rythums.Substance P: Pain response from body to thebrain.

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