Psychotropic Meds Flashcards
What are psychotropic medications?
Medications that affect neurotransmitters… Typically GABA, norepinephrine, dopamine and serotonin receptors and are primarily used to manage thoughts and behaviours
What are psychotropic medications most often used to treat?
- depression
- bipolar
- schizophrenia
- anxiety
- sleep disruptions
The stigma and uses of medication… In any given year how many people experience mental illness?
1 in 5
How common is psychotropic medication use?
10.1% of general population has expressed need for these medications in past year
Do psychotropic meds have side effects?
Yes, not everyone will have the same reaction with the meds
Side effects are usually minimal and short lived, but must be cautious when using another medicine to treat the side effects of the first medicine
What is the brown bag biopsy?
part of an assessment as often times several medications may be duplicated or used to treat side effects
What are the 4 classes of psychotropic meds?
- Antidepressants
- Antipsychotics
- Mood stabilizers
- Antiolytics (anti anxiety)
What are some examples of antidepressants?
SSRI’s
-Ciraplex, Prozac, Paxil, Zoloft, Celexa
What are serotonin and norepinephrine reuptake inhibitors?
Work the same as SSRI’s but also block norepinephrine reuptake
Ex. Effexor, Cymbalta
Often used to depression and anxiety, come in extended release formats
What is one of the most common side effects with SSRI’s and SNRI’s?
Sexual side effects- men have inability to have erection, women have decreased libido, both have difficulty reaching climax
What are other side effects of SSRI and SNRI’s?
nausea, headache, increased blood pressure, fatigue
-prescribed with caution if person has comorbid health issues
What are Atypical Antidepressants?
Have different mechanisms of action, work mostly on dopamine receptors
- Fewer side effects, more commonly seen in senior population
- ex. Wellbutrin, Remeron
How long do antidepressants take to work?
4-6 weeks to give full effect– this is called the “therapeutic range”
When therapeutic range is reached, side effects are usually minimal and manageable (can use gum to manage dry mouth, increase fibre to help with constipation)
What are the two classes of antipsychotic meds?
Typical (1st gen): Haldol (usually avoided because too intense), Loxapine, Largactil
Atypical (2nd gen): Clozapine, Zyprexa, Risperidone
How do antipsychotics work?
Most work on brain’s ability to produce and absorb dopamine
Too much dopamine causes…
Positive symptoms
Too little dopamine causes…
Negative symptoms
What is the advantage of 2nd gen antipsychotics?
Work well on both positive AND negative symptoms and can decrease suicidal and depressive thoughts
-Easier to take, last longer
Less side effects, but do include hunger, weight gain, increase risk of diabetes
What are long acting “depot” antipsychotics?
Depot= make an appt to get an injection by a nurse once or twice a month
- Used to manage people with severe and persistent mental health issues who have a history of not taking their meds on their own
What is the advantage of “depot” injections?
Given deep into muscle, lasts 1-4 weeks
Works more quickly with sever psychosis due to depression, bipolar and schizophrenia
What are mood stabilizers used for?
To treat bipolar or manic episodes
-Can have moderate effect on depressive symptoms but are usually added to an antidepressant
What is Lithium?
- mechanism of action not fully understood
- takes about 2-4 weeks to reach therapeutic level
- need regular blood tests to monitor level
- Lithium toxicity symptoms often resemble intoxication
What are Anxiolytics or Anti-anxiety meds used for?
Used on an “as needed” basis to control acute episodes of panic or anxiety
Ex.) Benzodiazepines and Beta Blockers
How do Benzodiazepines work?
Work quickly by slowing down the Central Nervous system
-fight or flight feeling is lessened, slow down heart rate, give sense of calm
But can impair judgement and slow reaction time, report feeling “tipsy”
What is the problem with Benzodiazepines?
They are highly addictive, so usually can only use them for a brief period of time and then switch to something else
- Build tolerance quickly
- When mixed with alcohol or other drugs, can be fatal
If it ends in “pam”, it is likely a….
Benzodiazepine (but other examples are Valium, Xanax)
What are Beta Blockers used for?
Used for cardiac and blood pressure management
-reduce anxiety by blocking effects of norepinephrine –> give short acting feeling of calm without slowed reaction like benzo
What disorders to beta blockers treat?
Social phobias, public speaking, specific anxieties
- Safer to take longer term than benzos
- but have significant impact on body by lowering blood pressure
What can abruptly stopping benzodiazepines result in?
Result in seizures, therefore slowly stopping is recommended
What can abruptly stopping antidepressants and mood stabilizers result in?
Withdrawal symptoms
Or rebound insomnia and rebound depression can occur and be worse
What meds are usually used for ADHD?
- Methylphenidates (stimulants): Ritalin (short-acting) and Concerta (long acting)
- Amphetamines (stimulant): Dexedrine (short-acting) and Adderall (long-acting)
- Atomoxetine (non-stimulant): Strattera (takes about 4-6 weeks to see effect)
What meds are used for eating disorders?
Can use Prozac for bulimia to manage depressive/anxious symptoms
What meds can be used for Personality disorders?
Mood stabilizers, anti-depressants, anti-psychotics
For old people or children, how do medication treatments change?
Usually less of drug is needed to be effective (Start Low, Go Slow)
Side effects quicker and more severe
Can impede cognitive functioning, so need to monitor
What is used to treat Dementia?
Acetylcholinesterase inhibitors- increase amount of acetylcholine in the brain
Ex. Aricept, Exelon, Reminyl
How are psychotropic drugs prescribed?
Can be managed by family doctor if they have a good understanding of history of patient and monitor symptoms
Will meds cure everything?
No! Many people with meds would benefit greatly from additional therapy treatment
