Health ministry of republic of moldova the university of medicine and pharmacy nicolae testemiţanu

 
 
Lecture X 
PSYCHOFARMACOLOGY. THE PLACEBO EFFECT 
 
Structure: 
1. Psychopharmacology. 
2. Placebo: definitions and effects. 
3. The placebo phenomenon and the doctor-patient relationship. 
Key terms:
 
psychopharmacology; psychoactive drugs; psychiatric 
medications; the placebo effect; the nocebo effect. 
1. Psychopharmacology
(from Greek ps
ȳ
khē, "breath, soul"; phar-
makon, "drug"; and “logia” science) is the study of drug-induced chan-
ges in mood, sensation, thinking, and behavior. 
The field of psychopharmacology studies a wide range of substances 
with various types of psychoactive properties. The professional and com-
mercial fields of pharmacology and psychopharmacology do not mainly 
focus on psychedelic or recreational drugs, as the majority of studies are 
conducted for the development, study, and use of drugs for the modification 
of behavior and the alleviation of symptoms, particularly in the treatment of 
mental disorders (psychiatric medication). Psychopharmacology focuses 
primarily on the psychoactive and chemical interactions with the brain. 
Physicians 
who 
research 
psychiatric 
medications 
are 
psycho-
pharmacologists, specialists in the field of psychopharmacology.
Psychoactive drugs may originate from natural sources such as 
plants and animals, or from artificial sources such as chemical synthesis 
in the laboratory. These drugs interact with particular target sites or re-
ceptors found in the nervous system to induce widespread changes in 
physiological or psychological functions. The specific interaction bet-
ween drugs and their receptors is referred to as 
"drug action",
and the 
widespread changes in physiological or psychological function is refer-
red to as "drug effect". 
The use of psychoactive drugs predates recorded history. Hunter-
gatherer societies tended to favor psychedelics, dissociatives and deliri-

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ants, and today their use can still be observed in many surviving tribal 
cultures. The exact drug used depends on what the particular ecosystem 
a given tribe lives in can support, and are typically found growing wild. 
Such drugs include various psychedelic mushrooms and cacti, along with 
many other plants. These societies generally attach spiritual significance to 
such drug use, and often incorporate it into their religious practices. 
With the proliferation of agriculture, new psychoactives came into 
use as a natural by-product of farming. Among them were opium, canna-
bis, and alcohol derived from the fermentation of cereals and fruits. 
Most societies began developing herblore, lists of herbs which were 
good for treating various physical and mental ailments.
In the latter half of the 20th century, research into new psychophar-
macologic drugs exploded, with many new drugs being discovered, 
created, and tested.
Only since the 1950s has the use of psychiatric drugs to restore 
mental health, or at least limit aberrant behavior, been a part of medical 
therapeutics, when a number of new classes of pharmacological agents 
were discovered. Additionally, psychedelic drugs (
LSD 
and 
psilocybin)
and 
empathogens 
(MDMA) were popularized among many psychiatrists 
for a certain time, as very helpful tools to assist psychotherapy. 
Lithium 
is widely used to allay the symptoms of affective disorders and espe-
cially to prevent recurrences of both the manic and the depressive epi-
sodes in manic-depressive individuals.
Since scientists have found a direct relationship between dopamine 
blockage and reduction of schizophrenic symptoms, many believe that 
schizophrenia may be related to excess dopamine.
In 
psychopharmacology,
researchers are interested in any substance 
that crosses the blood-brain barrier and thus has an effect on behavior, 
mood or cognition. Drugs are researched for their physicochemical pro-
perties, physical side effects, and psychological side effects.
Clinical studies are often very specific, typically beginning with 
animal testing, and ending with human testing. In the human testing pha-
se, there is often a group of subjects, one group is given a placebo, and 
the other is administered a carefully measured therapeutic dose of the 
drug in question. After all of the testing is completed, the drug is propo-
sed to the concerned regulatory authority, and is either commercially in-
troduced to the public via prescription, or deemed safe enough for over 
the counter sale. 

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Though particular drugs are prescribed for specific symptoms or 
syndromes, they are usually not specific to the treatment of any single 
mental disorder. Because of their ability to modify the behavior of even 
the most disturbed patients, the antipsychotic, and antidepressant agents 
have greatly affected the management of the hospitalized mentally ill, 
enabling hospital staff to devote more of their attention to therapeutic 
efforts and enabling many patients to lead relatively normal lives outside 
of the hospital.
There are