The Biomedical therapies of Psychiatrists

Pharmacotherapy/Drug therapy
Drug therapy aims to correct the neurological imbalance in the brain that is believed that leads to particular mental disorders. It is based on the theory of mind and body are linked and that imbalances in the brain should be remedied to reduce the symptoms triggered by these imbalances. Psychotropic drugs are available in four main classes.

Antipsychotics: Drugs such as chlorpromazine and haloperidol contain antipsychotics which are used in the treatment of schizophrenia mainly but can also be used to treat mania, paranoid disorders as well. It functions mostly by blocking dopamine receptors.70% of schizophrenic benefit from drugs and 30% of users suffer severe side effects.

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Antidepressants: These drugs are used for the treatment of major and bipolar depression, panic attacks, obsessive-compulsive disorder, and phobias. It mainly affects neurotransmitter systems of norepinephrine and serotonin and increases the availability of neurotransmitters at the neural synapse, and in the presynaptic cell, it decreases the reuptake of neurotransmitters. These drugs are effective in 80% of individuals.

Anti-Cycling Agents: They are called mood stabilizers. Lithium is used to treat bipolar disorders which are very effective and fast in action. It removes the manic phase of bipolar disorder and the depressive phase also typically ends until the maniac phase is eliminated, but lithium has a variety of significant side effects.

Hypno anxiolytics:

It includes antianxiety agents, hypnotics, atypical anxiolytics and all these have general calming effects. Anxiolytics alleviates anxiety and induces sleep. Hypnotic drugs induce sleep in case of insomnia. These drugs cause dose-dependent effects. The Controversial part of psychopharmacology is ‘cosmetic psychiatry’. There might be a potential for accidental misuse of prescriptions.

Electroconvulsive Therapy: ECT is a treatment method used when no other treatment method is effective for psychiatric disorders. A convulsion or seizure is caused during treatment by the application of electrical current to the brain. The exact function is unknown but it tends to shock the brain and decrease the number of neuronal links involved in depression or other disorders, thereby encouraging the formation of new links in other areas of the brain. Average 2–3 sessions a week is needed and 6-12 total treatments are recommended.

Efficacy: It is a safe procedure with very little mortality. This is used in the treatment of major depressive disorders, mania, schizophrenia, and catatonia and efficacy depend on the disorder it is being treated for.

Major depressive disorder: It is used when other treatments failed or in an emergency situation. Both unipolar and bipolar depression responds well to ECT.

Catatonia: In catatonia, it is the second line of treatment, when other treatments fail.

Mania: In case of severe or prolonged mania it is used as a treatment, especially only when other treatments fail or in a life-threatening situation.

Schizophrenia: It is used rarely in case of treatment-resistant schizophrenia, or when short-term global improvement is desired, or when the response to antipsychotic drugs is less.

Criticism of ECT
The Main criticism is because of its side effects like short-term nausea, headache, muscle pain, dental injuries, oral laceration, and myalgia even though these effects are short-lived and responds to symptomatic treatment. Cognitive difficulties may continue for a longer period. ECT can lead to persistent or permanent memory loss.

Psychosurgery: A group of neurosurgical procedures including cingulotomy, sub caudate tractotomy, limbic leucotomy, and corpus callosotomy is known as psychosurgery. A part of the brain is damaged or lost in this procedure. Depression, obsessive-compulsive disorder, and medical disorders such as epilepsy have been mainly used for psychosurgery, after surgery 30 to 50 percent shows the substantial change. It is also called functional neurosurgery which only is performed in the absence of any other successful treatment.

Cingulotomy: This surgery is used to treat obsessive-compulsive disorder and depression in which supracallosal fibers of the cingulum bundle will be severed.

SubcaudateTractonomy: It is primarily done for depression and OCD. It severs the fibers connecting the orbitofrontal cortex to the hypothalamus.

Limbic leucotomy: It combines cingulotomy and subcaudal tractotomy with the hypothesis that two lesions will produce better results.

Corpus callosotomy: It is a palliative surgical procedure for seizures. The goal of the procedure is to eliminate the pathways.

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