Psychotropic Medications G505: Individual Appraisal

Antipsychotics 4 Phenothiazines 4 Uses –Treatment of schizophrenia and major affective disorders –Earliest psychotropic brought to market –Acts on acetylcholine, dopamine receptors –Fast acting – mg dose ranges

4 Side Effects –Drowsiness –Postural hypotension –Rapid heart beat –Extrapyramidal symptoms –Gait problems –Tardive Dyskinesia

4 Not physcially adictive 4 Tolerance issues 4 Potentiates with alcohol and other drugs 4 Examples –Thorazine –Stelazine

4 Low Dose Antipsychotics 4 Uses –Schizophrenia, major affective disorders, mood disorders, developmental disorders – mg dose range –Effects on serotonin and dopamine receptors –Not physically addictive –No tolerance issues

4 Side Effects –Generally same as phenothiazines –Potentiation effects –Toxicity issues

4 Examples –Melaril –Haldol

4 Atypical Neuroleptics 4 Uses –Major affective disorders –Developmental disorders –Headaches and sleep problems –Depression and anxiety

–Newest medications in this class – mg dose range –Sustained release forms available for some medications –Dosed by weight; low tolerance issues –Not addictive –Generally no potentiation effects

4 Side Effects –Anticholinergic effects in some cases –Weight gain! –insomnia –Sedation –Anxiety –Low libido –Toxicity issue with Risperdol

4 These meds don’t always work with everyone 4 Examples –Risperdol –Zyprexa

Antimanics 4 Uses –Control mood swings, manic/depressive cycles –Facilitate anger control in rage disorders –Control ADHD symptoms –Dose ranges /Lithium is –Not addictive –Tolerance issues, also precribed by body weight –No potentiation

4 Side Effects (Lithium) –Drowsiness –Nausea –Fatigue –Tremors –Thirst –Excessive urination –Weight gain –Thyroid dysfunction

–Toxicity issues 4 Sides (Tegretol and Depakote) –Gastrointestinal disturbances –Double vision –Anxiety –confusion

Antidepressants 4 Uses –Control depressive symptoms –Headache control –Control anxiety associated with various disorders and treatments for same –Various non-psychiatric uses

4 Types –MAO inhibitors –Tricyclics –SSRIs –Unicyclics and atypicals –All antidepressants take about 28 days, more or less, to begin their work

4 MAO inhibitors –Inhibit action of MAO in taking up transmitter substance in synapses between neurons – mg dse range –No tolerance –No addiction –Potentiation –Parnate, Marplan, Nardil are examples

4 Sides –Diet restrictions –Anticholinergic effects –Weight gain –Postural hypotension –Sexual sides –drowsiness –Insomnia –anxiety

4 Tricyclics –Block uptake of norepinephrine and dopamine – mg dose range –No tolerance –No addiction –Potentiation –Elavil, Tofranil. Anafranil are examples

4 Side effects –Same as MAOs without the diet retrictions –Depressive nightmares early in use

4 SSRIs –Most commonly prescribed –Often co-prescribed with stimulants in ADHD Tx –Blocks uptake of Serotonin – mg dose ranges –No tolerance, prescribed by weight –No addiction –No potentiation

4 Sides (there may be no sides for a given patient) –Anticholinergic (rare) –Sexual sides (fairly common) –Weight gain (very common) –Insomnia –anxiety

4 Atypicals and Unicyclics –Used to treat depression, anxiety,and various other problems, including smoking cessation (I.e.., Wellbutrin) – mg dose ranges –No tolerance –No addiction –No potentiation

4 Sides –Same as SSRIs but without sexual side effects –Examples are: Wellbutrin (also known as Zyban) Celexa Lexapro Remeron

Antianxiety (Benzodiazapines) 4 Uses –Treats acute anxiety and panic – mg dose range –Tolerance issues –Addiction issues –Potentiation issues

4 Side Effects –Weight gain –Irritability –Anxiety and panic –Tachardia

4 Examples –Xanax –Valium –Klonopin –Librium

Stimulants 4 Uses –Treatment of ADHD, autistic spectrum disorders –Stimulates CNS –SR forms dose ranges –Dosed by weight, not tolerance –Addictive –potentiation

4 Side Effects –Anxiety –Bruising –Disorientation –Agitation –Weight loss –Irritability –insomnia

4 Examples –Ritalin –Adderal –Dexadrine –Cylert –Concerta –Metadate

Nonsitmulant ADHHD medications 4 These are not stimulants 4 Effectiveness varies 4 Examples are: Straterra (new; actions and sides similar to Concerta) Tegretol Depakote Included here for convenience are antihistamines