Mental Health Drugs Flashcards
how does amitriptyline work
tricyclic antidepressant
inhibits reuptake of serotonin + noradrenaline from synaptic cleft
Why does Amitryptiline have adverse effects
additionally blocks muscarinic, histamine, adrenergic and dopamine (D2) receptors
what are the side effects of amitriptyline
Blocking H1 and alpha1 can cause arrhythmias and heart block, hypotension, prolongs QT + QRS
antimuscarinic effects are dry mouth, constipation
why is amitriptyline dangerous in overdose
can cause severe hypotension, arrhythmias, convulsions, coma
what happens if amitriptyline is withdrawn suddenly
GI upset, neurological and influenza like symptoms
How does citalopram work?
Selective Serotonin Reuptake Inhibitor (SSRI)
preferred to tricyclics as more selective for serotonin, fewer side effects
when would citalopram be used?
1st line for moderate - severe depression, panic disorders, OCD
In what cases is citalopram contraindicated?
Epilepsy - lower seizure threshold
Peptic ulcer disease
Poor efficacy in young people - increase suicidal thoughts
Long QT, as will lengthen
What is serotonin syndrome?
Triad of autonomic hyperactivity, altered mental state and neuromuscular excitation
responds well to treatment withdrawal
Name some commonly prescribe benzodiazepines
Diazepam, temazepam, lorazepam, midazolam, chlordiazepoxide
How do benzodiazepines work?
enhance the binding of GABA to GABAa receptor, having relaxant and anticonvulsant effects
Indications for benzodiazepine use
management of seizures, status epilepticus
alcohol withdrawal syndrome
sedation if GA unsuitable
severe anxiety / insomnia
Why may diazepam be unsuitable for treatment of AWS?
May precipitate hepatic encephalopathy as are cleared by liver
if it is already damaged due to alcohol, consider lorazepam as an alternative
How does donepezil work
Acetlycholinesterase inhibitor
reversibly inactivates cholinesterases
What are some indications for the use of donepezil
Alzheimer’s - may slows progression
best used earlier on
