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Samenvatting Psychopharmacology ()

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Summary of the book by Leon Kenemans (UU, English version) in the Psychopharmacology course (). Focus on the book, with additions from the lectures. Good luck learning! Summary of the psychopharmacology book from Leon Kenyans (UU, English version) from the course Psychopharmacology (). Focus on the book, with additions from the lectures. Good luck studying!

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Psychopharmacology
UU

Contents
Chapter 1 What are psychotropic drugs?.........................................................2

Lecture 1....................................................................................................... 4

Lecture 2 Principles........................................................................................7

Chapter 5 Principles of psychopharmacology...................................................9

Lecture 5 Pharmacology of depression..........................................................10

Chapter 7 Mood modulators..........................................................................12

Chapter 6 Stimulants....................................................................................14

Chapter 8 Tranquillizers and social enhancers................................................17

Lecture 9 Anxiety.........................................................................................20

Chapter 9 Antipsychotics..............................................................................22

Lecture 7 Antipsychotics...............................................................................25

Chapter 10 Psychedelics and related substances...........................................27

Chapter 11 Dependence................................................................................30

,Chapter 1 What are psychotropic drugs?
= substances that influence behavior through an effect on the central nervous system,
primarily the brain

Substances that reach neurons from the bloodstream can influence the signals by causing a
chemical reaction with substances that are already in the brain.  this has an effect on
countless other parts of the brain that are connected with the affected area. Via connections
between the brain and muscles, a substance can exercise influence on patterns of muscle
activity = behavior.

Two different categories
- Recreational drugs: People administer drugs to themselves because the substance has
a reward effect. The reward effect increases the likelihood of readministering the drug.
 addiction.
- Medicinal drugs: used to reduce, change or control problematic behavior.  when it
leads to dysfunction for the person their selves or their surroundings.

Injection, smoking and insufflation (snorting via the nose) are quick ways to increase the
amount of substance in the blood and achieve a fast result in the brain.

Extended-release formula = a way of packaging drugs which releases medication into the
bloodstream more slowly, which makes it possible to achieve a more constant blood level
after the delivering peak. It has a more gradual course of the effects on behavior.

Therapeutic window = between the lowest dose that forms an average lower limit for
observing any desirable effect and the upper limit that is the highest average dose that results
in an unacceptable level of undesirable effects. The larger the window, the most suitable the
substance is for treatment.

Titration = the act of determining the optimal dose
A possible result of this process is the development of tolerance: reduced effects due to the
chronic administration of a substance.

The goal of scientific research is to explain phenomena and to make them predictable.  only
partially the case in psychopharmacological research. The main goal is usually to determine
whether the drug has a desired effect, not so much about the explanation of why.

Double blind, placebo-controlled experiments are needed for psychopharmacological
research. Random samples should be as balanced as possible. On average they should not
differ significantly on any possible relevant parameter. They should also be representative of
the intended population.

Clinical research into a new drug usually progresses through three phases
1. A small group of healthy volunteers is used to study which doses can be tolerated
without problems (titration)
2. The researched study possible therapeutic effects in a small group of patients with the
condition that the drug is intended to treat. (double-blind placebo-controlled).  the
drug must be safe and work better than existing medications

, 3. Confirmation of the results in phase 2 in a new double-blind placebo-controlled study,
involving groups of thousands of patients. At least two independent studies must be
conducted.
4. After phase 3 is positive, the drug van be registered, sold and prescribed by
physicians. In phase 4, any side effects that may occur are registered as accurately as
possible.

Before a potential new drug is subjected to clinical testing, it has often been subjected to years
of pre-clinical studies. These utilize animal models.

, Lecture 1
Pharmacology is the science that studies the influence of substances on biological processes.
 focus is on how it impacts behavior (psycho)
What impact the biological changes have on behavior

Interest?
Psychoactive substances are pervasive in our daily lives
Many substances that are used routinely in our life (coffee, nicotine). It is important to
understand how they act and what kind of impact they have

A lot of substances are psychoactive  have an impact on your behavior
How does that work?
They are meant to work on the brain

Pharmacokinetics: everything related with how a substance moves through the body

Pharmacodynamics: after the substances has reached the target site, what happens then?
- To what receptors does the substance bind?
- What effect does the substance have on the receptor?
- Interaction with neurotransmitters

A lot of what we know about psychoactive drugs is what we have known for a long time.
Mostly by observation
A lot has been discovered by accident (penicillin)

Hypothesis-based research
= research programs in pharmaceutical industry and universities for targeted drug discovery
Research into drugs is extremely costly. Conflict of interest with pharmaceutical companies
funding research. The whole process is very controlled.

- Basic knowledge (preclinical research)
How are neurotransmitter levels de- or increased?
What brain regions are involved in brain function?
What kinds of substances may affect neurotransmitters of neurons
What are the potential beneficial and side effect of a substance?

Each process / receptor has more than one function.  acting on everything that the system
has a role on. Any drug has side effects. How do you balance against unwanted effects?

A lot is done in animals, as you need to target specific sites.

- Clinical knowledge (clinical research)
What type of brain functions/cells/regions are involved in a psychiatric disorder?
There is not a one-to-one mapping between symptoms and disorders. Some degree of
variability of profile of the disease that they show  should be considered when formulating
hypotheses

Therapeutic window/index = relation between the toxic dose and the effective dose

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