Developmental psychology.pdf

474 Integration of Behavior
The patient was instructed to continue taking 500 mg of lithium carbonate
twice daily and also to follow a low-salt diet. After some time in the clinic he was sent
home again, remained well, and worked regularly on his new job.
Three years later J. W. became listless and apathetic. He also complained of
deafness and dryness of skin. Clinical examination revealed a hypothyroid condition,
apparently produced by the lithium. This condition is called a side effect, which is an
adverse and secondary outcome of treatment. When it was corrected by administration
of thyroxin, the patient's health again returned to normal.
During this period, the effects of lithium were tested by removing the drug
and substituting a salt pill with no medicinal properties. As predicted, the thyroid problem
disappeared and the periodic psychosis returned. Hence the patient was discharged
from the hospital with prescriptions for lithium and also thyroxin, and he went home
to normal health. Except for one minor disruption, when his dosage was incorrect, this
satisfactory condition has continued.
This history of J. W. emphasizes two points. First, a man who was essentially
unemployable for 18 years and "impossible" at home worked regularly for four years
and led a normal life under lithium treatment. Drug treatments, as his case shows, can
be extremely helpful. Second, arriving at a proper prescription for any individual can
be a complex, time-consuming task, often based on trial and error. The outcome can
be influenced by diet, health, and constitutional factors; it can include unwanted side
effects; and it can vary decidedly with the dosage (Musa, 1981). .
Types of Therapeutic Drugs The chief drugs used with psychosis are known as
antipsychotic drugs. One of these is lithium, used with J. W., and it can be especially
effective in depression and manic-depressive disorders. But as the case of J. W. shows,
drug treatment must be carefully monitored (Jefferson & Greist, 1981).
Other antipsychotic drugs include Thorazine and Stelazine, recognized as effective
in reducing hallucinations and delusions, evidently by blocking the activity of
certain neurotransmitters that play a role in brain arousal. Like lithium, they diminish
agitation to a point at which troubled patients can function in daily life and benefit
from other treatments, such as occupational therapy, recreational activity, and psychotherapy.
Also called major tranquilizers, these drugs are administered in cases of
incomplete recovery from LSD ingestion.
The minor tranquilizers, or antianxiety drugs, are used in less severe instances.
They induce relaxation and serenity, and in this category Valium is probably most
widely known today (Figure 17.15).
There are also antidepressant drugs or mood-elevating drugs, such as Elavil
and Tofranil. They stimulate the individual to increased activity and more interest in
the world, but some require 10 to 21 days before they have an effect.
Figure 17.15
Psychiatric Drugs. The use of these
drugs has increased precipitously in
recent generations.
Type of Drug
Antipsychotic
Antianxiety
Antidepressant
Generic Names
Chlorpromazine
Trifluoperazine
Meprobamate
Chlordiazepoxide
Imipramine
Amitriptyline
Indications for Use
Psychotic or other
severe
symptoms
Mild
maladjustment,
anxiety
Depression,
agitation, and
insomnia
Possible Side Effects
Dizziness, sleepiness, dry
mouth, blurred vision,
jaundice, liver damage
Initial dizziness, possible
addiction
Anxiety, trembling, sleep
problems, overt
psychosis