BIOMEDICAL INTERVENTIONS

A. Review of the Paradigm
1. The basic assumption: identify the biological cause and fix it
2. Early history of biomedical interventions
   a. Bleeding
   b. Heroin as a treatment for opium addiction
   c. Lobotomies
   d. ECT
   e. Sedatives
3. The modern era and the psychopharmacology revolution of the 1950s
4. Researching the effectiveness of biomedical interventions
   a. The double-blind placebo-control design reviewed
   b. Limitations
      (1) Poorly and inadequately designed studies
      (2) Efficacy vs. effectiveness
      (3) Short-term vs. long-term benefit
      (4) Clinical vs. statistical benefit
5. Comparing and combining biomedical and psychosocial interventions
   a. Are two always better than one?
   b. Is one always better than the other?
   c. Can one weaken or cancel out the other?
   d. The TDCRP study
6. The clash of paradigms and professions: psychology vs. psychiatry

B. Psychopharmacology
1. Anti-depressants
   a. Types
      (1) TCAs
      (2) MAOIs
      (3) SSRIs
   b. Uses
      (1) Depression
      (2) Fear and anxiety
      (3) Disordered eating
      (4) Substance abuse and addiction
      (5) Externalizing disorders in children
      (6) “Secondary” depression
   c. Issues
      (1) Side effects
      (2) Relapse and recurrence
      (3) The “masking the real problem” argument
2. Anti-anxiety medications
   a. Types
      (1) Benzodiazepines
      (2) Sedatives and hypnotics
      (3) Cardiac medications (beta-blockers, anti-hypertensives)
      (4) Other
   b. Uses
      (1) Fear and anxiety
      (2) Adjustment and trauma
      (3) Psychosomatic problems
      (4) Externalizing disorders in children
   c. Issues
      (1) Side effects
      (2) Potential for abuse and dependence
      (3) Interaction with alcohol
      (4) The “not facing one’s problems” argument
3. Antipsychotic medications
   a. Types
      (1) Phenothiazines (neuroleptics)
      (2) Atypical antipsychotics
   b. Uses
      (1) Psychotic disorders
      (2) Severe anxiety and trauma
      (3) Intoxication and withdrawal
   c. Issues
      (1) Effect on positive vs. negative symptoms
      (2) Side effects (EPS, TD)
      (3) Non-compliance and the “zombie” issue
4. Other forms of psychopharmacology
   a. Agonists, antagonists and aversives with substance use disorders
      (1) Antabuse
      (2) Methadone
      (3) Naltrexone
   b. Stimulants and ADHD
   c. Mood stabilizers and bipolar disorders
   d. Hormonal therapies and paraphilias

C. Other Biomedical Methods
1. Detoxification and substance dependence
2. ECT and depression
   a. Advantages
   b. Disadvantages
3. Psychosurgery
   a. Cingulotomy and OCD
   b. Amygdalectomy and IED
   c. Penile implants
4. Holistic methods
   a. Nutritional supplements
   b. Natural diets
   c. Light
   d. Exercise
   e. Meditation and biofeedback
   f. Other fads and folk remedies

Copyright ©1998 Beverly J. Volicer and Steven F. Tello, UMass Lowell.  You may freely edit these pages for use in a non-profit, educational setting.  Please include this copyright notice on all pages.