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Description: So, what comes to mind as a definition when you see the term Psychiatric Therapeutics? Psychiatric relates to what Psychiatrists and Psychiatry is the medical specialty that focuses upon mental functioning, mental illness etc. It also involves the training necessary to be permitted to prescribe medications to treat the symptoms of mental disorders. Psychologists, with the exception of those in 5 states (Iowa, Idaho, Illinois, New Mexico and Louisiana), are not permitted to prescribe drugs. As such Psychologists are typically associated with Psychotherapies or talking treatments. This division often leads to either/or discussions of how to treat the symptoms of mental disorders such as whether anti-depressant medications treat the symptoms of depression more effectively than talking therapies such as Cognitive Behavior Therapy (they are actually equally effective). Rather than an either/or approach, however, research into the effectiveness of different approaches to treating the symptoms of mental disorders looks across these professional boundaries and, in particular, at the efficacy of combining drugs and Psychotherapy techniques. The article linked below describes two recent studies looking at the efficacy of combined approaches to treatment. When you look though the article pay attention not only to the treatment findings but also to the research design issues noted (and others that may occur to you as you read the article).

Source: New Directions in Psychiatric Therapeutics, Demystifying Psychiatry, Eugene Rubin, Psychology Today.

Date: January 8, 2020

Image Credit: kadroi poldma / FreeImages

Article Link: https://www.psychologytoday.com/ca/blog/demystifying-psychiatry/202001/new-directions-in-psychiatric-therapeutics

The array of treatment options currently available for treating the symptoms of mental disorders is very broad and includes, in addition to drugs and Psychotherapy new treatments like trans cranial magnetic stimulation which treats the brain without using drugs at all. It is particularly important to note the effectiveness of combined therapeutic approaches that address distinct aspects of complex mental disorders and, together, provide more positive and longer lasting treatment results. We are well beyond waiting to find the one thing that will provide better treatment outcomes and are finding better outcomes with combinations of treatments. And, of course, this will require more research!

Questions for Discussion:

  1. What are the differences between Psychiatrists and Psychologists in terms of how they treat the symptoms of mental disorders?
  2. Why might combination treatments (drugs and talk) be more effective than one or the other alone?
  3. How is transcranial magnetic stimulation different than drugs as a brain focused treatment for the symptoms of mental disorders?

References (Read Further):

Dakwar, E., Nunes, E.V., Hart, C.L., Foltin, R.W., Mathew, S.J., Carpenter, K.M., Choi, C.J., et al. (2019). A single ketamine infusion combined with mindfulness-based behavioral modification to treat cocaine dependence: a randomized clinical trial. Am J Psychiatry. 176: 923-930. http://www.kaimacdonald.com/wp-content/uploads/2019/12/Dakwar-2019-ketamine-cocaine-IV-COUD-.pdf

Carmi, L., Tendler, A., Bystritsky, A., Hollander, E., Blumberger, D.M., Daskalakis, J., Ward, H., et al. (2019). Efficacy and safety of deep transcranial magnetic stimulation for obsessive-compulsive disorder: a prospective multicenter randomized double-blind placebo-controlled trial. Am J Psychiatry. 176: 931-938. https://www.brainsway.com/wp-content/uploads/2019/09/Carmi_American-Journal-of-Psychiatry-2019_H7_OCD.pdf

George, M.S. (2019). Whither TMS: a one-trick pony or the beginning of a neuroscientific revolution? Am J Psychiatry. 176: 904-910. https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2019.19090957

Hallett, M. (2000). Transcranial magnetic stimulation and the human brain. Nature, 406(6792), 147. http://www.psicomag.com/biblioteca/2000/hallet_00.pdf

Loo, C. K., Taylor, J. L., Gandevia, S. C., McDarmont, B. N., Mitchell, P. B., & Sachdev, P. S. (2000). Transcranial magnetic stimulation (TMS) in controlled treatment studies: are some “sham” forms active?. Biological psychiatry, 47(4), 325-331. http://www.academia.edu/download/3437850/2000_Loo.pdf.pdf

 

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