Psychotherapeutic Drugs Kim Edward Light, Ph.D. Professor, College of Pharmacy University of...
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Transcript of Psychotherapeutic Drugs Kim Edward Light, Ph.D. Professor, College of Pharmacy University of...
Psychotherapeutic Drugs
Kim Edward Light, Ph.D.
Professor, College of Pharmacy
University of Arkansas for Medical Sciences
Objectives Identify the different categories of drugs having
therapeutic value in treating CNS disorders. Identify the spectrum of disorders of brain function For each category of drugs not previously
discussed Identify therapeutic uses and indications Present pharmacological mechanisms Discuss specific features of drug action Present adverse reactions and side effects Identify contraindications and complications
Drug Categories
Antipsychotics / Neuroleptics
Antimanic Antidepressants Alzheimer's Antiparkinsonian Anticonvulsants
Stimulant Medications Antianxiety
Medications Hypnotics Narcotics - Opioid
Analgesics Addiction Treatment
Medications
Spectrum of Disorders1 Attention Deficit Hyperactivity Disorder
(ADHD, ADD) Autism Spectrum Disorders (Pervasive
Developmental Disorders) Bipolar Disorder (Manic-Depressive Illness) Borderline Personality Disorder Depression Eating Disorders
Spectrum of Disorders2
Generalized Anxiety Disorder Obsessive-Compulsive Disorder (OCD) Panic Disorder Post-Traumatic Stress Disorder
(PTSD) Social Phobia (Social Anxiety Disorder)
Schizophrenia Seizure Disorders
Traditional Antipsychotic Drugs chlorpromazine Thorazine®, Largactil®
fluphenazine Prolixin®, Permitil®
haloperidol Haldol®
loxapine Loxitane, Daxolin®
mesoridazine Serentil®
molindone Moban, Lindone®
perphenazine Trilafon®, Etrafon®
pimozide Orap®
thioridazine Mellaril®
thiothixene Navane®
trifluoperazine Stelazine ®
Atypical Antipsychotic Drugs
aripiprazole Abilify®
clozapine Clozaril®
olanzapine Zyprexa®, Zyprexa®, Zydis®
quetiapine Seroquel®
risperidone Risperdal®
ziprasidone Geodon®
Antipsychotic Drug Adverse Reactions
Tardive Dyskinesia Involuntary movements Long-term use and older patients Women > men
Neuroleptic Malignant Syndrome Blood pressure up and down Dazed and confused Difficulty breathing Muscle stiffness Rapid heart rate Sweating and shakiness Temperature above normal
Antipsychotic Drug Side Effects Blurred vision, Dry mouth Drowsiness, Slurred speech, Dizziness Muscle rigidity Nasal congestion, Lowered blood pressure Restlessness, Slowed heart rate Sensitivity to bright light Upset stomach, Constipation Weight gain
Bipolar Disorder Drugs
Lithium Carbonate - Eskalith®, Eskalith CR®, Lithane®,
Lithobid®, Lithonate®, Lithotabs®
Citrate - Cibalith®
AnticonvulsantsNeuroleptics – atypical
olanzapine Zyprexa®, Zyprexa®, Zydis®
quetiapine Seroquel® risperidone Risperdal® ziprasidone Geodon®
Lithium Side Effects
ataxia, fine hand tremor, hyperactive reflexes blurred vision, drowsiness, diarrhea, vomiting muscular weakness, dry mouth, polyuria, cardiac arrhythmia, hypotension, epileptiform seizures, coma large output of dilute urine
Regular monitoring of blood levels necessary
Antidepressant DrugsOlder MAO Inhibitorsisocarboxazid Marplan®
phenelzine Nardil®
tranylcypromine Parnate®
Tricyclics & Quarta-cyclics amitriptyline Elavil®
amoxapine Asendin®
clomipramine Anafranil®
desipramine Norpramin®
doxepin Sinequan®
imipramine Tofranil®
maprotiline Ludiomil®
nortriptyline Pamelor®
protriptyline Vivactil®
Antidepressant DrugsNewerSSRIs citalopram Celexa®
escitalopram Lexapro®
fluoxetine Prozac®
fluvoxamine Luvox®
paroxetine Paxil®
sertraline Zoloft®
SNRIs venlafaxine Effexor®,
Effexor ER®
nefazodone Serzone®
mirtazapine Remeron®
Others bupropion Wellbutrin®
trazodone Desyrel®
Antidepressant Drugs Adverse Reactions
MAO Inhibitors Foods containing tyramine at high levels
Serotonin Syndrome Produced by combination of products that act to
increase serotonin Similar to Neuroleptic Malignant Syndrome Euphoria, drowsiness, exaggerated reflexes,
sweating, hyperthermia, mental status changes
Antidepressant Drugs Side Effects
Older agentsDry mouth, dizziness, constipation, blurred vision, cardiac arrhythmias
Orthostatic hypotension, sexual dysfunction, weight gain
Newer agentsHeadache, nausea, nervousness, agitation, Sexual dysfunction, insomnia, weight gainSeizure risk (bupropion) Suicide or aggressive acts especially in adolescents
Anti-Parkinsonian DrugsDA Boosters L-DOPA L-DOPA / carbidopa Sinemet® or Atamet® entacapone Comtan®
MAO-B Inhibitor Selegiline Eldepryl® Atapryl® Carbex®
DA Agonists bromocriptine Parlodel® pergolide Permax® pramipexole Mirapex®
ropinirole Requip®
amantadine Symmetrel®, Symadine®
Anti-Parkinsonian DrugsAdjuncts
Anticholinergics benztropine Cogentin®
trihexyphenidyl Artane®
Anti-Alzheimer's Drugs Donepezil Aricept®
Galantamine Reminyl® Rivastigmine Exelon®
Tacrine Cognex®
Memantine Namenda®
Side Effects Dizziness, Confusion, Sleep problems Increased respiratory secretions, Urinary frequency Cardiovascular problems
Anticonvulsant Drugs carbamazepine Tegretol®
divalproex sodium Depakote®, valproate Depacon®, Depakene®
gabapentin Neurontin®
lamotrigine Lamictal®
levetiracetam Keppra® oxcarbazepine Trileptal®
tiagabine Gabitril®
topiramate Topamax®
Anticonvulsant DrugsSide Effects weight gain, memory and cognitive function
disturbances, photosensitivity, dermatological sensitivity leading to rashes, sinus congestion, hair thinning, impaired absorption of B vitamins.
Summary Discussed the various major classes of
drugs used to treat various mental disorders including: Antipsychotic drugs Bipolar disorder drugs Antidepressant drugs Anti-Parkinsonian drugs Anti-Alzheimer’s drugs Anticonvulsant drugs
Psychotherapeutic Medications Information http://www.nimh.nih.gov/healthinformation/index.cfm