pharmacology in psychiatry Flashcards
antidepressants used in
depression
organic mood disorders
schizoaffective disorders
anxiety disorders: OCD, panic, social phobia, PTSD
antidepressants classification
tricyclic acids (TCAs)
monoamine oxidase inhibitors (MAOIs)
selective seratonin reuptake inhibitors (SSRIs)
seratonin/noradrenaline reuptake inhibitors (SNRIs)
how much of a delay (after given dose til symptoms improve) is seen when taking anti depressants?
2-4 weeks
what antidepressant is lethal when taken as an overdose?
tricyclic antidepressants (TCAs)
side effects of TCAs
antihistamine (sedation and weight gain)
anticholinergic (dry mouth and eyes)
antiadrenergic (qt lengthening)
basic physiology of a Monoamine oxidase inhibitors
bind to monoamine oxidase to prevent the inactivation of amines such as:
norepinephrine
dopamine
serotonin
(leading to increased synaptic levels)
monoamine oxidase inhibitors side effects
orthostatic hypotension sedation, weight gain dry mouth/eyes sexual dysfunction sleep disturbance
cheese reaction
hypertensive crises when MAOIs are taken with tyramine rich foods or sympathomimetics
serotonin syndrome
MAOIs taken with other medicines that increase serotonin or have sympathomimetic effects
abdominal pain, diarrhoea,
sweats, tachycardia, HTN, myoclonus
irritability, delirium
basic physiology of SSRIs
block the presynaptic serotonin reuptake
SSRIs treat what?
anxiety and depressive disorders
common side effects of SSRIs
GI upset
sexual dysfunction
anxiety, restlessness
insomnia, fatigue
discontinuation syndrome: agitation, nausea
common SSRIs:
pharmacological names
fluoxetine (prozac)
Sertaline
paroxetine
Citalopram
basic SNRI physiology:
inhibit both serotonin and noradrenergic reuptake like the TCAs
(but without antihistamine, anticholinergic or anti-adrenergic side effects)
what are SNRIs used in?
depression
anxiety
neuropathic pain
who would you give a mood stabiliser to?
bipolar
cyclothymia
schizoaffective
what is unipolar depression?
persistent/ constant depression
3 classes of mood stabilisers:
lithium
anticonvulsant
antipsychotics
what is the only medication that officially reduces suicide rates?
lithium
what is the first line mania prophylaxis?
carbamazepine (anti convulsant)
when would you use anti psychotics?
bipolar
schizophrenia
schizoaffective disorder
antipsychotic basic physiology
D2 dopamine receptor antagonists
what is the difference between typical and a typical antipsychotics
typical - affect dopamine (dopamine receptor antagonists)
atypical - affect dopamine and serotonin (seratonin-dopamine 2 antagonists)
when would you use benzodiazepines?
insomnia
parasomnia
anxiety disorders
management of alcohol withdrawal
what would you use to treat Korsakoff syndrome?
thiamine
what is Korsakoff syndrome?
chronic memory disorder caused by a lack of thiamine
usually alcohol misuse
Korsakoff psychosis:
impairment of recent and remote memory
no general cognitive impairment
impaired learning and disorientation
what medication can be given in the management of alcohol withdrawal?
benzodiazepines
normally chlordiazepoxide
what medication should be used as deterrent/ aversion to alcohol?
Antabuse (disulfiram)
‘gives effects of hangover immediately after consumption’
how would you treat post natal depression?
just like depression
SSRI, TCA, MOI, SNRI, CBT, IPT, ECT
how do you treat mania?
1st, 2nd, 3rd line
antipsychotics
mood stabilisers
lithium
how do you treat obsessive compulsive disorder?
1st line:
CBT including exposure and response prevention (asking people to resist their urges/ compulsions)
2nd line:
SSRIs (fluoxetine, citalopram)
3rd lines:
TCA (clomipramine)
what kind of drug is sodium valproate?
mood stabiliser
