Psychiatry Flashcards
Methylphenidate
CNS stimulant
Increase catecholamines (NE and DA) at synaptic cleft.
ADHD, narcolepsy, appetite control
Dextroamphetamine
CNS stimulant
Increase catecholamines (NE and DA) at synaptic cleft.
ADHD, narcolepsy, appetite control
Methamphetamine
CNS stimulant
Increase catecholamines (NE and DA) at synaptic cleft.
ADHD, narcolepsy, appetite control
Phentermine
CNS stimulant
Increase catecholamines (NE and DA) at synaptic cleft.
ADHD, narcolepsy, appetite control
Haloperidol
Typical antipsychotic (neuroleptic) Block dopamine D2 receptors (increase cAMP) Schizophrenia (positive symptoms), psychosis, acute mania, Tourette syndrome Stored in body fat, extrapyramidal side effects, hyperprolactinemia, dry mouth, constipation, hypotension, sedation. Risk of neuroleptic malignant syndrome and tardive dyskinesia.
Trifluoperazine
Typical antipsychotic (neuroleptic) Block dopamine D2 receptors (increase cAMP) Schizophrenia (positive symptoms), psychosis, acute mania, Tourette syndrome Stored in body fat, extrapyramidal side effects, hyperprolactinemia, dry mouth, constipation, hypotension, sedation. Risk of neuroleptic malignant syndrome and tardive dyskinesia.
Fluphenazine
Typical antipsychotic (neuroleptic) Block dopamine D2 receptors (increase cAMP) Schizophrenia (positive symptoms), psychosis, acute mania, Tourette syndrome Stored in body fat, extrapyramidal side effects, hyperprolactinemia, dry mouth, constipation, hypotension, sedation. Risk of neuroleptic malignant syndrome and tardive dyskinesia.
Thioridazine
Typical antipsychotic (neuroleptic) Block dopamine D2 receptors (increase cAMP) Schizophrenia (positive symptoms), psychosis, acute mania, Tourette syndrome Stored in body fat, extrapyramidal side effects, hyperprolactinemia, dry mouth, constipation, hypotension, sedation. Risk of neuroleptic malignant syndrome and tardive dyskinesia.
Chlorpromazine
Typical antipsychotic (neuroleptic) Block dopamine D2 receptors (increase cAMP) Schizophrenia (positive symptoms), psychosis, acute mania, Tourette syndrome Stored in body fat, extrapyramidal side effects, hyperprolactinemia, dry mouth, constipation, hypotension, sedation. Risk of neuroleptic malignant syndrome and tardive dyskinesia.
Olanzapine
Atypical antipsychotic
Varied effects on 5HT2, DA, α, and H1 receptors.
Schizophrenia (positive and negative symptoms), bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette syndrome.
Fewer extrapyramidal and anticholinergic side effects than typical antipsychotics. Significant weight gain.
Risperidone
Atypical antipsychotic
Varied effects on 5HT2, DA, α, and H1 receptors.
Schizophrenia (positive and negative symptoms), bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette syndrome.
Fewer extrapyramidal and anticholinergic side effects than typical antipsychotics. Hyperprolactinemia leading to lactation, gynecomastia, decreases in GnRH, LH, and FSH leading to irregular menstruation and fertility issues.
Clozapine
Atypical antipsychotic
Varied effects on 5HT2, DA, α, and H1 receptors.
Schizophrenia (positive and negative symptoms), bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette syndrome.
Fewer extrapyramidal and anticholinergic side effects than typical antipsychotics. Significant weight gain, agranulocytosis (requires weekly WBC monitoring) and seizure.
Aripiprazole
Atypical antipsychotic
Varied effects on 5HT2, DA, α, and H1 receptors.
Schizophrenia (positive and negative symptoms), bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette syndrome.
Fewer extrapyramidal and anticholinergic side effects than typical antipsychotics.
Quetiapine
Atypical antipsychotic
Varied effects on 5HT2, DA, α, and H1 receptors.
Schizophrenia (positive and negative symptoms), bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette syndrome.
Fewer extrapyramidal and anticholinergic side effects than typical antipsychotics.
Ziprasidone
Atypical antipsychotic
Varied effects on 5HT2, DA, α, and H1 receptors.
Schizophrenia (positive and negative symptoms), bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette syndrome.
Fewer extrapyramidal and anticholinergic side effects than typical antipsychotics. May prolong QT interval.
Lithium
Mood stabilizer
Mechanism not established. Possibly related to inhibition of phosphoinositol cascade/interaction with cation transport in CNS.
Bipolar disorder (blocks relapse and acute manic events), SIADH
Tremor, sedation, edema, heart block, hypothyroidism, weight gain, polyuria (ADH antagonist, causes DI), teratogenesis (Ebstein anomaly and malformation of great vessels). Narrow therapeutic window requires close monitoring. Almost exclusively excreted by kidneys.
Early toxicity shows memory impairment, nausea, vomiting, and dysarthria; progresses to ataxia, hyperreflexia, incoordination, blurred visions, and scotoma. Late toxicity shows myoclonus, seizures, and coma.
Buspirone
Anxiolytic
Stimulations 5HT1A receptors.
Generalized anxiety disorder.
Does not cause sedation, addiction, or tolerance. Does not interact with alcohol (compared to barbiturates, benzodiazepines). Takes 1-2 weeks to take effect.
Fluoxetine
SSRI
5HT-specific reuptake inhibitor.
Depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD.
Fewer side effects than TCAs. GI distress, sexual dysfunction (anorgasmia, decreased libido), serotonin syndrome (hyperthermia, confusion, myoclonus, CV collapse, flushing, diarrhea, seizures).
Paroxetine
SSRI
5HT-specific reuptake inhibitor.
Depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD.
Fewer side effects than TCAs. GI distress, sexual dysfunction (anorgasmia, decreased libido), serotonin syndrome (hyperthermia, confusion, myoclonus, CV collapse, flushing, diarrhea, seizures).
Sertraline
SSRI
5HT-specific reuptake inhibitor.
Depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD.
Fewer side effects than TCAs. GI distress, sexual dysfunction (anorgasmia, decreased libido), serotonin syndrome (hyperthermia, confusion, myoclonus, CV collapse, flushing, diarrhea, seizures).
Citalopram
SSRI
5HT-specific reuptake inhibitor.
Depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobias, PTSD.
Fewer side effects than TCAs. GI distress, sexual dysfunction (anorgasmia, decreased libido), serotonin syndrome (hyperthermia, confusion, myoclonus, CV collapse, flushing, diarrhea, seizures).
Venlafaxine
SNRI
Inhibits 5HT and NE uptake.
Depression, generalized anxiety disorder, panic disorder.
SSRI side effects plus hypertension, stimulant effects, sedation, nausea, dizziness, diaphoresis.
Duloxetine
SNRI
Inhibits 5HT and NE uptake.
Depression, diabetic neuropathy.
SSRI side effects plus hypertension, stimulant effects, sedation, nausea, dizziness, diaphoresis.
Amitriptyline
Tricyclic antidepressant
Blocks reuptake of NE and 5HT
Major depression, fibromyalgia.
Sedation, α-1 blocking effects (postural hypotension), anticholinergic/atropine-like side effects (tachycardia, urinary retention, dry mouth). More anticholinergic effects than nortriptyline. Convulsions, coma, cardiac arrhythmias, respiratory depression, hyperpyrexia, confusion and hallucinations in elderly due to anticholinergic effects.
Nortriptyline
Tricyclic antidepressant
Blocks reuptake of NE and 5HT
Major depression, fibromyalgia.
Sedation, α-1 blocking effects (postural hypotension), anticholinergic/atropine-like side effects (tachycardia, urinary retention, dry mouth). Fewer anticholinergic effects than amitriptyline. Convulsions, coma, cardiac arrhythmias, respiratory depression, hyperpyrexia, less confusion and hallucinations in elderly than amitriptyline.
Imipramine
Tricyclic antidepressant
Blocks reuptake of NE and 5HT
Major depression, fibromyalgia.
Sedation, α-1 blocking effects (postural hypotension), anticholinergic/atropine-like side effects (tachycardia, urinary retention, dry mouth). Convulsions, coma, cardiac arrhythmias, respiratory depression, hyperpyrexia.
Despiramine
Tricyclic antidepressant
Blocks reuptake of NE and 5HT
Major depression, fibromyalgia.
Sedation, α-1 blocking effects (postural hypotension), anticholinergic/atropine-like side effects (tachycardia, urinary retention, dry mouth). Convulsions, coma, cardiac arrhythmias, respiratory depression, hyperpyrexia. Less sedating but has higher seizure incidence.
Clomipramine
Tricyclic antidepressant
Blocks reuptake of NE and 5HT
Major depression, fibromyalgia, OCD.
Sedation, α-1 blocking effects (postural hypotension), anticholinergic/atropine-like side effects (tachycardia, urinary retention, dry mouth). Convulsions, coma, cardiac arrhythmias, respiratory depression, hyperpyrexia.
Doxepin
Tricyclic antidepressant
Blocks reuptake of NE and 5HT
Major depression, fibromyalgia.
Sedation, α-1 blocking effects (postural hypotension), anticholinergic/atropine-like side effects (tachycardia, urinary retention, dry mouth). Convulsions, coma, cardiac arrhythmias, respiratory depression, hyperpyrexia.
Amoxapine
Tricyclic antidepressant
Blocks reuptake of NE and 5HT
Major depression, fibromyalgia.
Sedation, α-1 blocking effects (postural hypotension), anticholinergic/atropine-like side effects (tachycardia, urinary retention, dry mouth). Convulsions, coma, cardiac arrhythmias, respiratory depression, hyperpyrexia.
Tranylcypromine
MAOI
Nonselective MAO inhibition which increases levels of NE, 5HT, and DA
Atypical depression, anxiety, hypochondriasis
Hypertensive crisis (ingestion of tyramine in wine/cheese), CNS stimulation. Contraindicated with SSRIs, TCAs, St. John’s Wort, meperidine, and dextromethorpan (prevent serotonin syndrome). Relatively safe cardiac profile.
Phenelzine
MAOI
Nonselective MAO inhibition which increases levels of NE, 5HT, and DA
Atypical depression, anxiety, hypochondriasis
Hypertensive crisis (ingestion of tyramine in wine/cheese), CNS stimulation. Contraindicated with SSRIs, TCAs, St. John’s Wort, meperidine, and dextromethorpan (prevent serotonin syndrome). Relatively safe cardiac profile.
Isocarboxazid
MAOI
Nonselective MAO inhibition which increases levels of NE, 5HT, and DA
Atypical depression, anxiety, hypochondriasis
Hypertensive crisis (ingestion of tyramine in wine/cheese), CNS stimulation. Contraindicated with SSRIs, TCAs, St. John’s Wort, meperidine, and dextromethorpan (prevent serotonin syndrome). Relatively safe cardiac profile.
Selegiline
MAOI
Selective MAO-B inhibition which increases levels of NE, 5HT, and DA
Atypical depression, anxiety, hypochondriasis
Hypertensive crisis (ingestion of tyramine in wine/cheese), CNS stimulation. Contraindicated with SSRIs, TCAs, St. John’s Wort, meperidine, and dextromethorpan (prevent serotonin syndrome). Relatively safe cardiac profile.
Bupropion
Atypical antidepressant
Increases NE and DA via unknown mechanism.
Depression, smoking cessation.
Stimulant effects (tachycardia, insomnia), anxiety, dizziness, agitation, headache, seizures at high doses and in bulimic patients. No sexual side effects. Should not be used in patients who have abruptly stopped using CNS depressants.
Mirtazapine
Atypical antidepressant
Alpha-2 antagonist, increasing release of NE and 5HT, and potent 5HT2 and 5HT3 receptor antagonist.
Depression with insomnia, anorexia nervosa
Sedation, increased appetite, weight gain, dry mouth.
Trazodone
Atypical antidepressant
Blocks 5HT2 and α-1 receptors.
Insomnia.
High doses needed for antidepressant effects. Sedation, nausea, priapism, postural hypotension.
