A Review on Management of Psychosis using
Pharmacological Strategies. instead of Psychiatric
drugs in medical setting
Volume 2 - Issue 1
Amrish Kumar*, Asso.Prof.(Dr.) Vrish Dhwaj Ashwlayan, Assts.Prof.(Mrs.) Mansi Verma, Prof.(Dr.) Vipin Kumar
Garg, Assts.Prof.(Mr.) Avnesh Kumar, Prof. (Dr.) Satish Kumar Gupta, Asso.Prof(Dr.) Sameksha Koul, Assts.Prof.
(Dr.) Anjana Sharma, Asso.Prof(Dr.) Anurag Chaudhary, Prof(Dr.) Anoop Kumar, Asso.Prof. (Dr.) Sachin Kumar,
Mr. Firoj Khan, Asso.Prof.(Dr.) Lubhan Singh, Dr. Nitin Sharma, Prof. Mr. Abhinav Agrawal and Prof.(Dr.) Neeraj
Kant Sharma
-
Author Information
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- Amrish Kumar*, Vrish Dhwaj Ashwlayan, Mansi Verma, Vipin Kumar Garg, Anurag and SK Gupta
*Corresponding author:
Amrish Kumar, Department of Pharmaceutical Technology, Meerut institute of engineering and technology
meerut, N.H. 58, Delhi-Roorkee Highway, Baghpat road crossing, Meerut, Uttar Pradesh 250005, India
Received: October 03, 2018; Published: October 11, 2018
DOI: 10.32474/LOJMS.2018.02.000130
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Abstract
Psychiatric symptoms are very frequent in medical practice, up to 40% of the people that have physical problems present anxiety
or depressive symptoms associated to physical illness. Due to this, psychiatric liaison is an important part of hospital attention and
many people usually have psychiatric drugs associated to other treatments. In the second half of the last century, many clinicians
mostly psychoanalytically oriented-have opposed the use of psychoactive drugs for the treatment of mental illness, particularly in
the course of psychotherapy, arguing that they suppress conflicts and states of mind considered essential for the understanding
of suffering. Furthermore, psychoactive drugs were supposed to have a negative influence on psychotherapy by making it less
effective. In reality, in 1974 research demonstrated that integrated therapy (i.e. combined use of medication and psychotherapy) is
not harmful to the patient but is actually useful. However, the conflict between pharmacotherapy and psychotherapy had already
made a great disservice to patients, sometimes delaying the required drug treatment (e.g. the importance of duration of untreated
psychosis for the prognosis of schizophrenia) or other avoiding effective psychological interventions that could lead to a better
quality of life and reduce the risk of suicide. This may be the case when considering dialectical behavior therapy (DBT) or exposure
and response prevention (ERP) techniques in cognitive behavioral therapy (CBT) for borderline personality disorder (BPD) and
obsessive-compulsive disorder (OCD), respectively. Unfortunately, today, despite a much-vaunted integration of treatments, on
the one hand we often deal with reductionist attitudes that judge psychotherapy as irrelevant and consider drug therapy alone
sufficient for treatment. On the other hand, we deal with extreme psychological assumptions that consider psychiatric illness as a
social problem and treatable solely and only-through psychosocial interventions, including psychotherapy. Over time, psychiatry
seems to move from a “brainlessness” approach to a “mindlessness” one. In fact, before the introduction of psychoactive drugs
the psychiatrist’s attention was almost exclusively on unconscious and intrapsychic conflicts supposed to affect the mind (as
separate from the brain). After 1956, attention moved to neurotransmitters and other aspects of the brain, consequently with an
extensive use of drugs and less interest for the exploration of the life stories of patients and focused on symptoms. Therefore, a
biological model of mental illness prevailed, causing an important crisis for psychotherapy. In my opinion, the cause of this crisis is
simple: psychiatry reductionists, using data from scientific research, support the biological causes of psychiatric illness (e.g. excess
dopamine, serotonin deficiency, etc.), and therefore were supposed to be able to say when, how and why a treatment protocol is
effective, describing the mechanisms of action, therapeutic effects, limitations and side effects.
Keywords: Psychiatric drugs; Psychotherapy; Psychosis; Dialectical behavior therapy; Cognitive behavioral therapy; Obsessive
compulsive disorder
Abbreviations: DBT: Dialectical Behavior Therapy; ERP: Exposure and Response Prevention; CBT: Cognitive Behavioral Therapy;
BPD: Borderline Personality Disorder; OCD: Obsessive-Compulsive Disorder; SSRI: Serotonine Selective Reuptake Inhibitors; AP:
Antipsychotics
Abstract|
Introduction|
Antidepressants|
Classic and second-generation antipsychotics|
Benzodiacepines|
Renal failure and psychoactive drugs|
Conclusion|
References|