J. Alexander Bodkin is an American psychiatrist. He is the Director of the Clinical Psychopharmacology Research Program at McLean Hospital and Assistant Professor of Psychiatry at Harvard Medical School. Bodkin’s research focuses “on underutilized pharmacologic approaches to difficult-to-treat mood and anxiety disorders, such as MAO inhibitors, stimulants, and the opioid buprenorphine.” [1]
Bodkin is a leading advocate in a school of thought that post-traumatic stress disorder (PTSD) is over-diagnosed by mental health professionals, and testified on behalf of the Roman Catholic Archdiocese of Hartford in a clergy sexual abuse case. Bodkin disputed the plaintiff’s psychiatric experts’ claims that he would suffer long term damage as a result of the abuse and even claimed the relationship between the plaintiff and the priest had many positive aspects and that the “the clinical criteria for diagnosing the disorder had been manipulated to apply it to” the plaintiff. [2]
In the 1990s, Bodkin began a collaboration with Somerset to develop delivery of selegiline via a transdermal patch in order to avoid the well known dietary restrictions of MAO inhibitors. [3] [4] [5] Somerset obtained FDA approval to market the patch in 2006. [6]
Antidepressants are medications used to treat major depressive disorder, some anxiety disorders, some chronic pain conditions, and to help manage some addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, headaches, sexual dysfunction, and emotional blunting. Most types of antidepressants are typically safe to take, but may cause increased thoughts of suicide when taken by children, adolescents, and young adults. A discontinuation syndrome can occur after stopping any antidepressant which resembles recurrent depression.
An anxiolytic is a medication, or other intervention, that reduces anxiety. This effect is in contrast to anxiogenic agents, which increase anxiety. Together these categories of psychoactive compounds or interventions may be referred to as anxiotropic compounds or agents. Some recreational drugs such as alcohol induce anxiolysis initially; however, studies show that many of these drugs are anxiogenic. Anxiolytic medications have been used for the treatment of anxiety disorder and its related psychological and physical symptoms. Light therapy and other interventions have also been found to have an anxiolytic effect.
Monoamine oxidase inhibitors (MAOIs) are a class of drugs that inhibit the activity of one or both monoamine oxidase enzymes: monoamine oxidase A (MAO-A) and monoamine oxidase B (MAO-B). They are best known as highly efficacious anti-depressants, as well as effective therapeutic agents for panic disorder and social phobia. They are particularly effective in treatment-resistant depression and atypical depression. They are also used in the treatment of Parkinson's disease and several other disorders.
A psychiatric or psychotropic medication is a psychoactive drug taken to exert an effect on the chemical makeup of the brain and nervous system. Thus, these medications are used to treat mental illnesses. Usually prescribed in psychiatric settings, these medications are typically made of synthetic chemical compounds. Since the mid-20th century, such medications have been leading treatments for a broad range of mental disorders and have decreased the need for long-term hospitalization, therefore lowering the cost of mental health care. The recidivism or rehospitalization of the mentally ill is at a high rate in many countries and the reasons for the relapses are under research.
Post-traumatic stress disorder (PTSD) is a mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, or other threats on a person's life. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in how a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.
Sertraline, sold under the brand name Zoloft among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used to treat major depressive disorder, obsessive–compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, and social anxiety disorder. Sertraline is taken by mouth.
Phenelzine, sold under the brand name Nardil, among others, is a non-selective and irreversible monoamine oxidase inhibitor (MAOI) of the hydrazine class which is used as an antidepressant and anxiolytic. Along with tranylcypromine and isocarboxazid, phenelzine is one of the few non-selective and irreversible MAOIs still in widespread clinical use. It is taken by mouth.
Tranylcypromine is a monoamine oxidase inhibitor (MAOI); more specifically, tranylcypromine acts as nonselective and irreversible inhibitor of the enzyme monoamine oxidase (MAO). It is used as an antidepressant and anxiolytic agent in the clinical treatment of mood and anxiety disorders, respectively.
Selegiline, also known as L-deprenyl and sold under the brand names Eldepryl and Emsam among others, is a medication which is used in the treatment of Parkinson's disease and major depressive disorder. It is provided in the form of a capsule or tablet taken by mouth for Parkinson's disease and as a patch applied to skin for depression.
Moclobemide is a Reversible Inhibitor of Monoamine oxidase-A (RIMA) drug primarily used to treat depression and social anxiety. It is not approved for use in the United States, but is approved in other Western countries such as Canada, the UK and Australia. It is produced by affiliates of the Hoffmann–La Roche pharmaceutical company. Initially, Aurorix was also marketed by Roche in South Africa, but was withdrawn after its patent rights expired and Cipla Medpro's Depnil and Pharma Dynamic's Clorix became available at half the cost.
Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger. Doing so is thought to help them overcome their anxiety or distress. Procedurally, it is similar to the fear extinction paradigm developed studying laboratory rodents. Numerous studies have demonstrated its effectiveness in the treatment of disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, PTSD, and specific phobias.
A sympatholytic drug is a medication that opposes the downstream effects of postganglionic nerve firing in effector organs innervated by the sympathetic nervous system (SNS). They are indicated for various functions; for example, they may be used as antihypertensives. They are also used to treat anxiety, such as generalized anxiety disorder, panic disorder and PTSD.
Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.
Endogenous depression(melancholia) is an atypical sub-class of the mood disorder, major depressive disorder. It could be caused by genetic and biological factors. Endogenous depression occurs due to the presence of an internal stressor instead of an external stressor. Endogenous depression includes patients with treatment-resistant, non-psychotic, major depressive disorder, characterized by abnormal behavior of the endogenous opioid system but not the monoaminergic system. Symptoms vary in severity, type, and frequency and can be attributed to cognitive, social, biological, or environmental factors that result in persistent feelings of sadness and distress. Since symptoms are due to a biological phenomenon, prevalence rates tend to be higher in older adults. Due to this fact, biological-focused treatment plans are often used in therapy to ensure the best prognosis.
The Massachusetts General Hospital Psychiatry Academy is an educational organization for psychiatrists, psychologists, other mental health professionals, and other healthcare professionals who diagnose and treat patients with mental health disorders. It is directly organized and managed by the Department of Psychiatry at Massachusetts General Hospital, which is owned by Partners HealthCare, the largest healthcare provider in Massachusetts.
Ladostigil (TV-3,326) is a novel neuroprotective agent being investigated for the treatment of neurodegenerative disorders like Alzheimer's disease, Lewy body disease, and Parkinson's disease. It acts as a reversible acetylcholinesterase and butyrylcholinesterase inhibitor, and an irreversible monoamine oxidase B inhibitor, and combines the mechanisms of action of older drugs like rivastigmine and rasagiline into a single molecule. In addition to its neuroprotective properties, ladostigil enhances the expression of neurotrophic factors like GDNF and BDNF, and may be capable of reversing some of the damage seen in neurodegenerative diseases via the induction of neurogenesis. Ladostigil also has antidepressant effects, and may be useful for treating comorbid depression and anxiety often seen in such diseases as well.
Buprenorphine/samidorphan is a combination formulation of buprenorphine and samidorphan which is under development as an add on to antidepressants in treatment-resistant depression (TRD).
Joseph Zohar is the director of Psychiatry and the Anxiety and Obsessive Compulsive Clinic at the Sheba Medical Center in Tel HaShomer and professor of psychiatry at Tel Aviv University, Israel. He is the founder of the World Council on Anxiety as well as the Israeli Consortium on PTSD. He currently leads the chief installation of the Israeli Defense Force for the treatment of PTSD. He is a member of the Executive Committee of the European College of Neuropsychopharmacology, of which he is a former president, and chairman of the Expert Platform on Mental Health.
MDMA-assisted psychotherapy is the use of prescribed doses of MDMA as an adjunct to psychotherapy sessions. The study of MDMA as an enhancer for psychotherapy has been constrained since 1985 when the drug was classified in the United States as a Schedule I controlled substance. Research by the Multidisciplinary Association for Psychedelic Studies (MAPS) has provided evidence that MDMA can help address trauma-related disease, in particular post-traumatic stress disorder. In 2017, a Phase II clinical trial led to a designation of breakthrough therapy status by the US Food and Drug Administration (FDA).