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Psychopharmacology

Providing psychopharmacology in NYC

What is psychopharmacology?

Psychopharmacology is the use of medications to treat emotional or behavioral problems including depression, anxiety, and attention deficit disorder. Today one in six people takes a psychotropic medication. These medicines now play a major role in the progress we’ve made in treating widespread psychiatric diagnoses.

For ages, humans have ingested or inhaled substances with the express purpose of changing their psychological states and regulating their environments and goals. During the modern era, the enormous growth of knowledge in brain sciences, including advances in studying neural circuits and brain chemistry recognized by several Nobel prizes, has contributed to the development of effective medications targeting a range of conditions. These medications work by modulating the signaling activity of neurotransmitters, which we now know are central to brain functioning.

What are neurotransmitters?

The brain is a highly internetworked organ containing around 100 billion nerve cells, called neurons. During a person’s growth and development, starting in utero and proceeding at least into the early 20s, the neurons lay down permanently wired connections to each other, more than 100 trillion connections in total, resulting in multiple complicated neural circuits. The brain consumes about 20% of the body’s energy, even though it weighs only 2% of the body’s mass, and yet remarkably it doesn’t overheat, all while being orders of magnitude more efficient at most tasks than any supercomputer.

At the heart of this complex organ and processes are chemical messengers, called neurotransmitters. Neurotransmitters are the chemical signals which transmit messages from one neuron to the next in these more than 100 trillion connections. Modern psychotropic medications work primarily by changing the way neurons release or respond to neurotransmitters, thus changing the brain signaling. Even subtle changes in the nature of neurotransmitter release and in brain responses can cause significant changes in psychological state or behavior.

Scientists have identified more than 60 different neurotransmitters in the human brain, with 100s of distinct receptors for these neurotransmitters, all distributed in complex patterns. Some of these neurotransmitters have even entered into popular culture. For example, dopamine, which can be modulated by stimulant medications such as Adderall used to treat attention deficit disorder, is sometimes viewed a signal for motivation or energy or reward. Serotonin, which in popular lore is a resilience enhancing, mood improving, or stress reducing neurotransmitter, is affected by numerous antidepressants. Signaling by GABA, the brain’s main inhibitory neurotransmitter, is the basis of action of Xanax, Klonopin, Ambien, and other short-acting anti-anxiety or sleep-inducing medications. Release of glutamate, the main excitatory neurotransmitter in the brain, is modulated by Lamictal, a mood stabilizer used for bipolar disorder. From acetylcholine to endocannabinoids to endorphins to oxytocin, the list of neurotransmitters goes on and on.

Sometimes people say that imbalances in neurotransmitters “cause” various conditions such as anxiety, depression, distractibility, fatigue, insomnia, obsessive compulsive disorder, and many other symptoms or conditions. Although this way of talking about neurotransmitters is obviously an oversimplification, it can be a helpful shorthand, in that it can highlight the potential of psychotropic medications to treat these sorts of problems.

What are psychotropic medications?

Psychotropic medications are medicines that are used to treat psychiatric conditions. Psychotropic medications can be used to improve mood, reduce anxiety, improve mental focus, reduce inattentiveness, resolve insomnia, and treat other psychiatric problems. Modern psychotropic medications produce benefits primarily by modulating the actions of neurotransmitters. A psychopharmacologist is an experienced clinician who is expert in the use of these medicines.

These medicines are evaluated and thoroughly scrutinized in lengthy and expensive placebo-controlled double blind clinical trials to ensure that only the safest and most effective psychological medications come to market. When prescribed appropriately, they can be tremendously helpful for people dealing with psychiatric diagnosis

What is a psychopharmacologist?

A psychopharmacologist is an expert in the use of psychotropic medications to treat psychiatric diagnoses in a manner so as to maximize clinical benefits and minimize any potential side effects. They will work with you to help you choose how and when to use medication and when to go off of medication.

A psychopharmacologist must have an extensive understanding of basic neuroscience, pharmacology, clinical medicine, diagnosis of psychiatric disorders, and treatment options including not only medication but also non-pharmacological treatments. The field is so complex that the psychopharmacologist must be continuously up to date on all new advances. Psychiatrists are also psychopharmacologists thoroughly trained to treat psychiatric conditions with psychotropic medications.

Should I take medication?

Depending on the diagnosis and the situation, some people find that psychotropic medication alone helps them to manage their symptoms and allows them to deal with whatever psychiatric issues are troubling them. Others find a combination of medication and psychotherapy provides the best outcome. And many opt for psychotherapy alone as the preferred treatment option. There is no one size that fits all.

We have found that at times psychotherapy alone does not provide the intended results. In these cases, we may suggest a consultation with one of our expert psychopharmacologists in order to consider adding medication to your therapy. Used appropriately, medication can in fact enhance the effectiveness of psychotherapy, helping you become more present and active in therapy so you can learn new tools and techniques to help manage negative emotions.

When we find that a client is so overcome with their psychological problems that they are not fully or rapidly responding to psychotherapy alone, or when a client’s symptoms interfere markedly with daily life activities, we are likely to recommend medication in addition to therapy. Of course, the decision to take psychotropic medication is each individual’s decision. But combining medication with therapy can provide rapid relief from symptoms and restore healthy functioning and in so doing set the stage for a more productive psychotherapy and more psychological growth, all while living a more rewarding and enjoyable life.

Contact The Midtown Practice to schedule an appointment to discuss therapy and medication options.


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