Mental health drugs

Question 1

What medication is used on aggressive patients?

Answer 1

Benzodiazepines

1) . Lorazepam
2) . midazolam
2) . diazepam

Question 2

What is medication reverses the effects of benzodiazepines?

Answer 2

Flumazenil

Question 3

What is the mechanism of antipsychotic drugs?

Answer 3

They block the dopamine receptors.
Antipsychotics mainly block D2 receptors
1st generation tend to block D1 and D2
Drugs initially increase dopaminergic neuron activity, but over time it reduces, this is because the number of receptors increases over time.
(This is the same pathway of Parkinson’s disease so may get parkinsonism)

Question 4

What are the 4 main clinical effects seen by using antipsychotics?

Answer 4

1 - depression of emotional responses (treat delusions)
2 - sedation (treat confusion/restlessness)
3 - antiemetic effect (vomiting)
4 - antihistamine effect (allergies)

Question 5

What are the main conditions treated by antipsychotics?

Answer 5

• schizophrenia
• acute behavioural disturbances
• Used as an adjuvant in mania and psychotic depression

Question 6

The key difference between depression and anxiety?

Answer 6

In anxiety - overactivity of ascending noradrenergic neurons. Increases levels of arousal. In addition to this, excessive activity of 5-HT neurons leads to enhanced responses to nerve stimuli.

In depression - The opposite

Question 7

Treatment of anxiety

Answer 7

1) . CBT self-taught
2) . CBT therapist
3) . SSRI

Question 8

What is the formal name of bipolar disorder and what is it?

Answer 8

manic depression

• involves both depressive and manic episodes, corresponding ratios below:
• type 1 (1:1)
• type 2 (5:1)
• rapid cycling (>4 episodes a year)

Question 9

Acute manic episode treatments in bipolar disorder?

Answer 9

1st line - atypical antipsychotics (olanzapine, risperidone, quetapine, cloazapine)
2nd - valporate, lamotrigine (anticonvulsants), lithium

Question 10

What do you need to be careful of with regards to Clozapine?

Answer 10

AGRANULOCYTOSIS

Question 11

What set of drugs should you avoid in treating bipolar disorder during a depressive episode?

Answer 11

Anti-depressants - can cause rapid cycling of mood

Question 12

What drug can be used to treat rapid cycling of mood in bipolar disorder?

Answer 12

Clozapine (atypical antipsychotic)

Question 13

What is the first line drug as general maintenance in bipolar disorder?

Answer 13

Lithium

Question 14

What set of drugs would use in a depressive episode of someone with bipolar disorder?

Answer 14

atypical antipsychotic, anticonvulsant and lithium adjunct

Question 15

What is the first and second line drug treatment of depression?

Answer 15

1st line SSRI - fluoxetine, citalopram

2nd line - tricyclic antidepressants