Download Psycho-Pharmacology

Isahel N. Alfonso, R.N
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Selective Serotonin Reuptake Inhibitor (SSRI)
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Fluoxetine
Fluvoxamine
Paroxetine
Sertraline
Citalopram
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Tricyclic Compound (TCA)
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Impiramine
Despiramine
Amitriptyline
nortriptyline
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Doxepine
Trimipramine
Protriptyline
Maprotiline
Mirtrazapine
Amoxapine
Clomipramine
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Monoamine Oxidase Inhibitors (MAOI)
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Phenelzine
Tranylcypromine
Isocarboxazid
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Indication:
Treatment of major depressive disorder, anxiety disorder, depressed phase of bipolar
disorder and psychotic depression.
Off-label uses: Treatment of chronic pain, migraine, peripheral and diabetic
neurophaties, sleep apnea, certain dermatologic disorders, panic disorder and eating
disorder.
Mechanism of Action
Interacts with norepinephrine and serotonin that are responsible for arousal, attention,
mood and appetite.
SSRI’s block serotonin uptake
Cyclic antidepressants and venlafaxine primarily blocks norepinephrine and to some
extent serotonin.
MAOI’s interfere with enzyme metabolism.
Antidepressants take effect in: SSRI- 2-3 weeks, Cyclic-4-6 weeks, MAOI- 2-3 weeks
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SSRI: Anxiety, agitation, akathisia, nausea, insomnia, Sexual dysfunction,
diminish sexual drive, difficulty achieving orgasm, erection, weight gain,
sedation, sweating, hand tremors, headache and diarrhea.
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TCA: Dry mouth, Constipation, urinary hesitency/retention, Dry nasal
passages, Blurred vision, Agitation, Delirium, Orthostatic hypotension,
Sedation, Weight gain, Tachycardia, Sexual dysfunction
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MAOI: Daytime sedation, Insomnia, Weight gain, Dry mouth,
othostatic hypotension, Sexual dysfunction, hypertensive crisis.
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Lithium, Carbamazipine, Valproic, Gabapentin, Topiramate, Oxcarbazepine,
Lamotigrine.
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Indication: Treatment of bipolar disorders and acute episode of mania
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Mechanism of Action:
Lithium normalizes reuptake of serotonin, norepinephrine, acetylcholine and
dopamine.
Valproic acid and Topiramate increases GABA level.
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Lithium: Nausea, Diarrhea, Anorexia, Fine hand tremor, Polydipsia, Polyuria, Metallic
taste in mouth, fatigue, Lethargy and weight gain.
Therapeutic serum level: 0.6-1.2 mEq/L
Mild to moderate toxic reactions: 1.5-2 mEq/L
Moderate to severe toxic reactions: 2-3 mEq/L
Toxic effect: Severe diarrhea, vomiting, drowsiness, muscle weakness and lack of
coordination, coma and death if serum level is >3 mEq/L
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Carbamazepine and Valproic Acid: Drowsiness, sedation, dry mouth, blurred vision,
othostatic hypotension, weight gain, alopecia and tremor
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Carbamazepine and Valproic Acid: Drowsiness, sedation, dry mouth, blurred vision,
orthostatic hypotension, alopecia, weight gain, tremor
Toparimate: Dizziness, sedation, weight loss, increased incidence of renal calculi
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Benzodiazepinez
Alprazolam
Chlordiazepam
Clonazepam
Chlorazepate
Diazepam
Flurazepam
Lorazepam
Oxazepam
Temazepam
Triazolam
Non-benzodiazepines
Buspirone
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Indication
Use to treat anxiety and anxiety disorders, insomnia, obsessive compulsive disorders,
depression, post traumatic stress disorder and alcohol withdrawal
Mechanism of Action
Benzodiazepines mediate the actions of the amino acid GABA
Buspirone acts as a partial agonist at serotonin receptors which decreases serotonin
turnover.
Side Effects
Can cause physical dependency, drowsiness, sedation, poor coordination, impaired
memory and clouded sensation
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Methylphenidate
Dextroamphetamine
Amphetamine
Pemoline
Selective Norepenephrine Reuptake inhibitor
Atomoxetine
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Indication
For treatment of attention deficit hyperactive disorder and narcolepsy.
Mechanism of action
Acts as cortical and RAS stimulants by increasing the release of norepinephrine,
dopamine and serotonin from the presynaptic neurons and block their reuptake.
Paradoxical effect of calming hyperexcitability through CNS stimulation is related to
increase stimulation of an immature RAS (Receptor alpha stimulants).
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Adverse Reactions: Nervousness, Insomnia, Dizziness and headache, blurred vision,
Nausea, vomiting, hypertension, arrhythmia and angina
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Side Effects: Anorexia, weight loss, nausea, irritability, growth and weight
suppression