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Antipsycho, Antidep, Anxiolytics
Antipsycho, Antidep, Anxiolytics
Psychotropic drugs
Psychoses [Schizo,Mania, depression] Severe mental illness Not in touch with reality Hallucinations Delusions Abnormal behaviour Antipsychotics, Antidepressants, Antimanic drugs
Anxiety disorders [Neuroses] Less severe(Extreme suffering) In touch with reality ANXIOLYTICS
Antipsychotics
Classical: 1. Phenothiazines Aliphatic---Chlorpromazine Triflupromazine Piperidine---Thioridazine PiperazineTrifluperazine, Fluphenazine 2. Butyrophenones Haloperidol, Trifluperidol, Penfluperidol, 3. ThioxanthinesFlupenthixol 4. OthersPimozide, Loxapine Atypical Clozapine Risperidone Olanzapine Quetiapine Aripiprazole Ziprasidone
Antipsychotics Chlorpromazine[CPZ]
Beneficial Antipsychotic effect ADEs Extrapyramidal effect Galactorrhoea, Gynaecomastia Anticholinergic Hypotension Weight gain,sedation Arrhythmia
Actions of CPZ
In Normal person: Indifference to surroundings, Psychomotor slowing, Drowsiness, Unpleasant effects Neuroleptic syndrome* In psychotics Reduces irrational behaviour Aggression and agitation Psychotic symptoms Sedation-Tolerance develops
Extrapyramidal effects
1. Parkinsonism 2. Acute muscle dystonia 3. Akathisia 4. Malignant neuroleptic syndrome 5. Tardive dyskinesia Other ADEs Cholestatic jaundice, Agranulocytosis, Myocarditis
Uses of antipsychotics
Psychoses [Scizophrenia] a. Atypical preferred[Less adverse effects, more effective in negative symptoms] Antiemetic Intractable hiccough Mania
Antipsychotics
Classical More action on DA receptors Effective in positive symptoms More adverse effects Atypical Less. More in 5HT Effective in negative symptoms Less ADEs
Antidepressants
MAO-inhibitors Moclobemide Tricyclic antidepressants Imipramine, Amitriptyline, Selective Serotonin Reuptake Inhibitors Fluoxetine, Fluvoxamine Atypical Trazodone, mianserin
Antidepressants ADEs
Anticholinergic effect Sedation Weight gain Postural hypotension Cardiac arrhythmias
No extrapyramidal effects!
Antidepressants- uses
Endogenous depression Obsessive compulsive- neurosis[OCN] Phobias Neuropathic pain Enuresis Migraine
Anxiolytics[Antianxiety]
1. Benzodiazepines[Acts on GABA Rec] Diazepam, Alprazolam, Lorazepam 2. Azapirones Buspirone-Acts on 5HT receptors 3. Betablocker Propranolol [Used in symptoms of anxiety]
Anxiolytics -ADEs
1. Benzodiazepines Dependence, sedation, vertigo, confusional states Flumazenil-effective antagonist available 2. Azapirones Nausea, dizziness, sedation 3. Betablocker Bradycardia, bronchospasm, masking of symtoms of hypoglycemia
Anxiolytics -uses
Benzodiazepines
Anxiolytics, Sedativehypnotics, Anticonvulsants Pre anaesthetic Muscle relaxant
Azapirones [Buspirone]
Anxiolytics,
Anxiety
Anxiolytics -uses
1. Anxiety is normal response 2. It helps in vigilance & drive 3. Require treatment-when performance is affected [Alprazolam, buspirone] 4. Require treatment to control symptoms of anxiety [Betablockers]