PSYCH MEDS IV

Question 1

catecholamines in the synaptic cleft, especially norepinephrine and dopamine.

ADHD, narcolepsy, binge-eating disorder.

Nervousness, agitation, anxiety, insomnia, anorexia, tachycardia, hypertension, weight loss, tics, bruxism.

Answer 1

Central nervous system
stimulants

Methylphenidate, dextroamphetamine, methamphetamine, lisdexamfetamine.

Question 2

Block dopamine D2 receptor ( cAMP).

Schizophrenia (1° positive symptoms), psychosis, bipolar disorder, delirium, Tourette syndrome, Huntington disease, OCD. Use with caution in dementia.

High potency: Haloperidol, Trifluoperazine, Fluphenazine (Hal Tries to Fly High)—more neurologic side effects (eg, extrapyramidal symptoms [EPS]).

Answer 2

Typical antipsychotics

Haloperidol, pimozide, trifluoperazine, fluphenazine, thioridazine, chlorpromazine.

Question 3

Not completely understood. Most are 5-HT2 and D2
antagonists; aripiprazole is a D2 partial agonist. Varied effects on α and H1
receptors.

Schizophrenia—both positive and negative symptoms. Also used for bipolar disorder,
OCD, anxiety disorders, depression, mania,
Tourette syndrome.

All—prolonged QT, fewer EPS and anticholinergic side effects than typical antipsychotics.

Answer 3

Atypical antipsychotics

Aripiprazole, asenapine, clozapine, olanzapine, quetiapine, iloperidone, paliperidone, risperidone, lurasidone, ziprasidone.

Question 4

Not established; possibly related to inhibition of phosphoinositol cascade.

Mood stabilizer for bipolar disorder; treats acute
manic episodes and prevents relapse.

Tremor, thyroid abnormalities (eg, hypothyroidism), polyuria (causes nephrogenic diabetes insipidus), teratogenesis.

Answer 4

Lithium

Question 5

Stimulates 5-HT1A receptors.

GAD

Answer 5

Buspirone

Question 6

Inhibit 5-HT reuptake.

Depression, generalized anxiety disorder, panic disorder, OCD, bulimia, binge-eating disorder, social anxiety disorder, PTSD, premature
ejaculation, premenstrual dysphoric disorder.

Fewer than TCAs. Serotonin syndrome, GI distress, SIADH, sexual dysfunction
(anorgasmia, libido).

Answer 6

Selective serotonin
reuptake inhibitors

Fluoxetine, fluvoxamine, paroxetine, sertraline, escitalopram, citalopram.

Question 7

Inhibit 5-HT and NE reuptake.

Depression, generalized anxiety disorder, diabetic neuropathy. Venlafaxine is also indicated for social anxiety disorder, panic disorder, PTSD, OCD. Duloxetine and milnacipran are also indicated for fibromyalgia.

BP, stimulant effects, sedation, nausea.

Answer 7

Serotonin- norepinephrine reuptake inhibitors

Venlafaxine, desvenlafaxine, duloxetine, levomilnacipran, milnacipran.

Question 8

TCAs inhibit 5-HT and NE reuptake.

MDD, peripheral neuropathy, chronic neuropathic pain, migraine prophylaxis, OCD
(clomipramine), nocturnal enuresis (imipramine, although adverse effects may limit use).

Sedation, α1-blocking effects including postural hypotension, and atropine-like (anticholinergic)
side effects (tachycardia, urinary retention, dry mouth).

Answer 8

Tricyclic antidepressants

Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine.

Question 9

Nonselective MAO inhibition levels of amine neurotransmitters (norepinephrine, 5-HT, dopamine)

Atypical depression, anxiety. Parkinson disease (selegiline).

CNS stimulation

Answer 9

Monoamine oxidase
inhibitors

Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (selective MAO-B inhibitor).

(MAO Takes Pride In Shanghai).