Psychotherapeutic Medications Flashcards
Psychotherapeutic Medications
Medications that treat psychiatric alterations experienced by the client includes schizophrenia, delusional disorders, bipolar disorder, depressive psychoses, and druginduced psychoses.
Schizophrenia
Chronic psychotic illness characterized by disordered thinking and reduced ability to comprehend reality. They have their own perception and own world interpretation.
Positive Symptoms: there will be additions to the reality of the patient and these include hallucinations, delusions, agitation, tension, and/or paranoia.
Negative Symptoms: loss of diminution of normal function like lack of motivation, poverty of speech, blunted affect, poor self-care.
Cognitive Symptoms: includes disordered thinking, reduced ability to focus and prominent learning difficulties.
Hallucination vs Delusion
Hallucination is when you misinterpret something and usually from your senses like hearing voices or smelling something that isn’t there. While delusion is something that you think of yourself or false beliefs despite evidence to the contrary.
Medications for Schizophrenia (Antipsychotics)
- First Generation Antipsychotics (FGAs)
- primarily blocks dopamine in the patient’s CNS. However, it can cause serious movement disorders called Extrapyramidal Syndrome (EPS) thus, patient’s might exhibit parkinson-like if they used this medication for a long time or take this medicine more than the desired dosage.
- also called conventional antipsychotics
- e.g. Chlorpromazine (low potency) and Haloperidol (high potency) - Second Generation Antipsychotics (SGAs)
- moderately blocks dopamine but stronger blocking of receptors for serotonin thus it decreased blocking of dopamine leads to lesser risk of EPS.
- also called atypical antipsychotics
- e.g. Risperidone, Clozapine and Olanzapine
Extrapyramidal Syndrome
- movement disorders resulting from effects of antipsychotic drugs on the extrapyramidal motor system and characterized by acute dystonia, Parkinsonism, Akathisia, and tardive dyskinesia
Acute Syndrome
severe spasm of the muscle of the face, neck and back
Parkinsonism
bradykinesia, mask-like facies, drooling, tremor, rigidity, shuffling gait and stooped posture
Akathisia
pacing and squirming brought on by an uncontrollable need to be in motion.
Tardive Dyskinesia
involuntary choreoathetoid movements of the tongue and face
Abnormal Involuntary Movement Scale (AIMS)
A rating scale designed in the 1970’s and used by medical personnel to check involuntary movement related to Tardive Dyskinesia. The entire test can be completed in about 10 minutes.
Major Depression
depressed moods and loss of pleasure or interest in all or nearly all of one’s usual activities and pastimes that persist for longer than 2 months
5 Major Antidepressants
- tricyclic antidepressants
- selective serotonin reuptake inhibitors
- serotonin and norepinephrine reuptake inhibitors
- monoamine oxidase inhibitors
- atypical antidpressants
Tricyclic Antidepressant (TCA)
- first choice of treatment
- e.g. Imipramine, Amitriptyline, Doxepine
- primarily blocks the amine reuptake pump on the presynaptic terminal
Selective serotonin Reuptake Inhibitors (SSRI)
- primarily affect serotonin reuptake
- more effective in the treatment of melancholic and severe depression
-e.g. Fluoketine, Paroxetine, Sertraline, Fluvoxamine
Monoamine Oxidase Inhibitors (MAOIs)
- inhibits MAO from inactivating NE and serotonin
- e.g. Emsam, PaMaNa
Parnate
Marplan
Nardil
