Transcript Psychiatric Drugs - Cottonwood Springs

Psychotropic Medication:
Overview 1.0 CEU
Presented by Dr. Jeremy Burd MD
Medical Director at Cottonwood Springs
Hospital
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Psychiatric Drugs
• The development of psychiatric drugs to
treat major mental illnesses such as
schizophrenia and mood disorders has
both revolutionized the field of mental
health and provided insights into the
biochemical basis for mental illness.
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Psychiatric Drugs
• As effective as psychiatric drugs might
be for the mentally ill, none is without
side effects.
• The perfect drug has yet to appear on
the scene.
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The Biomedical Model
• The biomedical model, the prevailing
viewpoint among mental-health
professionals, asserts that abnormal
thoughts and behaviors result from
faulty biochemical processes in the
brain.
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Antipsychotic Drugs
and Schizophrenia
• Therapeutic medications for
schizophrenia patients are classified as
first-generation, second-generation, and
third-generation antipsychotic drugs.
• First-generation drugs include
chlorpromazine (brand name:
Thorazine) and haloperidol (brand
name: Haldol).
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Antipsychotic Drugs
and Schizophrenia
• Second-generation drugs include clozapine
(Clozaril), risperidone (Risperdal), olanzapine
(Zyprexa), quetiapine (Seroquel), ziprasidone
(Geodon), and apiprazadole(Abilify).
• The newest third-generation drugs include,
asenapine (Saphris),lurasidone (Latuda),
Ioperidone (Fanapt).
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Table 15.1
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Newer antipsychotics
Brand name
Generic
name
Dosage
range (in
mg/day)
Indications
Latuda
Lurasidone
20-120
Bipolar
depression
Schizophrenia
Saphris
asenapine
5-20
Bipolar I
Schizophrenia
Fanapt
iloperidone
2-24
Schizophrenia
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Antipsychotic Drugs
and Schizophrenia
• First-generation antipsychotic drugs have
been effective in reducing symptoms for
many patients, but they also carry the
potential for the development of severe
movement-related motor problems.
• Second-generation and third-generation
antipsychotic medications do not produce this
particular side effect.
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Antipsychotic Drugs
and Schizophrenia
• Antipsychotic medications are believed
to be clinically effective, and to involve
the least number of adverse side
effects, by virtue of a combination of
actions upon subtypes of dopamine and
serotonin receptors in the brain.
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Drugs Used to
Treat Depression
• First-generation antidepressant drugs
can be divided into two groups: MAO
inhibitors and tricyclic antidepressants.
• The MAO inhibitors were the first group
to be developed for the treatment of
depression.
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Drugs Used to
Treat Depression
• Although they are effective, patients need to
be on a restricted diet to avoid serious
adverse side effects.
• Tricyclic antidepressants do not require
dietary restrictions, but their effects on the
cardiovascular system make them
undesirable for certain patients.
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Drugs Used to
Treat Depression
• Second-generation antidepressants
include the well-known drug fluoxetine
(brand name: Prozac) and similar drugs
that slow the reuptake of serotonin.
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Drugs Used to
Treat Depression
• Collectively, they are referred to as
selective serotonin reuptake inhibitors
(SSRIs).
• Third-generation antidepressants slow
the reuptake of both serotonin and
norepinephrine in the brain.
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Drugs for Other Types
of Mental Disorders
• Mania and extreme mood swings
between mania and depression (bipolar
disorder) are two mood disorders that
have been treated successfully with
lithium carbonate or valproate (brand
name: Depakote).
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Drugs for Other Types
of Mental Disorders
• Also used are antipsychotic medications
such as risperidone (brand name:
Risperdal) and ziprasidone (brand
name: Geodon), or a combination of
antipsychotic and antidepressant
medications (brand name: Symbyax).
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Drugs for Other Types
of Mental Disorders
• Risperidone (brand name: Risperdal)
has been approved as a treatment for
symptoms of autism in children and
adolescents.
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Psychiatric Drugs, Social Policy,
and Deinstitutionalization
• Since the 1960s, a growing number of
psychiatric patients have been treated
outside a centralized hospital or
institution and placed in treatment-care
clinics in the community.
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Psychiatric Drugs, Social Policy,
and Deinstitutionalization
• Although the policy of
deinstitutionalization has sparked great
debate and significant social problems
remain, there is a growing consensus
that mental-care treatment implemented
in this manner is superior to
institutionalization.
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