Psychopharmacology can be defined as the study of changes in thinking, mood, behavior and sensation via intake of drugs or medications. Various environments we are surrounded with affect human experience and behavior. Some things, which an individual doesn’t understand, or finds difficult to cope up with, frightens him, and the things, which he finds himself acquainted with, relaxes and calms him. The feelings of depression at the time of failure, happiness on accomplishment and success and many other feelings are produced and learnt, in the whole process of human or individual development.
On some of these feelings or behavior, human beings do not have a control; it can be either situational or long term. But some medications or rather chemical formulations have the power of altering human feelings, and thus the relationship between human feelings and environment can be changed accordingly. But the condition is that they have to be administered in a proper and formal manner. The anxiety can be altered into calmness, sobriety and satisfaction. The study of the effects of these drugs and medications over the feelings and behavior of human beings is psychopharmacology.
Historically plant products were used for this purpose that bought the changes in moods of people and were also self-administered. Opium, tea, tobacco, coffee, alcohol was widely used in countries like Orient, America etc. there were also regulatory measures due to the effects they have on the moods and behavior of different people, and all the cultures had their boundations and limitations.
These were the widely available categories, and apart from these, different geographic locations supported different plantations having psychologically active substances. The practice of the same was called folk medicine and thus led to the development of formal medication to control anxiety and other uncomfortable human feelings. And presently, there are about hundred of different drugs for this purpose, some newly invented, some by accidental discoveries and some re-inventions of the folk medications.
But majority of these drugs are developed through research on the relationship and effects of same with the moods and behavior of human beings along with the brain chemistry.
The first review about psychopharmacology was published in 1985 by Ponterotto, which said that a thorough knowledge of the medications should be studied and understood for treatment of the psychological disorders by the use of the same.
A psychometric drug can affect the mood and behavior only when the drug comes in proper contact with the brain cells. It can be attained in many ways, depending on certain factors, which include; the effect and solubility of drugs on local body tissues, size and ionic character of the drug molecules, effects on metabolism rate etc.
Oral, subcutaneous, trans-dermal, inhalation is some routes of the intake of such drugs, out of which oral intake is the most common of all as it directly touches the stomach walls. Some little quantities can also be directly injected into the body.
The time for which decides the drug intake, is decided by metabolism rate as the drugs are metabolized into the some enzymes, which are inactive, usually produced by the lever.
Then the usual waste removal process i.e. through perspiration, passing urine or exhalation, removes them. The main problem is the decision of the dose of the drug and response of the body to the same. Drinking coffee can affect the sleep but intake of the same in less quantity might trigger the sleep and too much of it can lead to anxiety. In the medical terms, lowest drug necessary for effect is MED-50, lethal dosage is LD-50 and for the safety index is LD-50/MED-50, which shows that lethal dosage is very high than the required one.
The complications may also vary with the dosage. Too high or even too low doses may impair performances of various tasks, so the relationship between the drug and the effect can be determined by the chemistry and the biological characteristics of the drugs.
Also the law of initial values can be applied in the same manner to psychopharmacology. It is basically rate dependent. For ex. Anti-depressants change moods of those people also who are not suffering from anxiety.
A drug can also affect even when the dosage is nil which is known as placebo effect, which comes through the presence of a non-active substance in the drug, leading to relaxation and relief. It happens as the body responses to the nil substances, assuming them to be drugs. When there is a change in the body processes like metabolism, weight change, puberty etc, and the variances with the drugs can occur. Not only this, even cultural differences can cause changes in the effect of drugs.
Also another important factor that alters the drug-response relationship is the individual’s dependency of drugs or his/her medical history, which can either increase or decrease the sensitivity and also the effectiveness of drugs. So the use has to be totally controlled, and even under such conditions, the drug might be or might not be able to influence the single/ multiple neuro-transmitter systems. The side –effects of the drugs can also be lessened down by proper adjustment and altering of the dosage.
For ex. The drug used for release of anxiety might cause depression to some or inefficiency of work in others. The most proper usage and effect of any particular drug can be understood by the past or history of the usage of the drug in similar cases on different individuals. Still, the latest psychopharmacology is more dependent on the working, experimentation evidences and mechanisms.
The major assumption in psychopharmacology medications is that there has to be a specific biological etiology, which can be neuro-pathological, neuro-psychological or neuro-chemical, and genetic explanation. Besides the lack of evidences of such neuro-pathological, neuro-psychological etc, the belief still exists of the pharmacologists in the same, unlike the various other psychiatrists, who think that mental illnesses cause chemical and electric changes in neurons.
The treatment of psychiatric problems with the help of drugs with increased sophistication, modernization and a better understanding. It is basically done by balancing the disturbed chemical of the brain and the entire body system. There are specific drugs for specific problems. Anti oxidants for Alzheimer’s disease and naltoxone for alcohol addiction. In certain diseases, medications are very essential as in the case of depression or mania, to bring back the normal self. And for other diseases, these medications alter or control the symptoms to a certain degree, thus helping the person to regain the social status, and re indulge in the daily life activities. The patients of hallucinations can be helped with anti-psychotic medications.
It is still not very sure that these medications work, but still, it helps in regaining the essential balance of mind and life. The chemicals, which pass on messages to different nerve cells, are called the neuro-transmitters, and these are responsible for the determination of human behavior under different circumstances. They can be sleep or sleeplessness, nervousness, memorization, envy, jealousy etc. These neuro-transmitters are responsible for maintaining the balance in the brain via chemicals such as serotonin, norepinephrine etc.
So when an imbalance in the chemicals is observed, these medications are used, are helpful to a great extent, by bringing back the orderly behavior, and maintaining a strong emotional balance too. The rebalancing is done in various ways considering the relationship of the drugs and the body response.
The mood altering drugs produce changes in consciousness, by bringing in changes in the nervous system. Some are the stimulants, which increase wake fullness and alertness. When the dosage is too high, it helps in seizure, and mild dosage is given accordingly for the different problems. The depressants aggravate the symptoms relaxation and insomnia.
Another category is hallucinogens, which cause a distortion in the human thinking process, which if taken in higher dosages, can be psychotic too. These have a direct effect on the brain neurons. The other type of classification of psychopathology drugs is done on the basis of disease symptoms. First, the anti-anxiety drugs, for the treatment of reduction of daily life anxiety and fears of individuals.
Second, the anti-depressants, basically for the pessimistic people. It helps in reducing and removing the negative thoughts and feelings arising in the individuals mind, which if not timely treated, can lead to depression and suicide attempts.
Third are the anti-psychotic drugs. These are basically used for the treatment of severe forms of mental illnesses. For ex. Schizophrenia. This is a serious mental illness in which the patient engages himself in the activities or behavior, which is, leaps away from the normal beings, and goes away from the reality, thinking the false world to be normal.
These drugs also have a direct effect on the brain, still they are indirect in effect, as they require a couple of days or weeks to show their effect in the behavior. This process is known as neuro-modulation. The new medications are also under experimentation and development. Some of the old are phased out and some have been classified differently form previous classification.
All these drugs affect human behavior by having their influence on the human brain. The normal features and structure of the brain is similar, but the neurons undergo a continual change. Producing the change in environment, which in turn brings in changes in the brain cells also, changes the behavior; as all these are inter dependant and also inter-penetrating. And thus a particular medication can have single or multiple effects also, depending upon the change that is brought by in the environment and thus the brain.
The development pf psychopharmacology and the treatment via drugs arose from he combination of two different fields of study. The awareness about neurotransmission and Skinners methodology which is the operant conditioning techniques of the study of human behavior (Reynolds, 1975,5.1-2) which also provided various animal models for the potentially useful; drugs.
There are also central nervous system stimulants, which again comes under mood stabilizers. It helps in altering the arousal, the EEG arousal by affecting the motor activities of the brain. The convulsant drugs, for ex strychnine, penlylenetetrazol, picrotoxin helps in the blockage of glycine, effects the GABA in the brain, and reducing the time of action of any task. (Goodman & Gilman, 1990). Sometimes, apart of the usual effect these drugs have, sometimes in the induction of non-specific arousal also takes place. Which if is in normal quantity, improves the performance but if happens in larger quantity than required, impairs the performances and affect action in a negative manner.
Another category is the SSRIs which is Selective Serotonin Reuptake Inhibitor. This is widely used in the treatment of SAD, which is social anxiety disorder. It is very efficient and tolerant drug. Paxil, the SSRI is the most efficient in this treatment as of all present, having the response rate of 55%-70% (drs Carmona, Raza, and Blanco), tested on various patients who improved a lot from the very worst conditions too, with low incidence of side effects. The side effects may include: headache, insomnia, nausea, constipation, dry mouth etc.
Another SSRI, which is very effective, is Sertraline, also known as Zoloft and fluvoxamine also known as Luvox, for the treatment of SAD. As they are great responders and have similar efficiency in the treatment of anxiety and have a very good safety also.
However, the relapse rate might also be high under certain conditions. According to the American college of neuro-psychopharmacology, if the depression is treated by the use of SSRI’s in children below 18 yrs of age, it might lead to suicidal cases, or more of negative thinking. (Mann JJ, Emsilie G, Goodwin FK, Leon AC; 2006)
The psychopharmacology drugs are used in treatment of various other diseases also such as unipolar depression, substance abuse, alcohol abuse, sexual disorders, ADHD etc via, the mood stabilizers such as; lithium, ECT, gabapentin, valproate , acetazolamide etc. And also by the adjunctive medications like; hormones, inositol, thyroxine etc. (MD Peter M Brigham).
New evolution and even changing or processing of old drugs of psychopharmacology is very tough and time-consuming process. Controlled experimentation ensuring proper safety and efficiency is thud very necessary for a proper and foolproof decision making in this field. Good clinical practices, innovative designs, documentation, statistical evidences, old and new drug studies and effects, proper reporting, more safety measures have to be considered and focused on a lot.
This has brought about a phenomenal change since past 50 years in the treatment of various problems, which were once considered to be sinful and incurable, by chemical action on brain cells and the environment, and has a wide future scope to expand and make the full utilization of the invention. More awareness and reducing the likely side effects, by analyzing the proper risk / benefit of the drugs, are the two factors to be considered, to male it a more successful and more useful branch of medical science.
References
- Leonard W Hamilton & C. Robin Timmons.1994. Psychopharmacology. Published in: companion encyclopedia of psychology vol.1. Http//psypharm.htm
- Meyer, J.S& Quenzer, L.S(2004). Psychopharmacology: drugs, the brain and behavior. Sinauer Associates ISBN0-87893-534-7
- Goodman & Gilman. The pharmacological bases of therapeutics. The physician’s desk reference.
- Donald S. Robinson, M.D, and Nina R.Schoolar. back to psychopharmacology-The fourth generation progress. Clinical study design-critical issues. www.clinicalstudydesign/criticalissues.htm
- Mann JJ, Emsilie G, Goodwin FK, Leon AC.2006. www.diseaseanddisorderblog.htm
- Peter.M.Brigham, MD. The psychopharmacology of bipolar disorders. www.bipolarpsychopharmacology.htm
- Bruce G Charlton MD.94. the potential for pharmacological treatment of unpleasant psychological symptoms to increase fulfillment in old age.333-336. www.pharmacologyanndpersonalfulfillment.htm. Retrieved in 2001
