Mental Health drugs Flashcards
What class of drug is amitriptyline?
Tricyclic antidepressants
How does amitriptyline work?
Block uptake of amines by presynaptic nerve terminals by competition of binding site of amine A2-adrenoreceptors, most inhibit uptake of NA and 5-HT. Also bind muscarinic ACh, histamine and 5-HT receptors causing side effects
What is one of the important side effects of amitriptyline use?
Arrhythmias/heart block
How long should be given before concluding that amitriptyline isn’t working?
4-6 weeks, withdrawal should be gradual and contiued for 4 months post-remission
When should amitriptyline be taken?
Before bed due to sedative effects
What class of drug is citalopram and how does it work?
Selective serotonin reuptake inhibitor, strong selective inhibitory action on uptake of 5-hydroxypeptamine
Contra-indications to citalopram use?
Manic phase of illness, long QT as citalopram itself can prolong QT
Indications for citalopram?
Depressive illness, panic disorder
Indications for amitriptyline?
Depressive illness, neuropathic pain, migraine prophylaxis
How should citalopram be withdrawn?
Gradually
What class of drug is diazepam?
Benzodiazepines
How does diazepam work?
Binds non-specifically to benzodiazepine receptors which are coupled to GABAa receptors which increase the affinity for GABA leading to muscle relaxation, anticonvulsant activity and motor effects
Indications for diazepam?
Status epilepticus, febrile convulsions, poisoning convulsions, anxiety disorders
What enzymatic system metabolises diazepam and donepezil?
CyP450
Example of acetylcholinesterase inhibitor?
Donepezil
