Psychopharmacology samenvatting 2022/2023

PSYCHOPHARMACOLOGY
2022 - 2023




NINA DOBBELAERE
THOMAS MORE ANTWERPEN
Semester 1

,Content
1 History of Psychopharmacology..........................................................................................................3
1.1 Ancient history..............................................................................................................................3
1.2 Influences from psychology..........................................................................................................4
1.2.1 Experimental psychology.......................................................................................................4
1.2.2 Behavioral Psychology...........................................................................................................5
1.2.3 Behavioral Pharmacology......................................................................................................6
1.2.4 Biological Psychology & Psychopharmacology.......................................................................6
1.2.5 Example: Hebbian learning....................................................................................................6
1.3 Influences from psychiatry...........................................................................................................9
1.3.1 Early pharmacotherapy (1860 – 1930)...................................................................................9
1.3.2 Hallucinogenic experiments (1880 – 1940)..........................................................................10
1.3.3 The revolutionary decade (1949 – 1958).............................................................................12
1.4 In conclusion...............................................................................................................................15
2 Neurobiological frameworks of Psychopharmacology.......................................................................16
2.1 Key concepts of behavioral neuroscience...................................................................................16
2.1.1 Anatomy & organization of the nervous system..................................................................16
2.1.2 Origin of signals...................................................................................................................19
2.1.3 Neural communication........................................................................................................20
2.2 Key concepts of Psychopharmacology: pharmacokinetics..........................................................29
2.2.1 General framework..............................................................................................................29
2.2.2 Routes of Administration.....................................................................................................29
2.2.3 Absorption & Distribution....................................................................................................31
2.2.4 Depot binding......................................................................................................................34
2.2.5 Inactivation & biotransformation........................................................................................34
2.2.6 Excretion..............................................................................................................................37
2.2.7 Overview..............................................................................................................................37
2.3 Key concepts of Psychopharmacology: pharmacodynamics.......................................................37
2.3.1 CNS-Behavioral Categorization of Drugs..............................................................................37
2.3.2 Influencing synaptic communication...................................................................................37
2.3.3 Drugs as ligands...................................................................................................................38
2.3.4 Physiological responses of receptors...................................................................................39
2.3.5 Dynamic reactions...............................................................................................................41
2.3.6 From drug actions to drug effects........................................................................................41
2.3.7 Dose Response Curves (DRCs)..............................................................................................42

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, 2.3.8 From selectivity problem to versatility?...............................................................................42
2.3.9 Tolerance ↔ sensitization..................................................................................................43
3 Psychosocietal discussions.................................................................................................................45
3.1 Topic 1: Psychopharmacological research & ethical challenges.................................................45
3.1.1 Research cycle.....................................................................................................................45
3.2 Topic 2: Therapy adherence & medicalization............................................................................53
3.2.1 Defining therapy (non)adherence........................................................................................53
3.2.2 Factors related to therapy (non)adherence.........................................................................53
3.2.3 Societal problems related to therapy (non)adherence........................................................56
3.2.4 The case of Scott Martin: introduction & instructions.........................................................57
3.2.5 How to improve therapy adherence....................................................................................58
3.3 Topic 3: Substance use disorders (SUDs) & societal issues.........................................................60
3.3.1 Drug abuse, addiction & dependency..................................................................................60
3.3.2 Drug policies & societal issues.............................................................................................66
3.4 Topic 4: Consequences of medicalization...................................................................................68
3.4.1 Ethical marketing.................................................................................................................69
3.4.2 Use, misuse & abuse............................................................................................................70
3.4.3 Homeopathy doesn’t work..................................................................................................72




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, 1 History of Psychopharmacology
1.1 Ancient history
Before experimental psychology (19th century) – at the beginning of evidence-based medicine

3 men rose to the challenge of (self)experimenting with drugs:

1. Pièrre-Alexandre Charvet (1799 – 1879)
 Opium crisis
 Based on trade route between UK and China (Taiwan)
 Sailors noticed that locals used a lot of opioids (inhaling, eating) for
its pain relieving properties and there was quite a lot of
recreational use
 This caused conflict: recreational use = money!
 Taiwan missed out on cash and they saw their locals turn into a criminalized society
 Substance of interest: opium/heroin/morphine
 First experimental pharmacological studies
 Behavior > physiology: tranquillizing properties and euphoria with the right dose
 Systematically animal testing (e.g. snails, fish, frogs, birds…) and himself
 Observed behavioral effects
 Self-experimentation of a psychoactive substance (= compound that influences our
behavior)

2. Moreau de Tours (1804 – 1884)
 From angel-and-demons to humanistic approach
 Mental issues = demons
 Substance of interest: hasjisj
 A little bit of progress in psychiatry
 People suffering from mental issues were sent to prison during that time
 One person (Pinel) removed the chackles and put them into a clinic (same rights, but at
least they got some specialized “treatment”)
 First substance-based model of mental illnesses
 Behavioral comparison (psychosis, dreams)
 Hypothesized about central nervous system (CNS): there’s a link between the brain

3. Mantegazza (1831 – 1910)
 Anthropological (he was an anthropologist) exploitations in South America
 He saw the tribal use of coca leaves (Incas) for its energizing properties which caused
them to do horrible things such as human sacrifices
 Substance of interest: cocaine/coca leaves
 Self-experimentation
 Uplifting (euphoric) properties of coca
 He saw a clear link with “psychotic craziness” (= term for a lot of mood disorders; low
energy level)
 Enthusiastic supporter of coca
 First attempt at a classification system
 Based on psychoactive plants and plant extracts


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