12.1 Drugs used in Psychiatric Disease Flashcards
What are the core symptoms of depression?
Low mood
Anhedonia
Low energy
(2/3 needed)
What are some secondary symptoms of depresion?
Decreased appetite Sleep disturbance Hopelessness Self harm/suicidal thoughts Decreased libido
What is the monoamine hypothesis of depression?
Depression is due to lack of noradrenaline and serotonin
What is the receptor hypothesis of depression?
Abnormality in receptors for monoamine transmission
What are the 3 hypotheses for depression pathophysiology?
Monoamine
Receptor
Gene expression
What are some anti depressant drugs?
Imipramine Lofepramine Citalopram Fluoxetine Sertraline Venlafaxine Amitryptilline
Which antidepressants are SSRIs?
Fluoxetine
Citalopram
Sertraline
How do SSRIs work?
They inhibit the reuptake of serotonin
What are some ADRs of SSRIs?
Anorexia Nausea Diarrhoea Precipitation of mania Prolonged QT
Which antidepressants are TCAs?
Amitriptilline
Imipramine
Lofepramine
How do TCAs work?
Inhibits NA reuptake
Muscarinic blockade
Alpha 1 blockade
What are ADRs of TCAs?
CNS sedation
Autonomic block - decreased glandular secretions
Tachy cardia, postural hypotension, decreased contractility
Constipation
Which antidepressants are SNRIs (Serotonin, Noradrenaline reuptake inhibits)?
Venlafaxane
What are some ADRs of SNRIs?
(Same as SSRI) Anorexia, nausea, diarrhoea
+ sleep disturbance, hypertension, dry mouth
What are some positive symptoms of schizophrenia?
Hallucinations
Dellusions
Thought disorders
Abnormal behaviour
What are some negative symptoms of schizophrenia?
Blunted effect
Social withdrawal
What are some cognitive symptoms of schizophrenia?
Selective attention
Poor memory
Reduced abstract thought
What are some possible causes of schizophrenia?
Dopamine too high?
Serotonin too high?
Decreased glutamate function?
What are some typical schizophrenia drugs?
Haloperidol
Chlorapromazine
What are some atypical schizophrenia drugs?
Olanzapine
Risperidone
Quetiapine
Clozapine
What are some side effects of typical antischizophrenia drugs?
Extrapyramidal - Parkinsonism, tardive dyskinesia, acute dystonia Neuroleptic malignant syndrome Postural hypotension Weight gain CNS depression Cardiotoxicity
What are some side effects of atypical antischizoprenia drugs?
Weight gain
Hyperprolactinaemia
Extrapyramidal side effects if high dose
What is anxiety?
Fear out of proportion to situation?
What is used to manage anxiety?
CBT
Drugs - antidepressants, anxiolytics, sometimes antipsychotics
What are some anxiolytics that can be used to anxiety treatment?
Diazepam
Lorazepam
How do the benzodiazepine anxiolytics work?
Enhancing GABA and therefore inhibitory action on the brain
What do you need to be careful about with benzodiazepines?
Don’t give too long a dose - tolderance and dependence can occur quickly
What ADRs can occur with benzodiazepines?
Drowsiness Dizziness Psychomotor impairment Dry mouth Decreased BP
Benzodiazpines can be teratogenic, what problems can they cause in pregnancy?
Cleft lip and palate
Resp depression in late pregnancy
What are some mood stabilisers in biploar disorder?
Lithium
Valproic acid
What are some ADRs with lithium?
Nephrotoxic Memory problems Thirst Polyuria Tremor Hypothyroidism
What can be used to treat dementia?
AChesterase inhibitors - donepezil, galantamine
NMDA antagonist - mamantine
What are ADRs of ACh inibitors?
Nauesea, vomiting, anorexia, diarrhoea
Fatigue insomnia
Bradycardia
Peptic ulcers
What are some ADRs of memantine?
Hypertension
Dyspnoea
Dizziness
Drowsiness
