1. Psychotropic Medications G505: Individual Appraisal

2. Antipsychotics 4 Phenothiazines 4 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

3. 4 Side Effects –Drowsiness –Postural hypotension –Rapid heart beat –Extrapyramidal symptoms –Gait problems –Tardive Dyskinesia

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

5. 4 Low Dose Antipsychotics 4 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

6. 4 Side Effects –Generally same as phenothiazines –Potentiation effects –Toxicity issues

7. 4 Examples –Melaril –Haldol

8. 4 Atypical Neuroleptics 4 Uses –Major affective disorders –Developmental disorders –Headaches and sleep problems –Depression and anxiety

9. –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

10. 4 Side Effects –Anticholinergic effects in some cases –Weight gain! –insomnia –Sedation –Anxiety –Low libido –Toxicity issue with Risperdol

11. 4 These meds don’t always work with everyone 4 Examples –Risperdol –Zyprexa

12. Antimanics 4 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

13. 4 Side Effects (Lithium) –Drowsiness –Nausea –Fatigue –Tremors –Thirst –Excessive urination –Weight gain –Thyroid dysfunction

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

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

16. 4 Types –MAO inhibitors –Tricyclics –SSRIs –Unicyclics and atypicals –All antidepressants take about 28 days, more or less, to begin their work

17. 4 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

18. 4 Sides –Diet restrictions –Anticholinergic effects –Weight gain –Postural hypotension –Sexual sides –drowsiness –Insomnia –anxiety

19. 4 Tricyclics –Block uptake of norepinephrine and dopamine –10 - 100 mg dose range –No tolerance –No addiction –Potentiation –Elavil, Tofranil. Anafranil are examples

20. 4 Side effects –Same as MAOs without the diet retrictions –Depressive nightmares early in use

21. 4 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

22. 4 Sides (there may be no sides for a given patient) –Anticholinergic (rare) –Sexual sides (fairly common) –Weight gain (very common) –Insomnia –anxiety

23. 4 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

24. 4 Sides –Same as SSRIs but without sexual side effects –Examples are: Wellbutrin (also known as Zyban) Celexa Lexapro Remeron

25. Antianxiety (Benzodiazapines) 4 Uses –Treats acute anxiety and panic –.25 - 20 mg dose range –Tolerance issues –Addiction issues –Potentiation issues

26. 4 Side Effects –Weight gain –Irritability –Anxiety and panic –Tachardia

27. 4 Examples –Xanax –Valium –Klonopin –Librium

28. Stimulants 4 Uses –Treatment of ADHD, autistic spectrum disorders –Stimulates CNS –SR forms 10-150 dose ranges –Dosed by weight, not tolerance –Addictive –potentiation

29. 4 Side Effects –Anxiety –Bruising –Disorientation –Agitation –Weight loss –Irritability –insomnia

30. 4 Examples –Ritalin –Adderal –Dexadrine –Cylert –Concerta –Metadate

31. 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