Specific Treatments - Medication, Psychotherapy, ECT:

Of Two Minds: Biological Psychiatry vs. Psychotherapy
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File Source: Voices in the Family public radio show
File Date: April 10, 2000

A discussion of two major approaches in the field of psychiatry - biological psychiatry (pharmacological therapy), and psychotherapy. T.L. Luhrmann, a professor of anthropology at the University of California in San Diego, and the author of " Of Two Minds: The Growing Disorder in American Psychiatry ," talks about this growing dichotomy in medicine and medical education, the tendency to treat everything strictly within a biological-disease model, and the relative benefits of psychotherapy versus, or in conjunction with, prescription medication. The program specifically addresses the treatment of schizophrenia at times.

Therapy vs. Drugs (NPR All Things Considered, June 1998).
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File Source: National Public Radio
File Date: June 22, 1998

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A greater understanding of the brain and its chemistry has given pyschotherapists a whole new battery of chemical weapons - drugs like Prozac, Xanax, Paxil and Risperidone - against a host of mental illnesses, including depression, schizophrenia, and anxiety. Some therapists worry that in light of these advances, and goaded by cost and time constraints imposed by insurance companies, the profession may be forfeiting the time-honored technique of helping patients to talk through their woes to achieve longer term well-being. Others say that pills are helping advance talk therapy by enabling patients to get beyond acute symptoms to personal analysis. Frank Browning's first report in a series on changes taking place in the field of psychiatry.

New Pills for the Mind - A talk with author Samuel Barondes, MD
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File Source: The Edge, nonprofit information organization
File Date: Dec 4, 2003

Most of the psychiatric drugs we use today are refinements of drugs whose value for mental disorders was discovered by accident decades ago. Now we can look forward to a more rational way to design psychiatric drugs. It will be guided by the identification of the gene variants that predispose certain people to particular mental disorders such as schizophrenia or severe depression. Dr. Samuel Barondes, author of "Better Than Prozac: Creating the Next Generation of Psychiatric Drugs," presents.

For more information on ordering the book "Better than Prozac: Creating the Next Generation of Psychiatric Drugs", please see our Recommended Reading section.

Psychiatric Medications(Healthyplace.com radio program, June 1, 2002).
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File Source: Healthyplace.com radio
File Date: June 1, 2002

**NOTE about healthyplace.com - this is a commercial site supported largely by advertisers. While the information in these radio programs seem largely unbiased (mainly consist of callers and answers by a host psychiatrist), they contain significantly more advertisement segments than public radio programs.

How can someone that doesn't want to take psychiatric medications become aware that it is good for them to take them? What about quitting on your own; why do people stop taking their meds? Is psychotherapy just as good as antidepressants for the treatment of depression? Psychiatrist co-host, Dr. Kristeen Spratley answered those questions as well as listener questions about specific medications (one call is about Zyprexa). She also talks about prescribing medications vs. psychotherapy or other types of therapy from a psychiatrist's point of view. (A lot of the show is about depression, but some calls specifically address schizophrenia).

Patient Opinions of ECT - Interview with Diane Rose
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File Source: National Electronic Library of Mental Health
File Date: Jan 2004

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Dr Diana Rose is co-ordinator of SURE, the Service User Research Enterprise based at the Institute of Psychiatry. The core aim of SURE is to involve service users at all levels of the research process in a collaborative way. In this interview DR Rose talks generally about the work of SURE and specifically about the systematic review of patients' perspectives on electroconvulsive therapy which she recently published in the BMJ. According to this research, although about 80% of study subjects reported satisfaction with ECT treatment, "measures [of the studies]…did not take into account all the factors that may lead patients to perceive it as beneficial or otherwise".

The Post-Psychiatry Model of Treatment Play audio - click here
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File Source: BBC Radio (All In the Mind)
File Date: October 16, 2002

The 'post-psychiatry' model is committed to delivering what the service user needs and wants rather than what the service providers think they need.. It was developed by Pat Bracken and Phil Thomas, two consultant psychiatrists at the forefront of a movement called Critical Psychiatry. They were determined to deliver mental health services which really addressed the problems facing service users, believing that unless you confront the day to day pressures that poverty brings you have little hope of improving a person's mental health.

Mental Hospitals Play audio - click here
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File Source: Voices in the Family public radio show
File Date: April 9, 2001

Host Dr. Gottlieb talks with the producers of "Bellvue Inside-out," a documentary about America's oldest mental hospital (located in New York), as well as with doctors at Bellvue and Dr. Ritamary Hanly from Norristown State Hospital. The hour is a mixed bag - some of it talks about the making of the documentary, and other parts discuss the inner world of mental institutions in general (who gets committed, the treatments, the staff, the demands in terms of care, etc).

Psychiatric Hospitalization: What It's Like on the Inside
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File Source: Healthyplace.com radio
File Date: DEC 15, 2001

**NOTE about healthyplace.com - this is a commercial site supported by advertisers. While the information in these radio programs seem largely unbiased (mainly consist of callers and answers by a host psychiatrist), they contain significantly more advertisement segments than public radio programs.

Guests on the show include a doctor (Dr. Suda Kumar) who works at a psychiatric hospital, and a 29-year-old patient who was hospitalized by her fiancé. They both describe their experiences and impressions of mental hospital facilities.

Psychotropic Medication Adherance Play video - click here
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File Source: Wayne State University grand rounds
File Date: March 10, 2004
Speaker: Rick Berchou, Pharm.D. Assistant Professor, Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University School of Medicine.

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Video and slide presentation discusses the rate of medication adherence in psychiatric vs. other disorders. It explores patient groups with the highest rates of non-adherence, common reasons for non-adherence (esp. side-effects), consequences of non-adherence, and strategies to approach the problem.

Schizophrenia: Pill Taking is Just Like Golf
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File Source: University of New Mexico grand rounds
File Date: Feb 7, 2003
Speaker: Samuel Keith, M.D., Professor and Chair - Dept. of Psychiatry School of Medicine, Health Sciences Center University of New Mexico.

Pill-taking is like golf in that lots of people do it, but not many people are very good at it. He discusses the issues of noncompliance (or, as he prefers, non-adherence) - why it is a particular problem in schizophrenia, why clinicians have a hard time detecting it, what the implications are for the patient, and some solutions (i.e. psychosocial intervention, long-acting injections, etc) to help the problem.

A Comparison of Metabolic Effects of Antipsychotic Medications
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File Source: UCLA grand rounds
File Date: Oct 22, 2002
Speaker: Donna Wirshing, MD, Associate Professor UCLA Department of Psychiatry and Biobehavioral Sciences; Co-chief, Schizophrenia Treatment Unit, West LA Veterans Administration Medical Center.

Statistics from schizophrenia patients being treated with atypical antipsychotic medications show that sexual dysfunction and weight gain are the two most commonly cited problems. Dr. Wirshing talks about the issues associated with weight gain - the "tardive dyskinesia" of 2nd generation antipsychotics - in schizophrenia patients.

Mechanisms of Action of Antipsychotics Play video - click here
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File Source: UCLA grand rounds
File Date: Nov 19, 2002
Speaker: Jeffrey Lieberman, MD, Vice Chairman of Psychiatry, Professor Department of Psychiatry and Pharmacology, University of North Carolina School of Medicine.

Dr. Lieberman discusses the evolution of pharmacological treatments - which neurotransmitter systems are targeted by different drugs, and what those mechanisms of action in the brain tell us about the pathology of schizophrenia as a disease.

New and Newer Mechanisms of Action for Antipsychotic Medications
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File Source: UCLA grand rounds
File Date: May 28, 2002
Speaker: Carol Tamminga, MD, Professor of Psychiatry and Pharmacology, Maryland Psychiatric Research Center, University of Maryland School of Medicine.

DR Tamminga begins her presentation with a clinical, biological, and pathological profile of schizophrenia. She then briefly describes the history of schizophrenia treatments in the last hundred years, bringing the audience up the the 1st and 2nd generation of anti-psychotic medications. From there, she describes in some detail the biological mechanisms of these drugs in the brain - what neurotransmitter systems they target, how long they stay active in the body, what other biological/chemical effects they have, etc.

Functional Outcomes in Schizophrenia: Activities and Social Relations
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File Source: UCLA grand rounds
File Date: June 11, 2002
Speaker: Joseph P. McEvoy, MD, Associate Professor, Department of Psychiatry and Biobehavioral Sciences, Duke University Medical Center.

The best chance for schizophrenia patients to achieve a functional outcome (i.e. engage in meaningful activities and relationships) is to give them "clinical stability." Dr. McEvoy talks about some things proven to help stabilize schizophrenia patients - maintenance antipsychotic medication (relapse prevention), family therapy, assertive community treatment. He also discusses things that destabilize patients, such as co-morbid substance abuse disorders.

ECT-Current Practice and Guidelines: A Review and Indications for Use
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File Source: University of New Mexico grand rounds
File Date: March 12, 2004
Speakers: Alya Reeve, MD; Carol Fryer, MD; Roger Hammond, MD; Liz Romero, MD.

A panel of clinical experts discuss the history of ECT treatment, the training required to administer it, and the research that explains what it does and why it works.