Psychology

Drug therapies. Drug therapies (psychopharmacotherapy), which rely on medication for the treatment of mental disorders, are sometimes used by professionals with appropriate medical or pharmacological training in conjunction with psychotherapy. Therapeutic drugs for psychological problems fall into three major groups. Commonly used types of each and their generic names, trade names (and chemical names) follow.

• Antianxiety drugs (mild tranquilizers) are used to relieve anxiety.

• benzodiazepines: Valium (diazepam), Xanax (alprazolam), Librium (chlordiazepoxide)

• barbiturates: Miltown (meprobamate)

• hypnotics: Halcion (triazolam), Dalmane (flurazepam)

When people discontinue these drugs after taking them for a long time, they may suffer rebound anxiety (a reoccurrence of the earlier anxiety).

• Antipsychotic drugs (also called major tranquilizers or neuroleptics) are used primarily to treat schizophrenia and to reduce psychotic symptoms such as hyperactivity, hallucinations, delusions, and mental confusion.

• phenothiazines: Mellaril (thioridazine), Thorazine (chlorpromazine), Prolixin (fluphenazine)

• butyrophenones: Haldol (haloperidol)

Pharmacotherapy treatment may produce side effects such as drowsiness, constipation, and dry mouth. Antipsychotic drug treatment may cause a severe and lasting problem called tardive dyskinesia, a neurological disorder characterized by involuntary writhing and ticlike movements of the mouth, tongue, face, hands, or feet.

• Antidepressant drugs are used to elevate mood and to treat depressions. Three principal classes of antidepressants are

• tricyclics: Trofranil (imipramine), Elavil (amitriptyline)

• monoamine oxidase (MAO) inhibitors: Nardil (phenelzine), Marplan (isocarboxazid)

• selective serotonin reuptake inhibitors (SSRIs): Zoloft (sertraline), Prozac (fluoxetine), Paxil (paroxetine). Some patients taking Prozac have developed suicidal tendencies.

• Lithium (lithium carbonate) is used to treat patients with bipolar mood disorders to control mood swings. The drug may have dangerous side effects, however, such as kidney and thyroid damage.

Electroconvulsive therapy. In electroconvulsive therapy (ECT), a therapeutic procedure developed in the 1930s before many of today's psychopharmacological drugs had been developed, an electric shock is given to lightly anesthetized patients to produce a brief cortical seizure. The shock is administered to one side or sometimes to both sides of the brain through electrodes placed over the temporal lobes. The electric current produces a brief convulsive seizure during which the patient becomes unconscious. ECT was widely used in the 1940s and 1950s; its use has declined, but not entirely stopped, as treatment with new drugs has grown in favor. While favorable results with ECT have been reported for some cases, marked controversy still exists concerning whether it is effective and whether it produces permanent intellectual impairment.

Psychosurgery. Psychosurgery, a surgical procedure designed to change psychological or behavioral reactions (also developed in the 1930s), is more controversial than ECT and is rarely used today. The most widely used was lobotomy, also called prefrontal lobotomy, which requires the severing of nerve pathways linking the cerebral cortex to the lower brain centers as a means of controlling a patient's violent or aggressive tendencies. However, even if the procedure is successful in controlling violence, it often produces other side effects. More recently, different and technically more sophisticated (but still very experimental) surgical procedures for controlling some mental disorders are being investigated (such as electrical stimulation of a brain area to treat Parkinson's disease).