Transcript February 17, Biological Theories

• BEFORE LOBOTOMY, SHOCK, COMA NOW DRUGS
• CHANGE NEUROCHEMISTRY OF
BRAIN
• ELEVATE OR LOWER LEVELS OF
NEUROTRANSMITTERS IN SYNAPSES
AND WHAT RECEPTORS ABSORB
TREATMENTS
• ANTI-PSYCHOTICS
• LITHIUM FOR BIPOLAR
• PHENOTHIAZINES AND CLOZAPINE
FOR SCHIZOPHRENIA
• ILLNESS SPECIFIC
SSRI’S
• SELECTIVE SEROTONIN REUPTAKE
INHIBITORS - PROZAC, PAXIL,
XOLOFT (LATE 1980’S)
• UNLIKE OLDER DRUGS ARE
SPECIFICALLY DESIGNED TO
PREVENT REUPTAKE OF SEROTONIN
• NOT ILLNESS SPECIFIC (NOT “ANTIDEPRESSANTS”)
HUGH GROWTH
60
50
40
30
Millions
20
10
0
1985
1994
2000
HUGE GROWTH
• 10% OF ADULT POPULATION NOW
TAKING AN SSRI
• 300% INCREASE IN PAST 10 YEARS IN
NUMBER OF CHILDREN AND
ADOLESCENTS TAKING MEDICATION
ARE SSRI’S BETTER?
• NOT MORE EFFECTIVE THAN OLDER
DRUGS
• FEWER NEGATIVE SIDE EFFECTS
(ALTHOUGH POSSIBLY MORE
SUICIDE RISK)
• NOT ADDICTING
• LESS RISK OF OVERDOSE
DOWNSIDE OF SSRI’S
• NOT MUCH BETTER THAN PLACEBOS
FOR LESS SEVERE CONDITIONS
• LONG-TERM EFFECTS?
• ONLY ELIMINATE SYMPTOMS, NOT
UNDERLYING PROBLEM?
• MAKE PEOPLE ADJUST TO STATUS
QUO?
STRENGTHS OF BIOLOGY
• BEST FOR PSYCHOTIC DISORDERS
• MORE KNOWLEDGE ABOUT BRAIN
• ADVANCES IN DRUG TREATMENTS
FOR MANY CONDITIONS
1. OVERSTATEMENTS
• MOST CONVINCING FOR PSYCHOSES
• LESS EVIDENCE FOR OTHERS
• ARE CHEMICAL IMBALANCES
CAUSES OR EFFECTS?
2. GENES NOT DESTINY
• ONLY A MINORITY OF PEOPLE WITH
GENETIC SUSCEPTIBILITY DEVELOP
DISORDER
• OFTEN NEED ENVIRONMENTAL
PRECIPITANT
• ENVIRONMENT CAN SUPPRESS MORMONS AND ALCOHOLISM
3. WHAT DOES A GENE DO?
• DIFFERENCE OF GENOTYPE AND
PHENOTYPE (APPEARANCE)
• E.G. ANOREXIA
• CULTURE CAN SHAPE PHENOTYPE
• GENES MAY HAVE GENERAL, NOT
SPECIFIC, EFFECTS
4. MOST M.I. NOT GENETIC
• MOST PEOPLE WHO GET A DISORDER
DO NOT HAVE GENETIC PROPENSITY
TO THE DISORDER
SCHIZ. IN DENMARK
• THOSE WITH 1ST DEGREE RELATIVES
HAVE 10x RATE OF SCHIZ
• BUT 90% OF PEOPLE WHO DO GET
SCHIZ HAVE NO SCHIZ RELATIVES
• FAR MORE PEOPLE HAVE NO FAMILY
HISTORY OF SCHIZ SO DESPITE
LOWER % PRODUCE MORE CASES