The Agonist-To-Antagonist Spectrum of Action of Psychopharmacologic Agents
Agonists are neurotransmitters that stimulate receptors while antagonists obstruct the action of neurotransmitters at its receptor. Drugs act in the same manner where some medications trigger receptors just like neurotransmitters and therefore such drugs are agonists. Other medications normally obstruct the action of neurotransmitter at its receptor and therefore such medications are known as antagonists (Stahl, 2013). In addition, other medications act on the contrary to agonists and are known as inverse agonists. Therefore, psychopharmacologic agents acting at the receptor occur within a spectrum from a complete agonist to antagonist and then to inverse agonist (Zimmer, 2016) Foundational Neuroscience. The spectrum involves agonists that open the ion channel entirely, while antagonists maintain the resting state, and finally, the inverse agonists close the ion channel (Stahl, 2013).
Stahl (2013) explains that there are various medications that bind to neurotransmitter sites to produce signal transduction effects; these medications are direct-acting agonists. In addition, antagonists work by blocking agonists’ action. Therefore, antagonists can only function where an agonist is there; this means that medications that are antagonists do not have an inherent activity when an agonist is absent. Therefore, the antagonist will obstruct everything within the agonist spectrum (Stahl, 2013).
Actions of G Couple Proteins and Ion Gated Channels
G couple proteins normally have receptors that have trans-membrane regions that have binding sites for neurotransmitters. This facilitates the targeting of exact psychotropic medications. When medications bind to the sites, this can result in various modifications of receptor actions as a result of imitating or obstructing, the neurotransmitter function occurring at the receptor (Johnson & Lovinger, 2016). Actions of such medications can, therefore, influence molecular events. Similarly, the medications can alter the expressed genes and hence the proteins synthesized and the amplified functions. On the other hand, ion gated channels are linked to the ionotropic receptor; the ionotropic receptors are used as sites where neurotransmitters bind and therefore these can be target sites for medications (Stahl, 2013).
The Role of Epigenetics in Pharmacologic Action
Epigenetics is a system that regulates the silencing or expression of genes (Stahl, 2013). The body cells consist of comparable but differentiated pair of genes that can be silenced or expressed. Therefore, neurotransmission, genes or even medications can influence the specific genes that will be expressed or suppressed. Epigenetic control can suppress or express genes by altering the structure of chromatin using chemicals like phosphorylation, drugs, methylation or neurotransmission (Stahl, 2013). Chemical processes like methylation or phosphorylation can be disrupted using drugs and this controls if the genes are epigenetically suppressed or expressed. For instance, chromatin alterations from drug actions have led to antidepressant responses that are associated with triggering genetic changes (Stefanska & David, 2015).
How the information may Impact Medication Prescription to Clients
Some classes of drugs are prepared to control epigenetic action and thus pharmacologic action of such drugs is broader. This is because some pharmacological agents require epigenetically function on diverse genes in on to ensure their efficacy in treating some conditions (Stefanska & David, 2015). For example, while medications with the epigenetic function may be effective in treating some types of diseases like diabetes, the approach of using epigenetics in drugs has been shown not to be effective in the treatment of mental health disorders like schizoaffective disorder, depression or schizophrenia. Therefore, this information may impact the prescription of medications to clients in that some conditions may require drugs with an epigenetic action, while other conditions may not.
Johnson K & Lovinger D. (2016). Presynaptic G Protein-Coupled Receptors: Gatekeepers of Addiction? Front Cell Neurosci. 10(264).
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY, US: Cambridge University.
Stefanska B & David M. (2015). Epigenetics and pharmacology. British Journal of Pharmacology. 172(11), 2701–2704.
Zimmer L. (2016). Pharmacological agonists for more-targeted CNS radio-pharmaceuticals. Oncotarget. 7(49), 80111–80112.
1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.
2. Compare and contrast the actions of g couple proteins and ion gated channels.
3. Explain the role of epigenetics in pharmacologic action.
4. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.
Credible reference material within the last 5 yrs only will be accepted. Sites such as WebMD, epocrates, Mayo Clinic, Rx List, Wikipedia, drugs.com (among others) will not be counted.
Discussion: Does Psychotherapy Have a Biological Basis?
Biological Basis of Psychotherapy Treatments
Psychotherapy is a biological treatment because it actually addresses the brain in accordance with the brain development, maturation, as well as brain’s operations. This is because psychotherapy follows the ideologies of evolutionary adaptation and hence it is consistent with genetics (Jeon & Kim, 2016). As a result, psychotherapy treats and heals the problematic adaptations of the brain in exactly the same manner these problematic adaptations initially evolved. This is because psychotherapy disengages maladaptive brain mappings and substitutes these mappings with new and constructive mappings. Normally, the brain maps memories and experiences by connecting and linking many neuronal connections; consequently, psychotherapy deactivates the defective mappings and replaces them with new mappings (Zaman & Mark, 2016).
According to Jeon & Kim (2016) the implicit memory structure in the brain is responsible for processing information about affect and forms huge quantities of multifaceted information excerpts and stocks rules. The learning of the rules is implicit and this results in self-perpetuating bias when it comes to future interpretations of experiences; these interpretations guides and directs behaviors without any reflection (Zaman & Mark, 2016). During psychotherapy, there is reevaluation and reflection of the implicit rules and hence change is instituted by learning new patterns that are repeated continually until the new habit and behavior is embedded within the implicit memory structure in the brain. Accordingly, effective psychotherapy results to long-term behavioral, cognition and emotional change (Mathew & Ahn, 2014). Foundational Neuroscience.
The main types of psychotherapies include; psychodynamic, behavioral, and cognitive therapy. Behavioral psychotherapy addresses the dysfunction in modest forms of memory and learning and the associated motor behavior. The brain structures involved in behavioral psychotherapy include the hippocampus, amygdala, as well as basal ganglia (Zaman & Mark, 2016).
On the other hand, cognitive psychotherapy addresses the patterns involved in information processing as well as thinking patterns during a certain mental disorder (Mathew & Ahn, 2014). This means that cognitive psychotherapy tackles the defective and genitive cognitions that contribute to the development of the patient’s psychopathological state; cognitive psychotherapy examines and alters such defective thinking patterns. Neocortex is the brain structures involved in cognitive psychotherapy, particularly the frontal cortex (Zaman & Mark, 2016).
Finally, psychodynamic psychotherapy addresses the interpersonal depiction of the established expectations regarding self and other individuals, as well as their connection to behavior, affect, and behavior, as well as the neuropsychological factors behind these interpersonal representations. The brain regions involved during psychodynamic psychotherapy include subcortical regions and cerebral hemispheres (Zaman & Mark, 2016).
Influences of Culture, Religion, and Socioeconomics on Personal Perspectives of Psychotherapy Treatments
Religion and culture impact an individual’s perspective on psychotherapy in different ways. For instance, an extremely religious person may prefer to seek spiritual intervention, for example, prayers for healing instead of seeking psychotherapy. Individuals may also use religion as coping mechanisms instead of seeking psychotherapy. For example, a study conducted by Agorastos et al (2014) indicated that individuals may use religiosity and spirituality to ease grieving after the death of a loved one. Therefore, an individual’s perspective regarding psychotherapy can be influenced by religious beliefs Foundational Neuroscience.
Culture also influences an individual’s perspective regarding psychotherapy. Some cultures view psychotherapy as not appropriate and this influences an individual’s perspective on psychotherapy (Choudhry et al, 2016). For example, in the Czech Republic, psychotherapy is perceived as not okay when compared to pharmacotherapy. The culture supports taking pills than attending therapy sessions where those attending psychotherapy are sometimes stigmatized (Kuska et al, 2016) Foundational Neuroscience. This, therefore, indicates that culture influences how an individual views psychotherapy because in some cultures attending psychotherapy sessions is very appropriate.
Finally, socioeconomic status also influences an individual’s perspective on psychotherapy. At times a complete psychotherapy can be relatively costly and hence people from low socioeconomic status may not afford this form of treatment and may prefer other forms of treatments. Similarly, those who can afford psychotherapy sessions may view it as an effective option and faithfully attend the sessions (Cummings, 2014). Foundational Neuroscience.
Agorastos A, Demiralay C & Huber C. (2014). Influence of religious aspects and personal beliefs on psychological behavior: focus on anxiety disorders, Psychol Res Behav Manag. 1(7), 93–101.
Choudhry F, Mani V, Ming L & Khan T. (2016). Beliefs and perception about mental health issues: a meta-synthesis. Neuropsychiatr Dis Treat. 1(12): 2807–2818.
Cummings J. (2014). Contextual Socioeconomic Status and Mental Health Counseling Use Among U.S. Adolescents with Depression. J Youth Adolesc. 43(7), 1151–1162 Foundational Neuroscience.
Jeon S & Kim Y. (2016). Neurobiological Correlates on Psychotherapy in Depression. Acta Psychopathol. 2(12). doi: 10.4172/2469-6676.100039
Kuska M, Trinka R, Tavel P, Michael C, Angus L & Moertl K. (2016). The role of cultural beliefs and expectations in the treatment process: Clients’ reflections following individual psychotherapy. Sexual and Relationship Therapy. 31(3), 259–270.
Mathew L & Ahn W. (2014). Effects of biological explanations for mental disorders on clinicians’ empathy. Proc Natl Acad Sci U S A. 111(50), 17786–17790.
Zaman R & Mark A. (2016). Psychological Treatments and Brain Biology . Psychiatria Danubina. 21(1), 31–35 Foundational Neuroscience