Psychotropic Drugs |. ‘Antipsychotics The Classical and Atipycal Mood Stabilizers orb 22.4.2015 Psychiatric disorders iain Sloe (etorest er eee eee Aisa (rare ro ree meer 3) ghitinegton eo der chy brent eel 4) Diora bse (upland, shioaftchecnoes Psychic integration disorders + Invaded perception andor thinking processes siminished espacity to process infoand draw logical conclusion + Inabliey perceive he reality and o react nan equatemannertoa situation (eg aggression) + Hallucinations pereetionsin the absence of stil + Asean impression hat has no based + Auditoy sl, tate, ofctory, gustatory. somatic, Krnei ae Psychic integration disorders ieee inate teen ears nares Sel eis eid ches che agence gal aaeelacdear Super ee Pere aaa yee erage Sea fatersn abnormality eared ems + azar, nombizare, mond-songruent mood-neuea Late Paraphrenia nanioratecive css ‘Tends tobe es damage to personality rtemeticnl Taponsienen- no st erage appropiate tite allucinaton maybe experiened in several modalities + Delusonalihinkng=seristeratized delusons- et rate) eed nel seecrnees + In eaion tothe content ofthe dlesons Uniertndsbledturances of behavior not duetba primary Schizophrenia + Devastating disease with prevalence approx in population worldwide + Onsat often in adolescence or young adulthocd (very earlyoneet schizophrenia + Strong genetic component filial incidence high 8nd 4o to 50% concordance in monocytic ewins + Disturbances of thinkingand affect. impaired behavior fncton «+ Recurrent acute epizodes which may develop into comic diseaseSchizophrenia— symptoms + Basins hallacntions, delsons. ages. 1 Negri apti. tf acy neg. amc ‘anton nre inany socal ani, farce sg * Goes oneal of ane. otinb pocamng es lhigernasning met —tletsn cl ancien otcone Ral econsequenes 22.4.2015 Schizophrenia - aeti + unknown cal recpnig fasorerecgd + Neuetpmentlmodelimgledand mulated that he diseases tggeed by some i Experiences in ndidalspreapesed by anabors {Grochemical/anantomieal) mesolimbic stem + Dopamine hypothesis of schizophrenia~conceptof Underying neurochemical disorder Substance-induced psychosis ‘Symptoms development 2a dugsubtance use 23 Mian owns) ‘ghegmsctgwe mont te Substance-induced psychosis lage madaon nde) ‘teins ‘Selena ‘Medical conditions states, Eo mig, est ato rs, Antipsychotics * Chlorpromazine * Bate spe ith amigo action vigil for seein iPaic) + acon claus The gute arcen + Rebaed decor sera pechorrgey.insin sates + Bénin rinegaton feel bane + caramine cael" —tocorpre the le Antipsychotics - Uses X Indications + Acuteand chronic symptoms (poste, negate) Cognitive defcitand afer omponcnt eacepiaa + Otherevcted porches: Bipot dsraer zat drier reed eee {cum neler + Obie compaie dod + Sceseaptatonand pc22.4.2015 >= Antipsychotics - Uses X Indications * Disrupt behavior in chidsen * Disruptive behavourineldery * Dyskinsia and abnormal movements (Huntington's tres syndron sues Tourete) + Premelation lore anesthe oa fe} omits, ene, + Neurleptanslgsia augmentation of analgsis * Anorexia nerens, Bulimia + Poteniatnganemetic effects terminal ines with pied + Singleus Antipsychotic agents 2) Cassel greton coment lacie igh pony) 2 Sele le ty Iw mig ici ihe de 2) Atypical {SDA sratonindoamine antag MARTA mutating mer pd gets {Parca dopamine aeage , | Classical Antipsychotics Seda heise: Oeeon Meisner oes eeprom mseacry)—* ase hese ee (Gloag Peni 2p czonDION) Poste eo wks Final RAO ines eta IRON Classical Antipsychotics Mechanism of action Bloclade af dopaminergic neuctransmission in mesolimbic, mesocrta, igotritaland tuberainfindibulersytem Four dopaminergic pathways inthe brn PClassical Antipsychotics Mechanism of action Ae ava eng cfecr ntonceeo ea i) daapeien opts aererotins imesocorbealsjstem improvementaf posite 2) ‘ockade ofthe postsynaptic aD, receptors in acu, (nschiophreniaupregatd) Aouingchatictheshali:rinimal occupancy 90-6 ‘frorethan Bo ES) (Characteristics of binding tight, long-term Classical Sedative Antipsychotics Receptor pofiesof sedative antipsychotic agentsClassical Incisive Antipsychotics Receptar profiles of incisive antipsychticagents 22.4.2015 fassical Antipsychotics ‘Mechanism of Action — Clinical Features + Bau symptoms highefieacy ‘Negatseand dense smptnms (hypodopamsinerpe ‘Eee prfronta carta) let oF mosening ‘dopamine Hock) agnitinedetcit~ deepening + Aloclae of dopamine neurstranamision in {useranfundifea and higher Hackage na migtritl ‘peter adverse ets + Anat etait tens Nain trecalreenpcand anicholnegirecepors “adverse fier | Antipsychotics Adverse effects Doane tno noi ste ph Dene *Aete ptoia-wrmtaliesvement anterior of ‘ex eatiockcepetnne movements abnormal posure ‘Aathsa rete nt + aking = sah my Teen ee ee eee a fassical Antipsychotics Adverse effects Dopamine antagonism in tuberoinfundibula system: yperprolactinaemia: Endocrine signe: Sena dpfurcsion = Amenores, lsctorhee, + Lene of bio + Deiayed acuation + Erectledysfanetion, impotence Papin + oferty Ee fassical Antipsychotics Adverse effects Nearoepte Malignant yrdrome “Wesiveening compan, medil emergency (es pret moral) + sonra Symp 2" Htperterinfce 1 bike muah sees enrapyraidlets 1 nononie daft” nexened ood pesreand Peat ‘ate cee + Sup Dali, Coma “Rrra: temecargdacosinuationfaphotis, Bisidarte malig dope sgn (beepers SR Ide en) fassical Antipsychotics Adverse effects Lippert 1 nents ‘Senin derifassical Antipsychotics Adverse effects Otherside etfecs: + Cardia dysrythmia,Tosade de pointes + Seinures + Impaired hepatic function sos (relatively uncommon except fom rembocytopenia) + nreased fod intake + Weightanin 22.4.2015 ‘antipsychot Mechanism of Aetion ‘What Makes them Atco: *).Extrasteatal selectivity in blockade of D receptors 2) ining es tight, shore (clozapine, quetiapine) J ‘medium (olanzapine, sertindol2iprasidon half 3). Additional pharmacological activity (arieswith the rug): Benefits: agonists antagonists on M-rep ‘cognitive Fonction) amtagonistson 5-H. agonists on 5-H rep (negativeand depresivesympxoms) ——— pical antipsychotics Mechanism of Action Receptor Pofilesof Atypical Antipsychotes Mechanism of Aetion What Makes them Atypical Sezatne stoning mecanion 1 Blockade prsyapicD rep impel carer ghee ‘these Sopamierese S 3) clade Hic ep reeset wrote hh fet dopo rrsmtionn msacarialosten agher ‘dpomine cy rere easy candon Bochade 1c» Dan rena: depree cgnkve spe provement Laver incidence f expla hyperrlacinaemia Bee tkrance, perme Ee = eal antipsychotics. D4? antagonists paseo ee ees HEP Cicicainis Bidaiern ees nen 5 Sthtonedowsormicoos "ser > Gites md oo ‘Atypical antipsychotics SDA serotonine-dopamine antagonists Wistendane Boe a > Sa zis ten emeenrsen demesne > semicon‘Atypical antipsychotics SDA. serotonine-doparnine antagonists rade Teeyeehotseamphenssaine re > Maar ie pode bp salen eerste > Leer et decay ght nna > Prone QT neal ei mato) dee dope Mar RTA multi-acting receptor trgoted agents Clnapine(LEPONED) ‘Reseed for sevre efexctory schizophrenia and poposiedcvder ssn other tp hots agen Rot indcted in chron younger than re > Wt ta spay ieik t sBhpmchotes sa) inrerteeston > Ae shen eee pasion ‘Atypical antipsychotics [MARTA multi-acting receptor targeted agents Oaeapne 2YPRERA) PSthizphvena| 5 Nae pies BP, maintenance therapy reaps Maciceaaa see > fisted ere, RRS ees Sa esi "Batemans ena ahem ‘Atypical antipsychotics MARTA mult-actng receptor targeted agents Quetiapine 2Not indicated in patients younger years > Pacients over 65 years 030 - 50% lower clearence ~ Imporant slower dose ization after initiation 1 Dase 0-50 mgiday > Drug Interactions: Hepatic enzyme inducersand inducers of P450 34 ‘Atypical antipsychotics MARTA mult-acing receptor targeted agents ‘an ovoid are Seema as neta coe ea ‘Atypical antipsychotics Dopamine Agonist Speen ee ee a ce eee EIT acre geaenieenee Cee rm22.4,2015 Administration and Therapy ‘Lenght ofthe treatment nt easy etimate 1 Choieof the antpeyshotc gent determine by clinical state=monotherpy combination - medication + Cina evaluationof the phatmacoothenapy posible afer seeks: + Compliance ot eoperting patent depot formulas, Sota, Vlora * Acute phase ~ compensation ~ preventing lap omens eset) Interactions of Antipsychotics + Aaland oker ON peat ethane edt “Tee dopand anne cand Tad kc anthers ha pk ed + ean cro nepal tsa Soar dnt isontan gests —dpanineagonite incre tsofseunieiemaisantyaone ibamaaopie Pande eel aor aA nds ebrf CY 4 Thank you for your attention ‘Aad CU nestor.