Psychopharmacology Flashcards
Typical/Traditional antipsychotics vs. Atypical/Novel antipsychotics
Typical - treat positive symptoms (e.g. hallucinations, delusions, disorganized thinking) more effectively than negative symptoms (affective flattening, lack of motivation, poverty of speech, etc)
Novel - treat both positive and negative symptoms, sometimes more effective of the other psychotic disorders (e.g. delusional disorder)
Presumed mechanism of antipsychotics
all antipsychotics are DOPAMINE ANTAGONISTS to some extent, block postsynaptic dopamine receptors
novel antipsychotics exert stronger effects as antiserotonergc, antiadrenergic, anticholinergic, and antihistaminergic, than dopamine antagonist
side effects of antipsychotics - lower potency medications
sedation, anticholinergic effects (“drying out” or “holding in”), orthostatic hypotension - dizziness, lightheadeness on standing up, lowering of seizure threshold
side effects of antipsychotics - higher potency medications
extrapyramidal symptoms - movement related symptoms
dystonia - acute and paintful muscle spasms of the neck, back, tongue, eyes, and/or larynx
parkinsonism - mask-like face, shuffling gait, drooling, resting tremor, rigidity, and akinesia
akathisia - feelings of dysphoria, internal sense of restlessness or agitation, feeling of the “jitters’ or “fidgeting”
side effects of typical/traditional antipsychotics (Regardless of potency)
Tardive Dyskinesia - abnormal movements of the lips, tongue, jaw, limbs, trunk
dys = problem
kinesia = movement
side effects of CLozaril (clozapine)
agranulocytosis - sudden drop in granulocyte count, manifested as sore throat and high fever
dependence/withdrawal/overdose of antipsychotics
do not cause addiction, dependence, or tolerance
withdrawal is only caused when high dose is suddenly stopped
overdoses not highly lethal, except if full 30-60 day supply is taken at one time
primary mechanism of action of most antidepressants
block reuptake of norepinephrine and/or serotonin
side effects of tricyclics
can trigger manic episodes in bipolar patients
severe anticholinergic effects (E.g. confusion, memory problems, dry mouth)
sedation
orthostatic hypotension
weight gain
nausea
sexual dysfunction
side effects of SSRIs
much lower side effect profile than TCAs
headaches, nervousness, restlessness, insomnia, sedation, gastrointensiona distress, sexual dysfunction
side effects of MAOIs
orthostatic hypotension
weight gain
edema
sexual dysfunction
insomnia
MOST SERIOUS - tyramine-induced hypertensive crisis
can’t eat foods high in tyramine (e.g aged foods - alcohol, fava beans, aged cheese, etc) because they can induce a hypertensive emergency which requires medical attention
dependence/withdrawal/overdose of antidepressants
do not cause dependence, tolerance, or addiction
abrupt stopping can precipitate withdrawal symptoms that are not life-treatening
TCAs and MAOIs highly lethal if ODed, further increases if combined with alcohol
SSRIs not very lethal
presumed mechanism of action with Benzos
facilitate GABA’s ability to bind to its receptor site and thus they enhance the effects of GABA
side effects of Benzos
side effects benign
most common - sedation, drowsiness
mild cognitive impairment, some amnesia
ataxia (incoordination) and depression can occur when dosages high
can be fatal if taken with alcohol or other CNS depressants
dependence/tolerance/withdrawal/overdose of Benzos
patients can devleop physiological and psychologicla dependence
patients can develop tolerance - cross-tolerant with alcohol
withdrawal symptoms very serious and can be fatal
rarely fatal when taken alone
