Psychiatric Disorders

Question 1

Chlorpromazine (Thorazine)

Answer 1

Typical Antipsychotic

Moderate incidence of extrapyramidal side effects, but high sedative effects

Question 2

Haloperidol (Haldol)

Answer 2

Typical Antipsychotic
High incidence of extrapyramidal side effects
Does not work on serotonin receptors
Can treat acute mania

Question 3

Clozapine (Clozaril)

Answer 3

Atypical Antipsychotic

May be effective in drug resistant patients

Question 4

Aripiprazole (Ability)

Answer 4

Atypical Antipsychotic
Dopamine System Stabilizer
Not a dopamine receptor antagonist
Partial agonist at D2 dopamine receptors and 5HT1A receptors.
Antagonist at 5HT2A receptors
Activation of D2 causes low dopaminergic tone, inhibition causes high tone
Can treat acute mania, or combine with lithium for chronic mania

Question 5

Imipramine (Tofranil)

Answer 5

Tricyclic Antidepressant
Not euphoric - Dulling of depressive ideation
Therapeutic latency of 2-6 weeks
Block Monoamine transporters
Affects NE, 5HT, and DA levels

Question 6

Fluoxetine (Prozac)

Answer 6

Antidepressant
Selective Serotonin Reuptake Inhibitor 
Also dulling of depressive ideation
Therapeutic Latency of 2 or more weeks
SSRIs block serotonin transporters (inhibit reuptake)
Like tricyclics, but specific to 5HT
Fewer antimuscarinic side effects

Question 7

Phenylzine (Nardil)

Answer 7

Antidepressent
Monoamine Oxidase Inhibitor (Hydrazine)
Psychomotor stimulant, especially tranylcypromine
Therapeutic latency of 2-3 weeks
Irreversible inhibition of MAO, leading to increase NE, 5HT, and DA.
Side Effects: orthostatic hypotension, tremors and insomnia
Interacts with L-DOPA to cause agitation and hypertension
Tyramine can cause a hypertensive crisis (relies on MAO to break down)

Question 8

Tranylcpromine (Parnate)

Answer 8

Antidepressent
Monoamine Oxidase Inhibitor (non-hyrdazine)
Psychomotor stimulant, especially tranylcypromine
Therapeutic latency of 2-3 weeks can b earlier
Irreversible inhibition of MAO, leading to increase NE, 5HT, and DA.
Also inhibits DA uptake
Side Effects: orthostatic hypotension, tremors and insomnia
Interacts with L-DOPA to cause agitation and hypertension
Tyramine can cause a hypertensive crisis (relies on MAO to break down)

Question 9

Lithium

Answer 9

Antimanic
Calming effect, slow to develop
Prophylaxis in bipolar affective disorder
Inositol phosphate metabolism
Inibits glycogen synthase kinase-3b (GSK-3b)
GSK-3b enhances DA-mediated behaviors, so inhibition calms hyperactiviy.
Low therpeutic index (2-3)
0.9-1.4meq/L therapeutic, 2meq/L toxic

Question 10

Carbamezapine

Answer 10

Antimanic
Also effective as antiepileptic
Sodium channel blocker for antiepileptic
Mechanism as antimanic unknown
Effective mood stabilizer alone or with Lithium

Question 11

Typical Antipsychotic

Answer 11

Means common extrapyramidal side effects
High incidence of extrapyramidal side effects
Does not work on serotonin receptors

Question 12

Atypical Antipsychotic

Answer 12

Do not produce extrapyramidal side effects (at least very low)
Do not increase prolactin levels.
Can reduce negative and positive schizophrenia symptoms.