Transcript Psychotherapeutic Drugs

Chapter 28
Anxiolytics and Other
Agents Used to Treat
Psychiatric Conditions
Psychotherapeutics


Treatment of emotional and mental
disorders
Commonly prescribed drugs

Used when a person’s ability to cope with
his or her environment is seriously impaired
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Treatment

Drug agents used for treatment of:
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Anxiety
Mental and emotional disorders
Psychoses
Psychosis and affective disorders
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Anxiolytic Groups

Four groups of anxiolytics (antianxiety)
drugs used in the U.S.
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
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Barbiturates
Carbamates
Antihistamines
Benzodiazepines
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Affective Disorders

Two classes of agents used to treat
affective disorders
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
Antidepressant agents
Antimanic agents
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Anxiolytics
Barbiturates


The oldest drugs to be used as anxiolytic
agents

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Depress the CNS
Suppress REM sleep
Carbamates

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Depress the CNS
Similar to barbiturates
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Antihistamines and
Benzodiazepines
Antihistamines



Used as anxiolytics
Cause sedation
Benzodiazepines

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
First line of drugs used for anxiety disorders
Produce sedation and muscle relaxation
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Anxiolytics: Side Effect/Adverse
Effects
Usually safe

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
Sedation
Relaxation

Check vital signs
Dangerous when taken with:
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Other sedating medications
Alcohol


Respiratory arrest
Check kidney and liver labs
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Antipsychotic Agents
Treat mood disorders


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Schizophrenia
Organic psychoses
Manic phase of bipolar affective disorders
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(continued)
Antipsychotic Agents
Clients with psychotic disorders show
symptomatic improvement
Action


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Inhibit or alter the dopamine-mediated
response in the brain
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Side Effects/Adverse Effects
Extrapyramidal symptoms
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Tardive dyskinesia
Impaired temperature regulation
Lower the seizure threshold
Endocrine changes
Dermatological changes
Photosensitivity
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Clozapine (Clozaril)
An example of an antipsychotic drug
agent
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Very effective
Produces fewer side effects and adverse
effects

Agranulocytosis
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Antidepressant Agents
Cyclic antidepressants
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
Tricyclics
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Work by correcting an imbalance in the
norepinephrine transmitter
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Tricyclic Antidepressants
Used to treat

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Depression
Chronic pain
Bedwetting
Examples: amitriptyline and imipramine
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Cyclic Antidepressants
Adverse/side effects


Orthostatic hypotension, extrapyramidal
effects, sedation, weight gain, dry mouth,
tachycardia, urinary retention, tremors,
sexual dysfunction
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Monoamine Oxidase Inhibitors
(MAOIs)
Inhibit monoamine oxidase
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Monoamine oxidase
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Normally inactivates neurotransmitters such as
serotonin and dopamine
Dangerous side effects



Hypotension
Hypertension
Death
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Newer Agents
Sertraline HCl (Zoloft), Fluoxetine HCl
(Prozac), Paroxetine HCl (Paxil)
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Action: act in a similar fashion to the tricyclic
antidepressants
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Produce fewer sedative and anticholinergic
effects
Adverse effects and side effects
•
Nausea, dry mouth, headache, and dizziness
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Pediatric Considerations
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Higher risk for side effects, especially
extrapyramidal symptoms
Lithium, an antimanic agent, may lead to:
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Decreased bone density
Decreased bone formation
Children are very sensitive to these
agents.
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Geriatric Considerations
The elderly process these agents much
slower
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
Toxic effects
Side effects
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Orthostatic hypotension, sedation, and
anticholinergic side effects
Increased anxiety is associated with the
use of tricyclic antidepressants
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(continued)
Geriatric Considerations


May experience higher incidence of
cardiac dysfunction such as a myocardial
infarction
Lithium is more toxic in elderly clients;
lower doses are necessary.
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