Mechanisms of action of psychotropic medication Flashcards
Citalopram
SSRI
Paroxetine
SSRI
Fluoxetine
SSRI
Sertraline
SSRI
Escitalopram
SSRI
Venlafaxine
SNRI
Duloxetine
SNRI
Blocks norepinephrine, serotonin, and dopamine reuptake pumps
Desensitises serotonin 1A receptors and beta adrenergic receptors
Reboxetine
Selective noradrenaline reuptake inhibitor (NARI)
Mirtazapine
Noradrenergic and specific serotonergic antidepressant (NaSSA)
Antagonist at alpha2 adrenergic inhibitory receptors, antagonist of serotonin 5HT2 and 5HT3 receptors, and histamine receptor antagonist
Preferentially blocks histaminic receptor at low doses
Moclobemide
Reversible inhibitor of MAO-A selectively - RIMA
Trazodone
Serotonin agonist and reuptake inhibitor - SARI
Blocks the serotonin reuptake pump, and is an antagonist at 5HT2A and 5HT2C - mixed serotonin agonist/antagonist
Chlorpromazine
Typical antipsychotic
Flupenthixol
Typical antipsychotic
Zuclopenthixol
Typical antipsychotic
Sulpiride
Typical antipsychotic
Haloperidol
Typical antipsychotic
Clozapine
Atypical antipsychotic 5HT2>D2 antagonist D4 receptor blocker 5HT6 receptor blocker Weak D1 and D2 affinity
Risperidone
Atypical antipsychotic
D2 antagonist
5HT2A antagonist
Olanzapine
Atypical antipsychotic
Dopamine antagonist
5HT2a antagonist
Quetiapine
Atypical antipsychotic
Amisulpride
Atypical antipsychotic
D2-like selective antagonist (D2=D3>D4)
Aripiprazole
Atypical antipsychotic
5HT1a partial agonist
D2 partial agonist
5HT2A antagonist
St John’s Wort
Weak MAOI
Weak SNRI
Agomelatine
Melatonergic agonist
5-HT2C antagonist
Bupropion
Norepinephrine dopamine reuptake inhibitor
Nicotinic acetylcholine receptor antagonist
Donepezil
Selective reversible acetylcholinesterase inhibitor
Rivastigmine
Reversible acetylcholinesterase inhibitor
Butyrylcholinesterase inhibitor
Galantamine
Competitive reversible acetylcholinesterase inhibitor
Binds allosterically to the nicotinic acetylcholine receptor
Memantine
Non-competitive NMDA antagonist
Valproate
GABA agonist/potentiator
NMDA antagonist
Gabapentin
Unknown but binds to voltage activated calcium channels
Topiramate
GABA agonist
NMDA antagonist
Na channel stabiliser
Carbamazepine
Na channel stabiliser
Phenytoin
Na channel stabiliser
Lamotrigine
Na channel stabiliser
NMDA antagonist
Pregabalin
Alpha 2 delta voltage gated calcium channel ligand
Z-drugs
GABA-A agonist
Buspirone
5HT1A partial agonist
Partial agonist on serotonin 5-HT1a receptors; full agonist at pre-synaptic receptors and partial agonist at post-synaptic receptors; reduces the firing of serotonin-producing neurons
Presynaptic agonism leads to antianxiety effects
Postsynaptic agonism leads to antidepressant effects
Flumazenil
GABA-A antagonist
Lurasidone
Atypical antipsychotic D2 antagonist 5HT2A blocker Partial 5HT1A agonist 5HT7 antagonist
Lofexidine
Alpha 2 agonist
Clonidine
Alpha 2 agonist
Buprenorphine
Mu opioid receptor partial agonist
Naloxone
Opioid antagonist at mu, delta and kappa
Atomoxetine
Noradrenaline reuptake inhibitor
Varenicline
Nicotinic receptor partial agonist
Disulfiram
Irreversible binder to acetalydehyde dehydrogenase
Causes accumulation of acetaldehyde following ingestion of alcohol
Acamprosate
NMDA glutamate receptor antagonist
Synthetic taurine analogue
Allosteric modulator at GABA-A
Selegiline
Irreversible MAO B inhibitor
MAO A inhibitor at higher doses
Sildenafil
cGMP-specific phosphodiesterase type 5 inhibitor
Naltrexone
Reversible competitive antagonist at mu and kappa opioid receptors
Methadone
Full mu agonist
Barbiturates
Increase duration of chloride channel opening to potentiate the effect of GABA at GABAa receptors
Benzodiazepines
Increase the frequency of chloride channels to potentiate the effect of GABA at GABAa receptors - GABA a positive allosteric modulators
Carbamazepine
Binds to sodium channels to increase their refractory period
Donepezil
Reversible acetylcholinesterase inhibitor which prevents cholinesterase from breaking down acetylcholine
Galantamine
Reversible acetylcholinesterase inhibitor which prevents cholinesterase from breaking down acetylcholine, and binds allosterically to the nicotinic acetylcholine receptor
Rivastigmine
Reversible acetylcholinesterase inhibitor which prevents cholinesterase from breaking down acetylcholine and butyrylcholinesterase inhibitor
Memantine
NMDA receptor antagonist that blocks the effects of pathologically raised levels of glutamate
Flumazenil
Selective GABAa receptor antagonist that reverses the effects of benzodiazepines through competitive interaction
Zopiclone
Similar to benzodiazepines binds to GABAa receptor sites to enhance the action of GABA
Opioids
Act on opioid receptors µ, k, and δ (G-protein coupled receptors). Key receptor subtype is µ which causes most of the effects and side-effects
Methadone
Full agonist targeting µ receptors with some action against k and δ
Buprenorphine
Partial agonist targeting µ largely
Naloxone
Antagonist targeting all opioid receptors
Naltrexone
Reversible competitive antagonist µ and ĸ receptors
Bromocriptine
Dopamine receptor agonist
Ropinirole
Dopamine receptor agonist
Carbergoline
Dopamine receptor agonist
Levodopa
Crosses the blood brain barrier to directly increase dopamine concentrations
Selegeline
Selectively inhibits MAO-B to prevent the breakdown of dopamine
Moclobemide
Selective, reversible inhibitor of MAO-A which causes an increase in noradrenaline, dopamine and especially sertraline
Entacapone
Selective and reversible inhibitor of COMT - COMT breaks down dopamine so entacapone reduces breakdown of dopamine
Topiramate
Inhibits voltage gated sodium channels which suppresses action potentials; increases GABA levels
Varenicline
Selective nicotine-receptor partial agonist
Bupriopion
Noradrenaline-dopamine reuptake inhibitor and nicotinic acetylcholine receptor antagonist
Agomelatine
Melatonin receptor antagonist, and serotonin 5HT2C and 5HT2B receptor antagonist
Sodium Valproate
GABA agonist, possibly by inhibiting GABA degradative enzymes, blocks voltage gated sodium channels
Methadone
Pure mu agonist
Milnacipran
SNRI
Nefazodone
SNRI
Cyproheptadine
Antagonist of histamine H1 receptors
Vortioxetine
Serotonin transporter inhibition
5HT3 and 5HT7 receptor antagonist
5HT1A agonist
5HT1B/D weak partial agonist to antagonist
Carbidopa
Inhibits DOPA decarboxylase - therefore inhibits the conversion of L-dopa to dopamine outside the CNS, which increases the amount of L-dopa in the body. L-dopa is able to cross the blood brain barrier so the result is higher concentrations of dopamine in the brain and less peripherally
L-dopa
Acts as a precursor to dopamine
Nalmefene
Opioid receptor antagonist/opioid receptor modulator
SSRI mechanism of action
5HT1A agonism
5HT2 agonism
5HT3 agonism
Malnicipran
SNRI
Sulpride
Atypical antipsychotic
Binds to auto-inhibitory D4 receptors - presynaptic D4 antagonism
D2 antagonism