Side Effects of Psychotropics

ByAHMED ALBEHAIRY,M.D

PSYCHIATRY CONSULTANT, MOH

Important items in S.E of psycho tropics

Acting on many neurotransmitters, localized to many organs.

Categorizations of side effects according to the action on neurotransmitter system.

??? Several SE have nt been ,neurotransmitters, specifically identified.

Drug induced syndrome, movements. Expectation of SE , dec. trouble . Treatment of SE. Choose the treatment according to SE.

SE caused by blockade of muscarinic Ach

Blurred vision. Constipation. Decreased salivation, sweating. Delayed or retrograde ejaculation. Delirium. Exacerbation of asthmatic pts. Hyperthermia. Memory problems. Narrow angle glaucoma. photophobia,. Sinus tachycardia. Urinary retension.

Antdopaminergic SE

Hyperprolactinemia.Menstrual dysfunction.Sexual dysfunction.Akathesia.Dystonia.Parkinsonism.T dyskinesia.

Antiadrenergic ( a1)

Dizziness.

Postural hypotension.

Reflex tachycardia.

antihistaminergic

Sedation

Weight gain.

Excessive serottonergic

Akathesia, agitation.Anxiety.GIT upset and diarrhea.Headache. Insomnia or somnolence.Nausea Sexual dysfunction

Multiple neurotransmitter system

Agranulocytosis .Allergic reactions.Anorexia.Cardiac conduction abnormalities.Seizures.

Monoamine receptors : review

5HT1A-----AD,ANXIOLYTIC. 5HT1B-----ANIMAL MODEL OF 5HT1DB 5HT1Da---ANTIMIGRAINE 5HT1DB,1F---ANTIMIGRAINE 5HT2A------ATYPICAL ANTIPSYCHOTICS 2B---- STOMACH CONTRACTION 2C--- REGULATION OF APPETTITE,SEIZURE,

ANTIPSYHOTIC 5HT3----ANTEMETIC,ANXIOLYTIC,COGNITIVE

ENHANCER 5HT4----MODULATION OF COGNITION 5HT6--- ATYPICAL ANTIPSYCHOTIC 5HT7 --- REGULATION OF C RYTHM

Monoamine receptors : review

H1 ANTAG---- SEDATION,WT GAIN.

H2 ANTAG----TTT OF PEPTIC ULCER

H3 ANAG-----INC ARROUSAL,APPETITE SUPRESSION.

Monoamine receptors : review

D1----D1 &D2 SYNERGISM, COCAINE EFFECT

D2---- EPS,ANTIPSYCHOTICD3---UKD4---S-D ANTAGONIST, ATYPICAL

ANTIPSYCHOTICS.D5---- UK

Monoamine receptors : review

A1,a,b,c antagonist---antihypertensive A2 agonist------sedative ,antihypertensive B1---- cardic function B2--- br athma B3--- adipose tissue function

M1--- cognition,seizures M2---- cardiac function M3 --- smooth ms contraction M4---- antparkinsonism,anticholinergic

Treatment of common SE

Sexual dysfunction. Anxiety, akathesia,insomnia. GIT upset. Headache. Anorexia. Wt gain Somnolence Dry mouth Blurred vision Constipation Othostatic hypotension EPS T DYSKINESIA

Common SE of lithium

Tremors:--- dec dose, indral GIT UPSET– dec dose Wt gain---adj wt loss, warn in advance Cognitive imp--- check thyroid,treat depression D I--- SWITCH KIDNEY IMP--- DEC DOSE OR SWITCH PSORIASIS--- OMEGA 3 ACNE—RETNOIC ,TETRACYCLINE HYPOTHYROIDISM--- ELTROXIN

THANK YOU