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7 Cards in this Set
- Front
- Back
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Traditional Antipsychotics
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What: phenothiazine (chlorpromazine, fluphenazine), thioxanthene (thiothixene), and butyrophenone (haloperidol)
Why: positive symptoms of schizophrenia and psychotic symptoms of major depression How: block dopamine Effects: anticholinergic (dry mouth, blurry vision, tachycardia, urinary retention, constipation, delayed ejaculation - appear early and then decrease), Extrapyramidal (parkinsonism, akathisia, dystonia, tardive dyskinesia), neuroleptic malignant syndrome (can be fatal; rapid onset of muscle figidity, tachycardia, hyperthermia, altered consciousness). |
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Atypical Antipsychotics
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What: dibenzodiazepine (clozapine), benzisoxazole (resperidone), thienobenzodiazepine (olanzapine) and dibenzothiazepine (quetiapine)
Why: pos & neg sx; clozapine good for bipolar disorder, addiction, and motor symptoms of Huntington's & Parkinson's, but slower acting than traditionals How: act on dopamine as well as serotonin and glutamate Effects: anticholinergic, seizure, sedation; less extrapyramidal side effects & TD, but can produce agranulocytosis requiring blood monitoring. Can produce NMS (neuroleptic malignant syndrome) |
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Tricyclics
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What: amitiptyline, doxepin, imipramine, clomipramine
Why: best for vegetative, somatic sx of depression; panic disorder, agoraphobia, bulimia, OCD (clomipramine), and enuresis (imipramine) How: block reuptake of serotonin, norepinephrine, and/or dopamine, supporting catecholamine hypothesis (the norepinephrine) Effects: cardiovascular sx; anticholinergic; confusion, drowsiness, fatigue, weight gain, tremor, parethesia, blood dyscrasia |
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SSRI's
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What: fluoxetine, fluvoxamine, paroxetine, sertraline
Why: depression esp melancholic, OCD, bulimia, panic disorder, PTSD How: SSRI Effects: GI problems, insomnia, anxiety, headache, dizziness, anorexia, tremor, frequent urination, sexual dysfunction Other: less cardiotoxic, safer in overdose, less cognitive impairment, more rapid onset than tricyclics. Mixing w/MAOI can cause serotonin syndrome: headache, nystagmus, tremor, dizzoness, unsteady gate, irritability, confusion, delirium, cardiac arrhythmia |
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MAOI's
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What: isocarboxazid, phenelzine, tranylcypromine
Why: non-endogenous and atypical depressions w/anxiety, reversed vegetative sx (hypersomnia, hyperphagia) and interpersonal sensitivity How: inhibit MAO which is involved in deactivating dopamine, norepinephrine, and serotonin Effects: anticholinergic, insomnia, agitation, confusion, rash, weight gain, edema, headache, dizziness, tremor, blood dyscrasia, hypertensive crisis (dangerous) Other: must avoid barbiturates, amphetamines, antihistamines, and tyramine (aged cheese & meat, beer, red wine, chicken liver, avocados, bananas, fava beans) |
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Newer Antidepressants
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What: buproprion
Why: Major Depression, Bipolar Depression, smoking How: buproprion is a norepinephrine dopamine reuptake inhibitor (NDRI) Effects: fewer anticholinergic effects, reduced sexual dysfunction, but may aggravate pre-existing psychosis and seizures What: venlafaxine Why: Major Depression, OCD, and GAD How: Venlafaxine is a selective serotonin norepinephrine reuptake inhibitor (SNRI) Effects: Less dangerous in overdose than TCAs and may have faster onset. Can increase blood pressure What: Nefazodone and trazodone Why: major depression and bipolar depression How: serotonin-2 antagonists/reuptake inhibitors (SARIs) Effects of nefazodone: dry mouth, nausea, dizziness, blurred vision, confusion. Effects of trazodone: sedation, orthostatic hypotension, dizziness, headache, nausea, and (rarely) priapism |
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Mood Stabilizers
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What: Lithium:
Why: drug of choice for bipolar How: effects not clear but may be related to reuptake of serotonin and norepinephrine Effects: nausea fine hand tremor, polyuria, polydipsia, usually subside in a few weeks. Danger of toxicity and requires blood monitoring What: Carbamazepine Why:non-responders to lithium, rapid cyclers, dysphoric mania How: unknown mode of action but possibly related to serotonin levels Effects:dizziness, ataxia, visual disturbances, anorexia, nausea, rash, but tolerance develops quickly; contraindicated for cardiac conduction problem patients; requires blood monitoring because of risk of agranulocytosis and aplastic anemia |
