Psychotherapy as an epigenetic ‘drug’: psychiatric therapeutics target symptoms linked to malfunctioning brain circuits with psychotherapy as well as with drugs

Psychotherapy may be just as effective as psychopharmacology in treating psychiatric disorders. Psychotherapy focuses on psychodynamic and psychoanalytic prinicples while psychopharmacology is based on neurobiology. In the past, more emphasis was placed on psychopharmacology to treat psychiatric disorders. This article suggest that a psychotherapy could change the brain chemistry, eliciting the same results as drug therapy. Circuits in the brain are affected by efficiency of information processing. Many different disorders, that have various symptoms, are marked by inefficiency to process information, this could be too high or too low. By stimulating brain activity, symptoms of the disorder should be alleviated.

Psychotherapy can now be defined by its psychodynamic aspects and its capability of inducing epigenetic changes in the brain. The best approach is to combine psychotherapy and drug therapy. A study found that using cognitive behavior therapy and SSRIs to treat SSRI resistant depression was more effective than just medication treatment. This combination of treatments was also found more effective in treating adults with depression. The article states the best therapies to use in this combined approach are cognitive behavior therapy and interpersonal therapy.

Psychotherapy can activate epigenetic changes in the brain, or change brain circuits. This is the effect that psychopathic medications can also elicit. Given the limitations of both psychotherapy and pharmaceuticals, a combination of the two is best for therapies.

Stahl, S.M. (2011). Psychotherapy as an epigenetic ‘drug’: Psychiatric therapeutics target symptoms linked to malfunctioning brain circuits with psychotherapy as well as with drugs. Journal of Clinical Pharmacy and Therapeutics. doi:10.1111/j.1365-2710.2011.01301.x

CBT is Effective for Psychogenic Nonepileptic Seizures (A Pilot RCT)

newstudy-graphic-66x60.jpgThe objective of this study was to compare the efficacy of cognitive-behavioral therapy (CBT) and standard medical care as treatments for psychogenic nonepileptic seizures (PNES). The participants in this randomized controlled trial (RCT) were 66 PNES patients. One group received only standard medical care over four months, while the other group received both standard medical care and CBT.

At the end of the treatment period, the group who had received both standard medical care and CBT experienced greater seizure reduction than the group that only received standard medical care. At the 6-month follow-up, the group that had received the combination of treatments tended to be more likely to have had three seizure-free months. Both groups improved on some health service use measures and on the Work and Social Adjustment Scale. Mood and employment statuses showed no change. The researchers concluded that the combination of CBT and standard medical care is more effective than standard medical care alone in reducing seizures in PNES patients.


To read the entire study, click here:

CBT and CBT Plus Medication for the Treatment of OCD in Children

NewStudy-Graphic-72x72_edited-3 A recent study published in Child and Adolescent Mental Health found both Cognitive Behavior Therapy (CBT) and CBT in combination with medication to be effective in the treatment of Obsessive Compulsive Disorder (OCD) in children. During a ten-year period, 75 children were evaluated and treated for OCD in an outpatient setting. Investigators later contacted a subset of that sample to investigate the long-term maintenance of their therapeutic gains. Treatment groups in this follow up investigation included, (1) those treated with medication before beginning CBT, (2) those treated with CBT only, and (3) those treated with CBT and medication, simultaneously. Participants in each group had all met diagnostic criteria for OCD as determined by their Children’s Yale Brown Obsessive-Compulsive Scale (CYBOCS) scores. Long term maintenance was assessed by comparing post-treatment and pre-treatment CYBOCS scores. Results showed significant improvement for each group, yielding further support for the use of CBT and CBT plus medication (SSRIs) in the treatment of OCD.


Nakatani, E. (2009). Outcomes of cognitive behaviour therapy for obsessive compulsive disorder in a clinical setting: A 10-year experience from a specialist OCD service for children and adolescents. Child and Adolescent Mental Health, 14, 133-139.