Psych - Anxiolytics and Mood Stabilisers

Question 1

What is the major class of drug used to treat anxiety?
Give 2 examples

Answer 1

Benzodiazepines

Lorazepam and Diazepam

Question 2

What are the other indications for use of Benzodiazepines?

Answer 2

Short-term treatment of insomnia
Status epilepticus
Alcohol withdrawal reactions
Sedatives before GA

Question 3

What is the mechanism of action of the Benzodiazepines?

Answer 3

Act as full agonists at GABA receptors - facilitate and enhance binding of GABA
Receptor is a chloride channel, so chloride flows into cell when activated - cell hyperpolarised - decreased neurotransmission

Question 4

What are two significant problems with Benzodiazepines?

Answer 4

• Tolerance

- Dependence

Question 5

Give 4 ADRs of the Benzos

Answer 5

Drowsiness
Dizziness
Dry mouth
Amnesia

Question 6

Are benzos safe in pregnancy?

Answer 6

No

Question 7

What is the drug used to reverse Benzo toxicity?

Answer 7

Flumazenil

Question 8

How are benzodiazepines metabolised?

Answer 8

Via CYP450

Question 9

List some drugs used as mood stabilisers in the treatment of bipolar disorder

Answer 9

Lithium
Valproate
Carbemazepine
Lamotrigine

Question 10

What must be monitored when using Lithium?

Answer 10

Lithium levels - 3 monthly

Renal function and TFTs 6 monthly

Question 11

Give some ADRs of Lithium

Answer 11

• Memory problems
• Thirst
• Hypothyroidism
• Renal dysfunction

Question 12

What are some possible mechanisms of action of lithium?

Answer 12

• Increases serotonin - long-term this reduces receptor number
• Attenuates effects of certain neurotransmitters