Transcript Psychotropic Medicaitons

Psychotropic Medications
G505: Individual Appraisal
Antipsychotics
 Phenothiazines
 Uses
– Treatment of schizophrenia and major affective
disorders
– Earliest psychotropic brought to market
– Acts on acetylcholine, dopamine receptors
– Fast acting
– 100 - 3000 mg dose ranges
 Side Effects
– Drowsiness
– Postural hypotension
– Rapid heart beat
– Extrapyramidal symptoms
– Gait problems
– Tardive Dyskinesia
 Not physcially adictive
 Tolerance issues
 Potentiates with alcohol and other drugs
 Examples
– Thorazine
– Stelazine
 Low Dose Antipsychotics
 Uses
– Schizophrenia, major affective disorders, mood
disorders, developmental disorders
– 5 - 50 mg dose range
– Effects on serotonin and dopamine receptors
– Not physically addictive
– No tolerance issues
 Side Effects
– Generally same as phenothiazines
– Potentiation effects
– Toxicity issues
 Examples
– Melaril
– Haldol
 Atypical Neuroleptics
 Uses
– Major affective disorders
– Developmental disorders
– Headaches and sleep problems
– Depression and anxiety
– Newest medications in this class
– 1 - 200 mg dose range
– Sustained release forms available for some
medications
– Dosed by weight; low tolerance issues
– Not addictive
– Generally no potentiation effects
 Side Effects
– Anticholinergic effects in some cases
– Weight gain!
– insomnia
– Sedation
– Anxiety
– Low libido
– Toxicity issue with Risperdol
 These meds don’t always work with
everyone
 Examples
– Risperdol
– Zyprexa
Antimanics
 Uses
– Control mood swings, manic/depressive cycles
– Facilitate anger control in rage disorders
– Control ADHD symptoms
– Dose ranges 20 -200/Lithium is 300 - 900
– Not addictive
– Tolerance issues, also precribed by body weight
– No potentiation
 Side Effects (Lithium)
– Drowsiness
– Nausea
– Fatigue
– Tremors
– Thirst
– Excessive urination
– Weight gain
– Thyroid dysfunction
– Toxicity issues
 Sides (Tegretol and Depakote)
– Gastrointestinal disturbances
– Double vision
– Anxiety
– confusion
Antidepressants
 Uses
– Control depressive symptoms
– Headache control
– Control anxiety associated with various
disorders and treatments for same
– Various non-psychiatric uses
 Types
– MAO inhibitors
– Tricyclics
– SSRIs
– Unicyclics and atypicals
– All antidepressants take about 28 days, more or
less, to begin their work
 MAO inhibitors
– Inhibit action of MAO in taking up transmitter
substance in synapses between neurons
– 100 - 1000 mg dse range
– No tolerance
– No addiction
– Potentiation
– Parnate, Marplan, Nardil are examples
 Sides
– Diet restrictions
– Anticholinergic effects
– Weight gain
– Postural hypotension
– Sexual sides
– drowsiness
– Insomnia
– anxiety
 Tricyclics
– Block uptake of norepinephrine and dopamine
– 10 - 100 mg dose range
– No tolerance
– No addiction
– Potentiation
– Elavil, Tofranil. Anafranil are examples
 Side effects
– Same as MAOs without the diet retrictions
– Depressive nightmares early in use
 SSRIs
– Most commonly prescribed
– Often co-prescribed with stimulants in ADHD
Tx
– Blocks uptake of Serotonin
– 10-200 + mg dose ranges
– No tolerance, prescribed by weight
– No addiction
– No potentiation
 Sides (there may be no sides for a given
patient)
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Anticholinergic (rare)
Sexual sides (fairly common)
Weight gain (very common)
Insomnia
anxiety
 Atypicals and Unicyclics
– Used to treat depression, anxiety,and various
other problems, including smoking cessation
(I.e.., Wellbutrin)
– 20-600 mg dose ranges
– No tolerance
– No addiction
– No potentiation
 Sides
– Same as SSRIs but without sexual side effects
– Examples are:
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Wellbutrin (also known as Zyban)
Celexa
Lexapro
Remeron
Antianxiety (Benzodiazapines)
 Uses
– Treats acute anxiety and panic
– .25 - 20 mg dose range
– Tolerance issues
– Addiction issues
– Potentiation issues
 Side Effects
– Weight gain
– Irritability
– Anxiety and panic
– Tachardia
 Examples
– Xanax
– Valium
– Klonopin
– Librium
Stimulants
 Uses
– Treatment of ADHD, autistic spectrum
disorders
– Stimulates CNS
– SR forms
10-150 dose ranges
– Dosed by weight, not tolerance
– Addictive
– potentiation
 Side Effects
– Anxiety
– Bruising
– Disorientation
– Agitation
– Weight loss
– Irritability
– insomnia
 Examples
– Ritalin
– Adderal
– Dexadrine
– Cylert
– Concerta
– Metadate
Nonsitmulant ADHHD
medications
 These are not stimulants
 Effectiveness varies
 Examples are:
• Straterra (new; actions and sides similar to
Concerta)
• Tegretol
• Depakote
• Included here for convenience are antihistamines