Chemotherapy: Part 2 of 4

There is a growing number of antidepressant medications. A given person may be helped significantly by one kind, yet be virtually untouched by another. One form of depressed functioning that is relatively unresponsive to these antidepressant medications is the manic-depressive pattern. As you will recall from the chapter on abnormal psychology this form of depression, with its dramatic manic phase, is distinctly different from other forms. In recent years a different type of drug, not an antidepressant, has been found to significantly reduce the manic-depressive symptoms of people who have experienced them for many years without relief. This drug, lithium must be taken at just the right level to be effective. Below the necessary level, it offers little therapeutic value; above that level, it can be quite toxic and dangerous. For this reasons careful monitoring of people on lithium is critical.

It is not yet clear why lithium works with manic-depressives. One notion is that the problem itself reflects an imbalance of intercellular sodium and potassium and that lithium which has properties similar to those of sodium, corrects this imbalance (Coppen, 1967). Since the net effect of lithium is to produce a marked reduction in intracellular sodium, it is not surprising that taking too much lithium can be so dangerous.

Chemotherapy has rapidly become the most effective form of treatment for schizophrenia. largely because of the phenothiazines, a group of drugs introduced in the 1950s. Because of their success in relieving schizophrenic symptoms, the phenothiazines and related drugs became known as antipsychotic drugs. Before these drugs were discovered the populations of schizophrenic persons in mental hospitals had been increasing, with no end in sight. With these drugs. however, there has been a reversal in this trend, and in the past few decades the number of schizophrenics in mental hospitals has been reduced dramatically. Indeed, many state hospitals have closed altogether New philosophies of treatment have helped to bring this about but the antipsychotic medications have been the single most important factor. As revealed in our earlier discussion however the reliance upon antipsychotic medications is not wholly warranted. Psychotics released from hospitals often end up as homeless derelicts, wandering the streets of cities. Moreover, those individuals who have improved on these drugs enough to be discharged often show high readmission rates. This has led to what is Jailed the ''revolving-door syndrome''-patients improve enough to be released, but return to the hospital because they are incapable of coping with the outside world. Thus chemotherapy cannot be said to be a ''cure.'' Drugs often produce more normal functioning temporarily, hut behavior and functioning can lapse to pretreatment rates when the drugs are discontinued. Of course sometimes temporary alteration is sufficient.