SAMENVATTING
PSYCHOPHARMACOLOGY
INHOUD
PART I - Relieving the past: A lesson from history .................................................................................................. 3
Topic 1.1.: History of Psychopharmacology ........................................................................................................ 3
ONCE UPON A TIME ........................................................................................................................................ 3
EXPERIMENTAL PSYCHOLOGY ........................................................................................................................ 4
BEHAVIORAL PSYCHOLOGY ............................................................................................................................ 6
Behavioral pharmacology .............................................................................................................................. 7
BIOLOGICAL PSYCHOLOGY & PSYCHOPHARMACOLOGY .............................................................................. 7
PSYCHIATRY & PSYCHOPHARMACOLOGY ..................................................................................................... 7
FINAL REMARKS & SUMMARY ..................................................................................................................... 13
Topic 1.2.: PCDR Application ............................................................................................................................. 14
Het placebo-effect en het gebruik ervan in farmacologisch onderzoek ....................................................... 14
Het placebo-effect vanuit een biologisch behavioristisch oogpunt .............................................................. 15
PCDR: placebo-controlled dose reduction .................................................................................................... 18
PART II - Under the microscope: A lesson from biology ....................................................................................... 20
Topic 2.1.: BEHAVIOURAL NEUROSCIENCE ....................................................................................................... 20
Anatomy & organization of NS ...................................................................................................................... 21
Origin of signals ............................................................................................................................................. 23
Communicating signals ................................................................................................................................. 24
TOPIC 2.2.: Pharmacokinetics ........................................................................................................................... 35
General Framework ...................................................................................................................................... 35
Routes of administration............................................................................................................................... 36
Absorption & distribution ............................................................................................................................. 40
Depot binding ................................................................................................................................................ 42
Inactivation & biotransformation ................................................................................................................. 43
Excretion ....................................................................................................................................................... 46
TOPIC 2.3.:pharmacodynamics ......................................................................................................................... 47
Drug actions .................................................................................................................................................. 48
Drug effects ................................................................................................................................................... 57
Drug categorization ....................................................................................................................................... 59
kinetics & dynamics in actie .......................................................................................................................... 60
PART III - It's all in our mind: A lesson from society & psychology: DISCUSSION .................................................. 61
1
,Topic 3.1.: Research methods ........................................................................................................................... 61
(Psycho)pharmacological research cycle ...................................................................................................... 61
Clinical research: problems & solutions ........................................................................................................ 63
Animal research: Behavioural protocols ....................................................................................................... 66
Animal research: Reliability & Validity .......................................................................................................... 67
Animal research: Ethics ................................................................................................................................. 68
Topic 2: Addiction & Dependency problems from a psychosocial & societal perspective ............................... 70
A parable of Addiction .................................................................................................................................. 70
Addiction as an interaction of physical and psychological aspects ............................................................... 70
Working mechanisms of addiction ................................................................................................................ 71
Treating addiction ......................................................................................................................................... 74
Drug scheduling systems: international guidelines ....................................................................................... 75
Societal issues: From drug scheduling to policies ......................................................................................... 77
Topic 3.3.: Therapy adherance (therapietrouw) ............................................................................................... 79
What is therapy non-adherence? ................................................................................................................. 79
A framework of therapeutic (non-)adherence .............................................................................................. 80
The case of Scott Martin ............................................................................................................................... 83
Medicalization & pathologization ................................................................................................................. 86
Topic 3.4.: individual differences (e.g., how genetic & environmental differences can have an impact om
pharmacotherapy) from a biological, psychosocial & societal perspective .......... Error! Bookmark not defined.
2
,PART I - RELIEVING THE PAST: A LESSON FROM HISTORY
We start this series with a historical overview of how the field of Psychopharmacology came to be in the 20th
century. Under the influence of a long tradition of self-experimentation, experimental & biological psychology,
behaviourism, medicine and the pharmacological sciences, the field of Psychopharmacology was born. Gold
was struck in the 50s with the accidental discovery of Phenothiazines paving the way for the development of
modern drug classes, but also a rise in the recreational use of these drug classes.
TOPIC 1.1.: HISTORY OF PSYCHOPHARMACOLOGY
Three main goals:
• Students understand the multidisciplinary origins of psychopharmacology within the fields of
pharmacy, psychology, and psychiatry
• Students can explain the 'black-box' metaphor of behaviourism and explain its repercusions on the field
of psychopharmacology
• Students can give a (schematic) overview of contemporary psychiatric drug classes (including
antipsychotics, antidepressants, anxiolytics, moodstabilizers/antimanic drugs)
Study material includes:
• Class presentation: History of psychopharmacology
• Book section article: Badiani, A. (2015). History of Psychopharmacology. In I. P. Stolerman & L. H. Price
(Eds.), Encyclopedia of Psychopharmacology (pp. 752-764). Berlin, Heidelberg: Springer Berlin
Heidelberg.
Study tips:
• Main focus should be on the contents of the class presentation
• In-depth study of the article should be on sections "The origins of the term psychopharmacology" to
"Biological psychology and psychopharmacology" (p752-756)
• Contents discussed in "Psychiatry and psychopharmacology" (p756-763) provide you with a more
elaborated background story of the psychiatric drug classes.
• Drug names and dates discussed in the article should only be known if they were discussed during
class.
ONCE UPON A TIME
Voor 19de eeuw was er op wetenschappelijk (medisch) vlak niets geweten over psychoactieve componenten
(wel op recreatief vlak).
Drie mannen experimenteerden met drugs (voor de wetenschap):
1) Pièrre-Alexandre Charvet
2) Jacques-Joseph Moreau de Tours
3) Paolo Mantegazza
Ze wilden weten wat een drug doet met je lichaam (met dieren) en wat de bijdrage is voor
psychologie/psychiatrie.
➔ Pioniers!
3
, 1) “Opium for you! Opium for me! Opium for everyone!”→ Charvet (°1799 –†1879)
▪ De eerste die systematisch opium toediende aan verschillende diersoorten
▪ Comparative neuroscience = kijken wat een drug op niveau van neuronen doet (microscopisch)
▪ Hij beschreef gedragseffecten van opium en in zekere mate fysiologische effecten ervan
▪ Eerste auteur van experimentele psychofarmacologische studies
2) “I had a dream… to relate hasj is to madness and delirious states” → Moreau de Tours (°1804 –†1884)
▪ Comparing mentally ill patients (schizophrenia) to hashish induced mental states in healthy subjects
▪ No longer angels-demons point of view, but as worthy human psyche with Central nervous System
principles
▪ First to publish work on the effects of a drug and Central nervous system
Hij onderzocht wat gebeurde gedurende een psychotische episode
Focuste op het Paranoïde effect / behavior
Hij probeerde een mentale stoornis na te bootsen met een drug
Inhaleren van rook resulteert in een effect op het brein
“I had a nose for classifying drugs” → Mantegazza (°1831 –†1910)
▪ Eerste studie die focuste op de stimulerende effecten van cocaïne
▪ “Enthousiaste” supporter of cocaine: “I would rather have a life span of ten years with coca than one
of 10 000 000 000 000 000 000 000 centuries without coca.”
▪ Cocaïne kan gebruikt worden voor een alledaags down-gevoel vertelde hij
▪ Maakte een classificatie van psychoactieve planten & plantenextracten
→ Geen grote impact op psychologie en psychiatrie (wel biologie) → niet zo bij de andere twee!
EXPERIMENTAL PSYCHOLOGY
4
PSYCHOPHARMACOLOGY
INHOUD
PART I - Relieving the past: A lesson from history .................................................................................................. 3
Topic 1.1.: History of Psychopharmacology ........................................................................................................ 3
ONCE UPON A TIME ........................................................................................................................................ 3
EXPERIMENTAL PSYCHOLOGY ........................................................................................................................ 4
BEHAVIORAL PSYCHOLOGY ............................................................................................................................ 6
Behavioral pharmacology .............................................................................................................................. 7
BIOLOGICAL PSYCHOLOGY & PSYCHOPHARMACOLOGY .............................................................................. 7
PSYCHIATRY & PSYCHOPHARMACOLOGY ..................................................................................................... 7
FINAL REMARKS & SUMMARY ..................................................................................................................... 13
Topic 1.2.: PCDR Application ............................................................................................................................. 14
Het placebo-effect en het gebruik ervan in farmacologisch onderzoek ....................................................... 14
Het placebo-effect vanuit een biologisch behavioristisch oogpunt .............................................................. 15
PCDR: placebo-controlled dose reduction .................................................................................................... 18
PART II - Under the microscope: A lesson from biology ....................................................................................... 20
Topic 2.1.: BEHAVIOURAL NEUROSCIENCE ....................................................................................................... 20
Anatomy & organization of NS ...................................................................................................................... 21
Origin of signals ............................................................................................................................................. 23
Communicating signals ................................................................................................................................. 24
TOPIC 2.2.: Pharmacokinetics ........................................................................................................................... 35
General Framework ...................................................................................................................................... 35
Routes of administration............................................................................................................................... 36
Absorption & distribution ............................................................................................................................. 40
Depot binding ................................................................................................................................................ 42
Inactivation & biotransformation ................................................................................................................. 43
Excretion ....................................................................................................................................................... 46
TOPIC 2.3.:pharmacodynamics ......................................................................................................................... 47
Drug actions .................................................................................................................................................. 48
Drug effects ................................................................................................................................................... 57
Drug categorization ....................................................................................................................................... 59
kinetics & dynamics in actie .......................................................................................................................... 60
PART III - It's all in our mind: A lesson from society & psychology: DISCUSSION .................................................. 61
1
,Topic 3.1.: Research methods ........................................................................................................................... 61
(Psycho)pharmacological research cycle ...................................................................................................... 61
Clinical research: problems & solutions ........................................................................................................ 63
Animal research: Behavioural protocols ....................................................................................................... 66
Animal research: Reliability & Validity .......................................................................................................... 67
Animal research: Ethics ................................................................................................................................. 68
Topic 2: Addiction & Dependency problems from a psychosocial & societal perspective ............................... 70
A parable of Addiction .................................................................................................................................. 70
Addiction as an interaction of physical and psychological aspects ............................................................... 70
Working mechanisms of addiction ................................................................................................................ 71
Treating addiction ......................................................................................................................................... 74
Drug scheduling systems: international guidelines ....................................................................................... 75
Societal issues: From drug scheduling to policies ......................................................................................... 77
Topic 3.3.: Therapy adherance (therapietrouw) ............................................................................................... 79
What is therapy non-adherence? ................................................................................................................. 79
A framework of therapeutic (non-)adherence .............................................................................................. 80
The case of Scott Martin ............................................................................................................................... 83
Medicalization & pathologization ................................................................................................................. 86
Topic 3.4.: individual differences (e.g., how genetic & environmental differences can have an impact om
pharmacotherapy) from a biological, psychosocial & societal perspective .......... Error! Bookmark not defined.
2
,PART I - RELIEVING THE PAST: A LESSON FROM HISTORY
We start this series with a historical overview of how the field of Psychopharmacology came to be in the 20th
century. Under the influence of a long tradition of self-experimentation, experimental & biological psychology,
behaviourism, medicine and the pharmacological sciences, the field of Psychopharmacology was born. Gold
was struck in the 50s with the accidental discovery of Phenothiazines paving the way for the development of
modern drug classes, but also a rise in the recreational use of these drug classes.
TOPIC 1.1.: HISTORY OF PSYCHOPHARMACOLOGY
Three main goals:
• Students understand the multidisciplinary origins of psychopharmacology within the fields of
pharmacy, psychology, and psychiatry
• Students can explain the 'black-box' metaphor of behaviourism and explain its repercusions on the field
of psychopharmacology
• Students can give a (schematic) overview of contemporary psychiatric drug classes (including
antipsychotics, antidepressants, anxiolytics, moodstabilizers/antimanic drugs)
Study material includes:
• Class presentation: History of psychopharmacology
• Book section article: Badiani, A. (2015). History of Psychopharmacology. In I. P. Stolerman & L. H. Price
(Eds.), Encyclopedia of Psychopharmacology (pp. 752-764). Berlin, Heidelberg: Springer Berlin
Heidelberg.
Study tips:
• Main focus should be on the contents of the class presentation
• In-depth study of the article should be on sections "The origins of the term psychopharmacology" to
"Biological psychology and psychopharmacology" (p752-756)
• Contents discussed in "Psychiatry and psychopharmacology" (p756-763) provide you with a more
elaborated background story of the psychiatric drug classes.
• Drug names and dates discussed in the article should only be known if they were discussed during
class.
ONCE UPON A TIME
Voor 19de eeuw was er op wetenschappelijk (medisch) vlak niets geweten over psychoactieve componenten
(wel op recreatief vlak).
Drie mannen experimenteerden met drugs (voor de wetenschap):
1) Pièrre-Alexandre Charvet
2) Jacques-Joseph Moreau de Tours
3) Paolo Mantegazza
Ze wilden weten wat een drug doet met je lichaam (met dieren) en wat de bijdrage is voor
psychologie/psychiatrie.
➔ Pioniers!
3
, 1) “Opium for you! Opium for me! Opium for everyone!”→ Charvet (°1799 –†1879)
▪ De eerste die systematisch opium toediende aan verschillende diersoorten
▪ Comparative neuroscience = kijken wat een drug op niveau van neuronen doet (microscopisch)
▪ Hij beschreef gedragseffecten van opium en in zekere mate fysiologische effecten ervan
▪ Eerste auteur van experimentele psychofarmacologische studies
2) “I had a dream… to relate hasj is to madness and delirious states” → Moreau de Tours (°1804 –†1884)
▪ Comparing mentally ill patients (schizophrenia) to hashish induced mental states in healthy subjects
▪ No longer angels-demons point of view, but as worthy human psyche with Central nervous System
principles
▪ First to publish work on the effects of a drug and Central nervous system
Hij onderzocht wat gebeurde gedurende een psychotische episode
Focuste op het Paranoïde effect / behavior
Hij probeerde een mentale stoornis na te bootsen met een drug
Inhaleren van rook resulteert in een effect op het brein
“I had a nose for classifying drugs” → Mantegazza (°1831 –†1910)
▪ Eerste studie die focuste op de stimulerende effecten van cocaïne
▪ “Enthousiaste” supporter of cocaine: “I would rather have a life span of ten years with coca than one
of 10 000 000 000 000 000 000 000 centuries without coca.”
▪ Cocaïne kan gebruikt worden voor een alledaags down-gevoel vertelde hij
▪ Maakte een classificatie van psychoactieve planten & plantenextracten
→ Geen grote impact op psychologie en psychiatrie (wel biologie) → niet zo bij de andere twee!
EXPERIMENTAL PSYCHOLOGY
4
