Psychotherapy long-term

Benzodiazepines are used commonly in SAD however, there are limited data supporting their use. Clonazepam has been effective for social anxiety, fear, and phobic avoidance, and it reduced social and work disability during acute treatment.58 Long-term treatment is not desirable for many SAD patients owing to the risk of withdrawal and difficulty with discontinuation, cognitive side effects, and lack of effect on depressive symptoms. Benzodiazepines may be useful for acute relief of physiologic symptoms of anxiety when used concomitantly with antidepressants or psychotherapy. Benzodiazepines are contraindicated in SAD patients with alcohol or substance abuse or history of such. 

Psychotherapy looks even better when its long-term effectiveness is assessed.17 Formerly depressed patients are far more likely to relapse and become depressed again after treatment with antidepressants than they are after psychotherapy. As a result, psychotherapy is significantly more effective than medication when measured some time after treatment has ended, and the more time that has passed since the end of treatment, the larger the difference between drugs and psychotherapy. This long-term advantage of psychotherapy over medication is independent of the severity of the depression. Psychotherapy outperforms antidepressants for severely depressed patients as much as it does for those who are mildly or moderately depressed.18... 

MDMA (Ecstasy) No clinical uses, although it has been used for psychotherapy recreational use widespread acute hyperthermic problems midweek depression during neurochemical depletion long-term problems include neurotoxicity, memory/cognitive deficits and a range of psychiatric problems. 

During the early 1960s, Timothy Leary conducted the Concord Prison Experiment to study the psychotherapeutic use of hallucinogenic drugs in prison inmates. Treatment involved administration of psilocybin and group psychotherapy in 32 prisoners. A follow-up study of recidivism in these prisonsers concluded that there was no long-term treatment effect and emphasized the value of postrelease social support (Doblin 1998). 

Nierenberg AA, Petersen TJ, Alpert JE. Prevention of relapse and recurrence in depression the role of long-term pharmacotherapy and psychotherapy. J Clin Psychiatry 2003 64(Supplement 15) 13-17. 

The duration of pharmacotherapy for generalized anxiety disorder is controversial. Psychotherapy is recommended for most patients with this disorder, and it may facilitate the tapering of doses of medication. However, generalized anxiety is often a chronic condition, and some patients require long-term pharmacotherapy. As in other anxiety disorders, the need for ongoing treatment should be reassessed every 6-12 months. 

Muller and Schoneich (1992) also reported on favorable experience with intensive outpatient psychotherapy combined with antipsychotic drug treatment. On the basis of a before-and-after comparison over 2x5 years in a university outpatient clinic, they were able to show that the duration of rehospitalizations required by 89 patients could be reduced from a mean of 10 weeks to 2 weeks per year when a special schizophrenia outpatient service offering individualized psychotherapy and psychosocial treatment was available to the patients instead of the routine psychiatric outpatient service. A beneficial effect of psychotherapy was demonstrated both in those patients taking antipsvchotics continuously for long-term prophylaxis and in those taking the drugs intermittently when prodromal symptoms appeared in order to prevent relapse. 

Kupfer, DJ., Frank, E. The interaction of drug and psychotherapy in the long-term treatment of depression. J. Affect. Disord. 62, 131 137, 2001. 

In this context, the type of psychosocial interventions used in schizophrenia has changed radically in the last 15 years. In the 1950 s and 1960 s, the emphasis was on psychodynamic psychotherapy, and in particular long-term psychoanalysis was practiced in institutions such as Chestnut Lodge or the Menninger Clinic. 

If depression has interfered with happiness or success, its treatment can have many positive consequences and result in a fuller and happier social life. Treatment may be long term, and may require psychotherapy in addition to the antidepressant drugs. 

This procedure utilizes the properties of hallucinogenic substances to stimulate the emotions and promote a fluid, dreamlike state that is experienced in clear consciousness and with good recollection of what is occurring. In this manner, subconscious conflicts and memories can be re-created and made accessible to psychotherapy. It is understood that it is not the pharmacological effect that causes the therapeutic result, but the long-term therapeutic processing of material that has been exposed. 

The fact that the shamans include family members and relatives probably intensifies the impact of occasional interventions. Due to less frequent but higher dosages in shamanistic treatment, the awareness of the self is subject to greater fluctuation. In contrast, psycholytic therapists concentrate on the treatment of chronic neurotic diseases in the course of serial sessions. These chronic problems are usually based on structural distortions of the personality, so long-term treatment in psychotherapy promises success. 

Although medications are the primary treatment modality for bipolar disorder, it is important to consider the impact of medications in conjunction with other forms of treatment. For instance, milieu therapy, when inpatient care is necessary, will be most effective after initial medication response has reestablished some degree of cooperation and insight. Psychotherapy, especially cognitive, behavioral, and psycho-educational approaches, is effective with the medication-stabilized patient. Group therapy, which can include families, will often revolve around acceptance of the disease as well as of the need for long-term medication treatment, the side effects, and the implications of noncompliance. In instances of medication resistance or contraindications, ECT should be considered. 

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