AFFECTIVE DISORDERS Anxiety----uneasiness from apprehension and worry about possible events. Try psychotherapy first. benzodiazepenes: xanax/alprazolam valium/diazepam avitan/lorazepam equanil/meprobamate Adverse reactions: drug dependance, sedation, depression, possible birth defect, muscle relaxation

Anti-anxiety agents: Benzodiazepines=(lam/pam drugs) Mechanism of Action Benzodiazepines bind to benzodiazepine receptors in the CNS and act as agonists(activate). They enhance the action of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Reduce anxiety and panic. Cause sedation. Skeletal muscle relaxation Uses The short-term treatment of anxiety, panic attacks, insomnia, and alcohol withdrawal. Some benzodiazepines are used to treat seizure disorders.

Anti-anxiety agents: Barbiturates=(barbital/tal drugs) These drugs are the original sedative-hypnotics. They have been associated with a high rate of abuse and complete respiratory and cardiovascular depression. They are lethal in an overdose. Benzodiazepines have pretty much replaced barbiturates in treating anxiety, insomnia and panic because of their more acceptable safety profile. Barbiturates are used to treat seizure disorders and to induce general anesthesia. moa---like benzodiazepine but also help block glutamate, the principal excitatory CNS neurotransmitter. Butalbital=Fiorinal, Fioricet Phenobarbital=Lumina Thiopental=Pentothal

Depression feelings of pessimism, worry, sadness, reduced eating and sleeping, concentration. Types of antidepressants----- SSRI Tricyclic MAOI

Anti-depressant---SSRI SSRI--selective seratonin reuptake inhibitor moa---blocks reuptake of seratonin(brain neurotransmitter. reduced seratonin may affect mood. indications---major depression,obsessive-compulsion adverse effect---takes 2-3weeks to work, insomia, nervousness, diarrhea, weight loss, reduced libido

SSRI antidepressants celexa cymbalta prozac paxil zoloft effexor

Tricyclic antidepressant (TCA) moa--block reuptake of seratonin or norepinephrine(hormone and neurotransmitter most responsible for alertness ) indications--depression, bedwetting children adverse reactions---cardiotoxic in high dose, drowsiness, several weeks to work

Tricyclic antidepressant (TCA) Examples amytriptyline doxepin imipramine desipramine

MAOI antidepressant monoamine oxidase inhibitor catecholamines are monoamine---mostly epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine MAOIs act by inhibiting the activity of monoamine oxidase, thus preventing the breakdown of monoamine neurotransmitters and thereby increasing their availability. indications--atypical depression(real depression) adverse effect---hypertension, avoid certain wines,yeast,cheese. avoid ephedrine,levopoda

MAOI examples phenelzine---Nardil tranylcypromine---Parnate selegiline-----Eldepryl

Bipolar disorder swings between mania and depression lithium moa unknown….has sodium properties to generate action potentials, also enhance seratonin.watch salt diet. use carbamezepine more severe cases but interferes with many many drugs adverse reactions--bloating, abnomral fetus, increased weight, acne

Psychosis not living in reality,hallucinations, bizarre behavior dose varies drug to drug moa--affects neurotransmitters adverse reactions---sedation, bone marrow suppression, pseudoparkinson’s allow 6-12 weeks for improvement

Anti-psychotics haldol abilify compazine risperdal geodon prolixin