Psychiatric Drugs Flashcards
What class of drugs are used in ADHD?
Stimulants
How do stimulants work for ADHD?
Increases CNS dopamine and NE activity
This gives the patient a sense of stimulation so that they don’t seek stimulation through excessive actions
Most common stimulant used?
Amphetamine
Issues with stimulants
Abuse potential
What drug can be used in ADHD when there is a risk of abuse?
Atomoxetine
It is not a stimulant
Selective NE reuptake inhibitor
Can’t cause euphoria due to having no effect on dopamine
How do alpha-2 agonists work in ADHD
Increase prefrontal cortex activity
Regulates attention and behaviour
Name alpha-2 agonists
Clonidine
Guanfacine
Explain biogenic amine theory
Depression: decrease of NE and serotonin at the synapse
Mania: excess of NE and serotonin at the synapse
Name the classes of antidepressants
Tricyclic
MAO inhibitors
SSRIs
SNRIs
Name some SNRIs
Venlafaxine
Duloxetine
Name some TCAs
Amitryptiline
Imipramine
Name the monoamines
Serotonin
Dopamine
Norepinephrine
Histamine
How do TCAs work?
Block NE and serotonin reuptake
What other receptors do TCAs affect?
They block 5-HT, alpha-1, H-1 and M receptors
Therefore consider the side effects
Features of overdose of TCAs?
Seizures
Coma
Hyperthermia
Hypotension
QT pronged arrhythmias
Features of serotonin syndrome?
Mental status changes like agitation, restlessness and disorientation
Autonomic hyperactivity like diaphoresis, tachycardia and hyperthermia
Neuromuscular hyperactivity like tremor, clonus, hyperreflexia, bilateral Babinski sign
How do we treat serotonin syndrome?
Cyproheptadine which is a 5-HT antagonist
Common cause of serotonin syndrome?
MAO combines with another serotonin drug
How long do SSRIs take to work?
4 to 8 weeks
Side effect of SNRIs not present with SSRIs?
Increased BP due to NE effects
How do typical/first generation antipsychotics work?
Block postsynaptic D2 receptors
How do atypical/second generation antipsychotics work?
Inhibition of presynaptic 5-HT2A receptors which modulates dopamine release
Difference in side effects between typical and atypical antipsychotics?
Atypical have fewer extra-pyramidal side effects
Atypical have more metabolic effects
Atypical have fewer ACh effects
Examples of first generation/ typical antipsychotics?
Haloperidol
Chlorpromazine
Anything ending in -azine
Examples of atypical/ second generation antipsychotics
Clozapine
Olanzapine
Quetiapine
Risperidone
Anything ending -apine
Anything ending in -idone
Bipolar drugs?
Carbamazepibe
Lamotrigine
Lithium
Valproic acid
