CHEMOTHERAPY

The use of psychoactive (psychotropic) drugs in the treatment of mental disorder. Chemotherapy is a branch of the larger field of psychopharmacology, which develops and investigates all types of drugs that produce changes in psychological processes. Today’s psychotherapeutic drugs, sometimes termed psychochemicals, fall into two major categories: tranquilizers or ataractics,used to calm disturbed, excited, hyperactive or anxious patients; and antidepressants, or energizers, used as “mood elevators” in depressive reactions. Tranquilizers were developed first, but both types have come into widespread use only within the past ten to twelve years.In this short period of time chemotherapy has created a revolution in modern psychiatry. Practically all phases of the care and treatment of psychotic patients have benefited. Carefully prescribed drugs have enabled thousands of patients to avoid hospitalization, and have brought earlier discharges to thousands of others. The use of maintenance doses has also prevented relapses and has enabled many patients to live useful lives in the community.Thanks to these drugs the symptoms of overactive patients are now being controlled to a point where locked wards, isolation rooms and restraint are rarely needed. Depressed patients become less suicidal and more sociable; apathetic patients begin to take an interest in themselves and the world; and many deteriorated patients reach a point where they can care for their basic physical processes. The management of patients is therefore greatly facilitated, and the total climate of the hospital is greatly improved.Due to their potentiating or reinforcing effects, tranquilizers and energizers frequently reduce the need for strong doses of other drugs. Unlike some of the more drastic techniques, they do not inspire fear or anxiety. They have helped materially to outmode psychosurgery and in many cases have shortened the course of electroshock therapy or have eliminated the need for it altogether. Moreover, it has been found that drug treatments not only alleviate the symptoms of the disorder, but usually render patients amenable to psychotherapy and sociotherapy. The milder tranquilizers have also proved helpful in relieving anxiety in psychoneurotics and in reducing the tensions of normal individuals; and the milder energizers have proved effective in cases of neurotic depression.The effectiveness of these drugs is frequently increased by using them in combination. Stronger tranquilizers, such as chlorpromazine, or the milder meprobamates, may be combined with an energizer in treating depressive reactions or cases where acute anxiety is accompanied by depression. When acutely disturbed schizophrenics are relieved by tranquilizers, depressive symptoms sometimes develop, and in that case a combination of the two types of drugs may also be used. Tranquilizers are often combined with electroshock therapy in particularly resistant cases. In addition to increasing the rate of improvement, combination treatments often result in fewer side effects due to the fact that smaller doses of the drugs are required.In spite of its pronounced benefits, chemotherapy cannot be considered a panacea. It must also be carried out with great caution and on a highly individual basis. For each patient the drug must be carefully selected, the proper dosage determined, and then administered under close supervision. The medication or dosages may have to be changed as the patient’s reactions are observed. Some patients have physical disorders which contraindicate the use of psychotropic drugs altogether, while others suffer unpleasant or even dangerous side effects with certain drugs. Moreover, both the energizers and tranquilizers tend to mask symptoms and give the false impression that the patient is completely cured, and there may be a tendency to delay or avoid psychotherapy when it is vitally needed for full recovery. Finally, there is as yet too little information on the longterm effects of most of these drugs. What has been discovered so far, however, is reassuring. See TRANQUILIZERS, ENERGIZERS, ELECTROSHOCK THERAPY, NARCOSYNTHESIS, NARCOTHERAPY, COMBAT REACTIONS, HYPNOTHERAPY, LYSERGIC ACID, HALLUCINOGEN, DRUG ADDICTION, EPILEPSY (ETIOLOGY AND THERAPY).