PSYCHOTROPIC medication presentation.pptx

PSYCHOTROPICS

1. PSYCHOTROPIC DRUGS BY - SHALOM NWACHUKWU

2. OUTLINE Introduction. Classification Antipsychotics Antidepressants Mood stabilizers Anxiolytics Sedative-hypnotics Risks and drug interaction

3. Psychotropic drug, in pharmacology, is any agent that induces changes in awareness, behaviour, mood, perception, or sensation. There are five main types of psychotropic medications: antidepressants, anti-anxiety medications, stimulants, antipsychotics, and mood stabilizers. They may also sometimes be referred to as psychiatric medications or psychotherapeutic drugs. Psychotropic drugs exert their actions by either mimicking the effects, blocking the activity, or altering the storage, release, or uptake of neurotransmitters Psychotropic medications are not a cure. They can only treat mental health disorders, and they are sometimes most effective when combined with psychotherapy. introduction

4. ANTIPSYCHOTICS (NEUROLEPTICS) Antipsychotics are a group of substances used primarily to treat schizophrenia, psychosis, mania, delusions, and states of agitation. Antipsychotic drugs are subdivided into typical and atypical antipsychotics. Typical antipsychotic drugs (first-generation antipsychotics) work by blocking dopamine receptors The mechanism of action of atypical antipsychotics, sometimes called second-generation antipsychotics, is less clear, though they seem to inhibit various neurotransmitters, particularly acetylcholine, dopamine, norepinephrine, or serotonin.

5. - First generation “typicals”, used mainly for positive symptoms such as delusions and hallucinations. First generation have higher risk of EPS (Extra Pyramidal Symptoms): muscle spasms, tardive dyskinesia (irregular, jerky movements), parkinsonism (rigidity, speech changes), akathisia (restlessness, unable to sit still, need to move around to feel relief) -Second Generation “atypicals”, used to treat negative symptoms flat affect, apathy anhedonia as well as positive symptoms Less EPS symptoms but still possible, Greater metabolic effects, weight gain, hypertension, increase risk of diabetes

6. SIDE EFFECTS Extrapyramidal symptoms: due to blockade of D2 receptors: acute dystonia, akathisia, and tardive dyskinesia, are the most common side effects of first-generation antipsychotics. Metabolic side effects (e.g., weight gain, insulin resistance) are more typical of second-generation antipsychotics. Neuroleptic Malignant Syndrome (NMS) is an emergency complication and it can occur with both first and second gen antipsychotics.

7. Antidepressants Depression is a mood disorder and is likely caused by a combination of genetic, biologic, and environmental factors. In terms of the biologic basis, there is an abnormality in neurotransmitters in the brain Neurotransmitters are natural chemicals in the brain that affect mood and emotional response. Antidepressant medications work to balance these chemicals. Serotonin, Norepinephrine, and Dopamine are 3 neurotransmitters that are involved in depression. All antidepressants achieve their effects by inhibiting the body’s reabsorption or inactivation of monoamine neurotransmitters, thus allowing the neurotransmitters to accumulate and remain in contact with their receptors for prolonged periods of time Side effects include: constipation, weight gain, low libido, dry mouth

8. MOOD STABILIZERS A group of drugs used to treat acute episodes of mania and depression and to prevent relapses of manic, hypomanic, or depressive episodes in patients with bipolar disorder and schizoaffective disorder. Drugs used to stabilize mood work in a variety of ways. Lithium reduces the excitatory activity of dopamine and glutamate and increases the inhibitory activity of GABA. Carbamazepine, an anticonvulsant drug, modulates inhibitory effects of neurons by altering the activity of voltage-gated ion channels, including those involved in the conductance of calcium, potassium, and sodium.

9. ANXIOLYTICS Anti-anxiety medications treat an array of anxiety disorders. These medications can be used to treat panic attacks, phobias, generalized anxiety, and various anxiety-related symptoms. A variety of substances grouped together based on their anxiety-reducing properties. Agents of several drug classes have anxiolytic effects. 1. Benzodiazepines- alprazolam,chlordiazepoxide, diazepam. 2. Azapirones -Buspirone, Ispapirone, gepirone 3. Beta blockers - Propranalol 4. Sedative antihistaminic - Hydroxyzine 5. Carbamates - Meprobamates

10. SEDATIVE-HYPNOTICS Sedative-hypnotics are a class of drugs that depress CNS function, inducing sedation, sleep, and unconsciousness with increasing dose. They include benzodiazepines, nonbenzodiazepine hypnotics (Z-drugs), barbiturates, and melatonin agonists. Most sedative-hypnotic drugs increase GABAergic transmission, except for melatonin agonists, which act on hypothalamic melatonin receptors.

11. STIMULANTS Stimulants can be prescribed for a variety of neurological or physiological conditions e.g for attention deficit hyperactivity disorder (ADHD), narcolepsy, Hyperphagia. Stimulants encompass a wide variety of prescription and recreational drugs that are used to enhance arousal and/or alter mood and awareness. They can have the potential for dependence and substance misuse..

12. SIDE EFFECTS Common side effects result from excessive CNS depression and include confusion somnolence respiratory depression. Long-term use of sedative-hypnotics is associated with a risk of tolerance and seizures during withdrawal.

13. SIDE EFFECTS Most stimulants achieve their desired neuropsychiatric effect by increasing the concentration of synaptic neurotransmitters in the central nervous system, but a simultaneous increase of neurotransmitters in the peripheral nervous system can cause generalized sympathetic nervous system hyperactivity such as Hypertension, Tachycardia and/or tachyarrhythmias Hyperthermia Tachypnea, Diaphoresis, Mydriasis Psychomotor agitation: anxiety, agitation, psychotic symptoms, e.g., delusions, hallucinations Seizures and/or dyskinesias hyperactive bowel sounds, nausea, chest pain, abdominal pain Risk for addiction

14. Risks & Precautions for Psychotropic Medications Antidepressants: These psychotropic medications carry an increase in suicidal thoughts for certain people, especially younger patients. Benzodiazepines: These medications have a risk of abuse or misuse, risk of physical dependence, and risk of serious side effects, including death, when combined with an opioid. Stimulants: These medications have a serious risk of abuse and misuse. Antipsychotics: These medications can increase the risk of death when used in elderly patients with dementia. Taking a medication that interacts with a psychotropic medication can be very dangerous. It can cause severe reactions with deadly side effects, or cause the medications not to work as prescribed. Some common drugs and substances that can interact with psychotropic medications include: Alcohol Opioids Serotonergic medications Seizure medications Asthma medications Drug Interactions with Psychotropic Medications

15. References MedEd PPD: http://www.mededppd.org/psychiatric-drugs/ MGH Center for Mental Health: http://www.womensmentalhealth.org/ National Institute of Mental Health: http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml