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Psychopharmacology

Drugs, the Brain, and Behavior

Third Edition

Jerrold S. Meyer and Linda F. Quenzer

Publication Date - March 2018

ISBN: 9781605355559

840 pages
Hardcover
8.5 x 10.75 inches

In Stock

Retail Price to Students: $129.95

Unique in its breadth of coverage ranging from historical accounts of drug use to clinical and preclinical behavioral studies, Psychopharmacology is appropriate for undergraduates studying the relationships between the behavioral effects of psychoactive drugs and their mechanisms of action.

Description

Unique in its breadth of coverage ranging from historical accounts of drug use to clinical and preclinical behavioral studies, Psychopharmacology is appropriate for undergraduates studying the relationships between the behavioral effects of psychoactive drugs and their mechanisms of action.

New to this Edition

  • New coverage on immune system dysfunctions in schizophrenia that lead to neurodevelopmental brain abnormalities
  • Discussion of the opioid epidemic, designer drugs, and use of naloxone
  • Updated coverage of new research techniques, including magnetic resonance spectroscopy, DTI, optogenetics, and others
  • New discussion of orexin-based medications for treating sleep disorders
  • Coverage of new findings in the genetic and epigenetic factors of drug addiction
  • Coverage of synthetic cannabis and the potential therapeutic uses of hallucinogenic drugs

Features

  • Chapter-opening vignettes foster student engagement
  • Breakout boxes present novel and, in some cases, controversial topics for special discussion. Box themes include: History of Psychopharmacology; Pharmacology in Action; Clinical Applications; Of Special Interest; and The Cutting Edge.
  • The book is extensively illustrated with full-color photographs and line art depicting important concepts and experimental data
  • Section Summaries highlight key concepts from the section of text just read
  • Chapter-ending Recommended Readings offer suggestions for further study

About the Author(s)

Jerrold S. Meyer is Professor Emeritus of Psychology and former Director of the interdeparmental Neuroscience and Behavior Program at the University of Massachusetts, Amherst. Linda F. Quenzer is Adjunct Professor of Psychology and Neuroscience at the University of Hartford.

Reviews

"This is the best textbook out there. The prose is easy to understand, the examples are clear, and the illustrations make complex information easy to follow." --Jeffrey Rudski, Muhlenberg College

"The material is timely, thorough, and more up-to-date than many texts available. I would consider using this book for my courses. I like the book so much I would love to read the entire book." --Cheryl Kirstein, University of South Florida, Tampa

"I believe that the textbook is an amazing resource, it cites so many pivotal sources and it gives the students a very well rounded picture of psychopharmacology. I think that as long as you keep the content current, you are doing an amazing job!" --Matthew Clasen, American University

Table of Contents

    Preface

    Chapter 1. Principles of Pharmacology
    Pharmacology: The Science of Drug Action
    Placebo effect
    Box 1.1. Pharmacology in Action: Naming Drugs
    Pharmacokinetic Factors Determining Drug Action
    Methods of drug administration influence the onset of drug action
    Multiple factors modify drug absorption
    Drug distribution is limited by selective barriers
    Depot binding alters the magnitude and duration of drug action
    Biotransformation and elimination of drugs contribute to bioavailability
    Therapeutic Drug Monitoring
    Box 1.2. Pharmacology in Action: Interspecies Drug Dose Extrapolation
    Pharmacodynamics: Drug-Receptor Interactions
    Box 1.3. Pharmacology in Action: Drug Categories
    Extracellular and intracellular receptors have several common features
    Dose-response curves describe receptor activity
    The therapeutic index calculates drug safety
    Receptor antagonists compete with agonists for binding sites
    Biobehavioral Effects of Chronic Drug Use
    Repeated drug exposure can cause tolerance
    Chronic drug use can cause sensitization
    Pharmacogenetics and Personalized Medicine in Psychiatry

    Chapter 2. Structure and Function of the Nervous System
    Cells of the Nervous System
    Neurons have three major external features
    Box 2.1. The Cutting Edge: Embryonic Stem Cells
    Characteristics of the cell membrane are critical for neuron function
    Glial cells provide vital support for neurons
    Box 2.2. Of Special Interest: Astrocytes
    Electrical Transmission within a Neuron
    Ion distribution is responsible for the cell's resting potential
    Local potentials are small, transient changes in membrane potential
    Sufficient depolarization at the axon hillock opens voltage-gated Na+ channels, producing an action potential
    Drugs and poisons alter axon conduction
    Organization of the Nervous System
    Box 2.3. The Cutting Edge: Finding Your Way in the Nervous System
    The nervous system comprises the central and peripheral divisions
    CNS functioning is dependent on structural features
    The CNS has six distinct regions reflecting embryological development
    Box 2.4. Of Special Interest: Neuroendocrine Response to Stress
    The cerebral cortex is divided into four lobes, each having primary, secondary, and tertiary areas
    Rat and human brains have many similarities and some differences

    Chapter 3. Chemical Signaling by Neurotransmitters and Hormones
    Chemical Signaling between Nerve Cells
    Neurotransmitter Synthesis, Release, and Inactivation
    Neurotransmitters encompass several different kinds of chemical substances
    Box 3.1. Clinical Applications: Orexin-Based Medications: New Approaches to the Treatment of Sleep Disorders
    Neuropeptides are synthesized by a different mechanism than other transmitters
    Neuromodulators are chemicals that don't act like typical neurotransmitters
    Classical transmitter release involves exocytosis and recycling of synaptic vesicles
    Lipid and gaseous transmitters are not released from synaptic vesicles
    Several mechanisms control the rate of neurotransmitter release by nerve cells
    Neurotransmitters are inactivated by reuptake and by enzymatic breakdown
    Neurotransmitter Receptors and Second-Messenger Systems
    There are two major families of neurotransmitter receptors
    Second messengers work by activating specific protein kinases within a cell
    Tyrosine kinase receptors mediate the effects of neurotrophic factors
    Pharmacology of Synaptic Transmission
    Synaptic Plasticity
    The Endocrine System
    Endocrine glands can secrete multiple hormones
    Mechanisms of hormone action vary
    Why is the endocrine system important to pharmacologists?
    Box 3.2. Pharmacology in Action: Sex Hormones and Drug Abuse

    Chapter 4. Methods of Research in Psychopharmacology
    Research Methods for Evaluating the Brain and Behavior
    TECHNIQUES IN BEHAVIORAL PHARMACOLOGY
    Evaluating Animal Behavior
    Animal testing needs to be valid and reliable to produce useful information
    A wide variety of behaviors are evaluated by psychopharmacologists
    Box 4.1. Pharmacology in Action: Using the Three-Chamber Social Interaction Test
    Box 4.2. Clinical Applications: Drug Testing for FDA Approval
    TECHNIQUES IN NEUROPHARMACOLOGY
    Multiple Neurobiological Techniques for Assessing the CNS
    Stereotaxic surgery is needed for accurate in vivo measures of brain function
    Neurotransmitters, receptors, and other proteins can be quantified and visually located in the CNS
    New tools are used for imaging the structure and function of the brain
    Genetic engineering helps neuroscientists to ask and answer new questions
    Box 4.3. Pharmacology in Action: Transgenic Model of Huntington's Disease
    Behavioral and neuropharmacological methods complement one another

    Chapter 5. Catecholamines
    Catecholamine Synthesis, Release, and Inactivation
    Tyrosine hydroxylase catalyzes the rate-limiting stepin catecholamine synthesis
    Catecholamines are stored in and released from synaptic vesicles
    Catecholamine inactivation occurs through the combination of reuptake and metabolism
    Organization and Function of the Dopaminergic System
    Two important dopaminergic cell groups are found in the midbrain
    Ascending dopamine pathways have been implicated in several important behavioral functions
    Box 5.1. Clinical Applications: Mutations That Affect Dopamine Neurotransmission
    There are five main subtypes of dopamine receptors organized into D1- and D2-like families
    Dopamine receptor agonists and antagonists affect locomotor activity and other behavioral functions
    Box 5.2. The Cutting Edge: Using Molecular Genetics to Study the Dopaminergic System
    Organization and Function of the Noradrenergic System
    Norepinephrine is an important transmitter in both the central and peripheral nervous systems
    Norepinephrine and epinephrine act through alpha- and beta-adrenergic receptors
    The central noradrenergic system plays a significant role in arousal, cognition, and the consolidation of emotional memories
    Several medications work by stimulating or inhibiting peripheral adrenergic receptors

    Chapter 6. Serotonin
    Serotonin Synthesis, Release, and Inactivation
    Serotonin synthesis is regulated by enzymatic activity and precursor availability
    Similar processes regulate storage, release, and inactivation of serotonin and the catecholamines
    Box 6.1. History of Psychopharmacology: "Ecstasy"--Harmless Feel-Good Drug, Dangerous Neurotoxin, or Miracle Medication?
    Organization and Function of the Serotonergic System
    The serotonergic system originates in the brainstem and projects to all forebrain areas
    The firing of dorsal raphe serotonergic neurons varies with behavioral state and in response to rewards and punishments
    There is a large family of serotonin receptors, most of which are metabotropic
    Multiple approaches have identified several behavioral and physiological functions of serotonin
    Box 6.2. The Cutting Edge: Serotonin and Aggression

    Chapter 7. Acetylcholine
    Acetylcholine Synthesis, Release, and Inactivation
    Acetylcholine synthesis is catalyzed by the enzyme choline acetyltransferase
    Many different drugs and toxins can alter acetylcholine storage and release
    Acetylcholinesterase is responsible for acetylcholine breakdown
    Box 7.1. Pharmacology In Action: Botulinum Toxin--Deadly Poison, Therapeutic Remedy, and Cosmetic Aid
    Organization and Function of the Cholinergic System
    Cholinergic neurons play a key role in the functioning of both the peripheral and central nervous systems
    Box 7.2. The Cutting Edge: Acetylcholine and Cognitive Function
    There are two acetylcholine receptor subtypes: nicotinic and muscarinic

    Chapter 8. Glutamate and GABA
    GLUTAMATE
    Glutamate Synthesis, Release, and Inactivation
    Neurons generate glutamate from the precursor glutamine
    Glutamate packaging into vesicles and uptake after release are mediated by multiple transport systems
    Organization and Function of the Glutamatergic System
    Glutamate is the neurotransmitter used in many excitatory pathways in the brain
    Both ionotropic and metabotropic receptors mediate the synaptic effects of glutamate
    Box 8.1. Clinical Applications: Fragile X Syndrome and Metabotropic Glutamate Receptor Antagonists: A Contemporary Saga of Translational Medicine
    AMPA and NMDA receptors play a key role in learning and memory
    High levels of glutamate can be toxic to nerve cells
    GABA
    GABA Synthesis, Release, and Inactivation
    GABA is synthesized by the enzyme glutamic acid decarboxylase
    GABA packaging into vesicles and uptake after release are mediated by specific transporter proteins
    GABA is coreleased with several other classical neurotransmitters
    Organization and Function of the GABAergic System
    Some GABAergic neurons are interneurons, while others are projection neurons
    The actions of GABA are primarily mediated by ionotropic GABAA receptors
    Box 8.2. Clinical Applications: GABA and Epilepsy
    GABA also signals using metabotropic GABAB receptors

    Chapter 9. Drug Abuse and Addiction
    Introduction to Drug Abuse and Addiction
    Drugs of abuse are widely consumed in our society
    Drug use in our society has increased and has become more heavily regulated over time
    Features of Drug Abuse and Addiction
    Drug addiction is considered to be a chronic, relapsing behavioral disorder
    There are two types of progression in drug use
    Box 9.1. Of Special Interest: Should the Term Addiction Be Applied to Compulsive Behavioral Disorders That Don't Involve Substance Use?
    Which drugs are the most addictive?
    Factors That Influence the Development and Maintenance of Drug Abuse and Addiction
    The addiction potential of a substance is influenced by its route of administration
    Most abused drugs exert rewarding and reinforcing effects
    Drug dependence leads to withdrawal symptoms when abstinence is attempted
    Discriminative stimulus effects contribute to drug-seeking behavior
    Genetic factors contribute to the risk for addiction
    Psychosocial variables also contribute to addiction risk
    The factors contributing to drug addiction can be combined into a biopsychosocial model
    The Neurobiology of Drug Addiction
    Drug reward and incentive salience drive the binge-intoxication stage of drug use
    The withdrawal/negative affect stage is characterized by stress and by the recruitment of an antireward circuit
    The preoccupation/anticipation stage involves dysregulation of prefrontal cortical function and corticostriatal circuitry
    Molecular neuroadaptations play a key role in the transition to an addicted state
    Is addiction a disease?

    Chapter 10. Alcohol
    Psychopharmacology of Alcohol
    Alcohol has a long history of use
    What is an alcohol and where does it come from?
    The pharmacokinetics of alcohol determines its bioavailability
    Chronic alcohol use leads to both tolerance and physical dependence
    Alcohol affects many organ systems
    Box 10.1. Pharmacology in Action:The Role of Expectation in Alcohol-Enhanced Human Sexual Response
    Neurochemical Effects of Alcohol
    Animal models are vital for alcohol research
    Alcohol acts on multiple neurotransmitters
    Alcohol Use Disorder (AUD)
    Defining alcohol use disorder and estimating its incidence have proved difficult
    The causes of alcohol use disorder are multimodal
    Multiple treatment options provide hope for rehabilitation

    Chapter 11. The Opioids
    Narcotic Analgesics
    The opium poppy has a long history of use
    Minor differences in molecular structure determine behavioral effects
    Bioavailability predicts both physiological and behavioral effects
    Opioids have their most important effects on the CNS and on the gastrointestinal tract
    Box 11.1. Clinical Applications: Saving a Life: Naloxone for Opioid Overdoses
    Opioid Receptors and Endogenous Neuropeptides
    Receptor binding studies identified and localized opioid receptors
    Four opioid receptor subtypes exist
    Several families of naturally occurring opioid peptides bind to these receptors
    Box 11.2. The Cutting Edge: Science in Action
    Opioid receptor-mediated cellular changes are inhibitory
    Opioids and Pain
    The two components of pain have distinct features
    Opioids inhibit pain transmission at spinal and supraspinal levels
    Other forms of pain control depend on opioids
    Opioid Reinforcement, Tolerance, and Dependence
    Animal testing shows significant reinforcing properties
    Dopaminergic and nondopaminergic components contribute to opioid reinforcement
    Long-term opioid use produces tolerance, sensitization, and dependence
    Box 11.3. Of Special Interest: The Opioid Epidemic
    Several brain areas contribute to the opioid abstinence syndrome
    Neurobiological adaptation and rebound constitute tolerance and withdrawal
    Environmental cues have a role in tolerance, drug abuse, and relapse
    Treatment Programs for Opioid Use Disorder
    Detoxification is the first step in the therapeutic process
    Treatment goals and programs rely on pharmacological support and counseling

    Chapter 12. Psychomotor Stimulants: Cocaine, Amphetamine, and Related Drugs
    COCAINE
    Background and History
    Basic Pharmacology of Cocaine
    Mechanisms of Cocaine Action
    Acute Behavioral and Physiological Effects of Cocaine
    Cocaine stimulates mood and behavior
    Cocaine's physiological effects are mediated by the sympathetic nervous system
    Dopamine is important for many effects of cocaine and other psychostimulants
    Brain imaging has revealed the neural mechanisms of psychostimulant action in humans
    Several DA receptor subtypes mediate the functional effects of psychostimulants
    Cocaine Abuse and the Effects of Chronic Cocaine Exposure
    Experimental cocaine use may escalate over time to a pattern of cocaine abuse and dependence
    Chronic cocaine exposure leads to significant behavioral and neurobiological changes
    Box 12.1. The Cutting Edge: Neurochemical Mechanisms of Cocaine Tolerance and Sensitization
    Repeated or high-dose cocaine use can produce serious health consequences
    Pharmacological, behavioral, and psychosocial methods are used to treat cocaine abuse and dependence
    THE AMPHETAMINES
    Background and History
    Basic Pharmacology of the Amphetamines
    Mechanisms of Amphetamine and Methamphetamine Action
    Behavioral and Neural Effects of Amphetamines
    Amphetamine and methamphetamine have therapeutic uses
    High doses or chronic use of amphetamines can cause a variety of adverse effects
    METHYLPHENIDATE, MODAFINIL, AND SYNTHETIC CATHINONES
    Methylphenidate
    Box 12.2. Clinical Applications: Psychostimulants and ADHD
    Modafinil
    Synthetic Cathinones

    Chapter 13. Nicotine and Caffeine
    NICOTINE
    Background and History
    Basic Pharmacology of Nicotine and Its Relationship to Smoking
    Features of tobacco smoking and nicotine pharmacokinetics
    Features of e-cigarette vaping and nicotine pharmacokinetics
    Nicotine metabolism
    Mechanisms of Action
    Behavioral and Physiological Effects
    Nicotine elicits different mood changes in smokers compared with nonsmokers
    Nicotine enhances cognitive function
    Nicotine exerts both reinforcing and aversive effects
    Nicotine produces a wide range of physiological effects
    Nicotine is a toxic substance that can be fatal at high doses
    Chronic exposure to nicotine induces tolerance and dependence
    Cigarette Smoking and Vaping
    What percentage of the population are current users of tobacco and/or e-cigarettes?
    Nicotine users progress through a series of stages in their pattern and frequency of use
    Box 13.1. The Cutting Edge: How Safe Are E-cigarettes?
    Why do smokers smoke and vapers vape?
    Smoking is a major health hazard and a cause of premature death
    Behavioral and pharmacological strategies are used to treat tobacco dependence
    CAFFEINE
    Background
    Basic Pharmacology of Caffeine
    Behavioral and Physiological Effects
    Acute subjective and behavioral effects of caffeine depend on dose and prior exposure
    Caffeine consumption can enhance sports performance
    Regular caffeine use leads to tolerance and dependence
    Caffeine and caffeine-containing beverages pose health risks but also exert therapeutic benefits
    Mechanisms of Action

    Chapter 14. Marijuana and the Cannabinoids
    Background and History of Cannabis and Marijuana
    Forms of cannabis and their chemical constituents
    History of cannabis
    Basic Pharmacology of Marijuana
    THC
    Cannabidiol
    Mechanisms of Action
    Cannabinoid effects are mediated by cannabinoid receptors
    Pharmacological and genetic studies reveal the functional roles of cannabinoid receptors
    Endocannabinoids are cannabinoid receptor agonists synthesized by the body
    Acute Behavioral and Physiological Effects of Cannabinoids
    Cannabis consumption produces a dose-dependent state of intoxication
    Marijuana use can lead to deficits in memory and other cognitive processes
    Rewarding and reinforcing effects of cannabinoids have been studied in both humans and animals
    Cannabis Abuse and the Effects of Chronic Cannabis Exposure
    Chronic use of cannabis can lead to the development of a cannabis use disorder
    Chronic cannabis use can lead to adverse behavioral, neurobiological, and health effects
    Box 14.1. Of Special Interest: Beyond Cannabis: The Rise of Synthetic Cannabinoids

    Chapter 15. Hallucinogens, PCP, and Ketamine
    HALLUCINOGENIC DRUGS
    Mescaline
    Psilocybin
    Dimethyltryptamine and Related Tryptamines
    LSD
    Box 15.1. History of Pharmacology: The Discovery of LSD
    NBOMes
    Salvinorin A
    Pharmacology of Hallucinogenic Drugs
    Different hallucinogenic drugs vary in potency and in their time course of action
    Hallucinogens produce a complex set of psychological and physiological responses
    Most hallucinogenic drugs share a common indoleamine or phenethylamine structure
    Indoleamine and phenethylamine hallucinogens are 5-HT2A receptor agonists
    Salvinorin A is a kappa-opioid receptor agonist
    The neural mechanisms underlying hallucinogenesis are not yet fully understood
    Hallucinogenic drug use leads to adverse effects in some users
    Can hallucinogenic drugs be used therapeutically?
    PCP AND KETAMINE
    Background and History
    Pharmacology of PCP and Ketamine
    PCP and ketamine produce a state of dissociation
    PCP and ketamine are noncompetitive antagonists of NMDA receptors
    PCP and ketamine have significant abuse potential
    Use of PCP, ketamine, or related drugs can cause a variety of adverse consequences
    Box 15.2. Pharmacology In Action: Getting High on Cough Syrup
    Novel therapeutic applications have been proposed for ketamine

    Chapter 16. Inhalants, GHB, and Anabolic-Androgenic Steroids
    INHALANTS
    Background
    Inhalants comprise a range of substances including volatile solvents, fuels, halogenated hydrocarbons, anesthetics, and nitrites
    Abused inhalants are rapidly absorbed and readily enter the brain
    These substances are particularly favored by children and adolescents
    Behavioral and Neural Effects
    Many inhalant effects are similar to alcohol intoxication
    Chronic inhalant use can lead to tolerance and dependence
    Rewarding and reinforcing effects have been demonstrated in animals
    Inhalants have complex effects on central nervous system (CNS) function and behavioral activity
    Health risks have been associated with inhalant abuse
    GAMMA-HYDROXYBUTYRATE
    Background?
    Behavioral and Neural Effects
    GHB produces behavioral sedation, intoxication, and learning deficits
    GHB and its precursors have reinforcing properties
    Effects of GHB are mediated by multiple mechanisms
    Medical and Recreational Uses of GHB
    GHB is used therapeutically for the treatment of narcolepsy and alcoholism
    GHB has significant abuse potential when used recreationally
    ANABOLIC-ANDROGENIC STEROIDS
    Background and History
    Anabolic-androgenic steroids are structurally related to testosterone
    Anabolic-androgenic steroids were developed to help build muscle mass and enhance athletic performance
    Anabolic-androgenic steroids are currently taken by many adolescent and adult men
    Anabolic-androgenic steroids are taken in specific patterns and combinations
    Pharmacology of Anabolic-Androgenic Steroids
    Research is beginning to unravel the mechanism of action of anabolic-androgenic steroids on muscle
    Many adverse side effects are associated with anabolic-androgenic steroid use
    Regular anabolic-androgenic steroid use causes dependence in some individuals
    Box 16.1. Of Special Interest: Anabolic-Androgenic Steroids and "Roid Rage"
    Testosterone has an important role in treating hypogonadism

    Chapter 17. Disorders of Anxiety and Impulsivity and the Drugs Used to Treat These Disorders
    Neurobiology of Anxiety
    What is anxiety?
    The amygdala is important to emotion-processing circuits
    Multiple neurotransmitters mediate anxiety
    Box 17.1. The Cutting Edge: Neural Mechanism Responsible for High Tonic Cell Firing Mediating Anxiety
    Genes and environment interact to determine the tendency to express anxiety
    The effects of early stress are dependent on timing
    The effects of early stress vary with gender
    Characteristics of Anxiety Disorders
    Drugs for Treating Anxiety, OCD, and PTSD
    Barbiturates are the oldest sedative-hypnotics
    Benzodiazepines are highly effective for anxiety reduction
    Second-generation anxiolytics produce distinctive clinical effects
    Antidepressants relieve anxiety and depression
    Many novel approaches to treating anxiety are being developed

    Chapter 18. Affective Disorders: Antidepressants and Mood Stabilizers
    Characteristics of Affective Disorders
    Major depression damages the quality of life
    In bipolar disorder moods alternate from mania to depression
    Risk factors for mood disorders are biological and environmental
    Animal Models of Affective Disorders
    Models of bipolar disorder
    Neurochemical Basis of Mood Disorders
    Serotonin dysfunction contributes to mood disorders
    Norepinephrine activity is altered by antidepressants
    Norepinephrine and serotonin modulate one another
    Neurobiological Models of Depression
    Box 18.1.The Cutting Edge: Epigenetic Modifications in Psychopathology and Treatment
    Therapies for Affective Disorders
    Monoamine oxidase inhibitors are the oldest antidepressant drugs
    Tricyclic antidepressants block the reuptake of norepinephrine and serotonin
    Second-generation antidepressants have different side effects
    Third-generation antidepressants have distinctive mechanisms of action
    Drugs for treating bipolar disorder stabilize the highs and the lows

    Chapter 19. Schizophrenia: Antipsychotic Drugs
    Characteristics of Schizophrenia
    There is no defining cluster of schizophrenic symptoms
    Etiology of Schizophrenia
    Abnormalities of brain structure and function occur in individuals with schizophrenia
    Genetic, environmental, and developmental factors interact
    Box 19.1. The Cutting Edge: Epigenetic Modifications and Risk for Schizophrenia
    Preclinical Models of Schizophrenia
    Box 19.2. Pharmacology In Action: The Prenatal Inflammation Model of Schizophrenia
    Neurochemical Models of Schizophrenia
    Abnormal dopamine function contributes to schizophrenic symptoms

    The neurodevelopmental model integrates anatomical and neurochemical evidence
    Glutamate and other neurotransmitters contribute to symptoms
    Classic Neuroleptics and Atypical Antipsychotics
    Phenothiazines and butyrophenones are classic neuroleptics
    Dopamine receptor antagonism is responsible for antipsychotic action
    Side effects are directly related to neurochemical action
    Atypical antipsychotics are distinctive in several ways
    Practical clinical trials help clinicians make decisions about drugs
    There are renewed efforts to treat the cognitive symptoms

    Chapter 20. Neurodegenerative Diseases, by Jennifer R. Yates, Ohio Wesleyan University
    PARKINSON'S DISEASE AND ALZHEIMER'S DISEASE
    Parkinson's Disease
    The clinical features of PD are primarily motor related
    Patients with Parkinson's may also develop dementia
    The primary pathology of PD is a loss of dopaminergic neurons in the substantia nigra
    Animal models of PD have strengths and limitations
    Pharmacological treatments for PD are primarily symptomatic, not disease altering
    There are several unmet needs in PD diagnosis and treatment
    Alzheimer's Disease
    AD is defined by several pathological cellular disturbances
    There are several behavioral, health, and genetic risk factors for AD?
    Alzheimer's disease cannot be definitively diagnosed until postmortem analysis
    Several different animal models contribute to our understanding of AD
    Symptomatic treatments are available, and several others are under study for slowing disease progression
    Box 20.1. The Cutting Edge: Alzheimer's Disease: It's all in your gut???
    OTHER MAJOR NEURODEGENERATIVE DISEASES
    Huntington's Disease
    Symptoms
    Only symptomatic treatments are available for HD; none alter disease progression
    Amyotrophic Lateral Sclerosis
    The symptoms and disease progression in ALS are devastating
    The loss of motor neurons in ALS is complicated and poorly understood
    Two medications exist that are approved for ALS treatment
    Multiple Sclerosis
    The symptoms of MS are variable and unpredictable
    Diagnosis
    Causes of MS
    Treatments fall into several categories for MS and can be very effective
    Box 20.2. Pharmacology in Action: Can We Repair or Replace Myelin?

    Glossary
    References
    Author Index
    Subject Index

    Note: Environmental Neurotoxicants and Endocrine Disruptors, by Susan A. Rice, Susan A. Rice and Associates, Inc.-Chapter 17 in the Second Edition-has moved to the Web.

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