Download Biological Basis for Understanding Psychotropic Drugs

Chapter 3
Biological Basis for
Understanding Psychotropic
Drugs
Function of the Brain
• Maintenance of homeostasis
• Regulation of autonomic nervous system
(ANS) and hormones
• Control of biological drives and behavior
• Cycle of sleep and wakefulness
Function of the Brain
Continued
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Circadian rhythms
Conscious mental activity
Memory
Social skills
Cellular Composition
of the Brain
Neurons
• Respond to stimuli
• Conduct electrical impulses
• Release chemicals
– Neurotransmitters
Cellular Composition of the Brain
Continued
• Presynaptic neuron
synapse
postsynaptic neuron
• Transmitter destruction
– Enzymes
– Reuptake
Neuronal Action
Neurons can release more than one
chemical at the same time
• Neuropeptides
– Long-term changes in cells
• Neurotrophic factors
– Proteins
– Gases
• Effect of steroid hormones
Major Areas of the Brain
• Brainstem
• Cerebellum
• Cerebrum
Function of Brainstem
• Core – regulates internal organs and
vital functions
• Hypothalamus – basic drives and link
between thought and emotion and
function of internal organs
• Brainstem – processing center for
sensory information
Function of Cerebellum
• Regulates skeletal muscle
– Coordination and contraction
– Maintains equilibrium
Function of Cerebrum
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Mental activities
Conscious sense of being
Emotional status
Memory
Control of skeletal muscles –
movement
• Language and communication
Visualizing the Brain
• Structured imaging techniques
– Computed tomography (CT)
– Magnetic resonance imaging (MRI)
• Functional imaging techniques
– Positron emission tomography (PET)
– Single photon emission computed
tomography (SPECT)
Antianxiety and Hypnotic
Drugs
• Benzodiazepines
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Diazepam (Valium)
Clonazepam (Klonopin)
Alprazolam (Xanax)
Lorazepam (Ativan)
Antianxiety and Hypnotic Drugs
Continued
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Flurazepam (Dalmane)
Temazepam (Restoril)
Triazolam (Halcion)
Estazolam (ProSom)
Quazepam (Doral)
Antianxiety and Hypnotic
Drugs Continued
• Short-Acting Sedative-Hypnotic Sleep
Agents (“Z-hypnotics”)
– Zolpidem (Ambien)
– Zaleplon (Sonata)
– Eszopiclone (Lunesta)
Antianxiety and Hypnotic
Drugs Continued
• Melatonin Receptor Agonist
– Ramelteon (Rozerem)
• Buspirone (BuSpar)
Antidepressant Drugs
• Typical or standard antidepressants
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Tricyclic antidepressants (TCAs)
Amitriptyline (Elavil)
Imipramine (Tofranil)
Nortriptyline (Pamelor)
Antidepressant Drugs
Continued
• Selective serotonin reuptake
inhibitors (SSRIs)
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Fluoxetine (Prozac)
Sertraline (Zoloft)
Paroxetine (Paxil)
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluvoxamine (Luvox)
Antidepressant Drugs
Continued
• Serotonin-Norepinephrine Reuptake
Inhibitors (SNRIs)
– Venlafaxine (Effexor)
– Duloxetine (Cymbalta)
Antidepressant Drugs
Continued
• Serotonin-Norepinephrine Disinhibitors
(SNDIs)
– Mirtazapine (Remeron)
Antidepressant Drugs
Continued
• Monoamine oxidase inhibitors
(MAOIs)
– Phenelzine (Nardil)
– Tranylcypromine (Parnate)
– Selegiline (ENSAM)
Other Antidepressant Drugs
• Bupropion (Wellbutrin, Zyban)
• Trazodone (Desyrel)
Mood Stabilizers
• Lithium
• Anticonvulsant drugs
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Valproate (Depakote, Depakene)
Carbamazepine (Tegretol)
Lamotrigine (Lamictal)
Gabapentin (Neurontin)
Topiramate (Topamax)
Oxcarbazepine (Trileptal)
Antipsychotic Drugs
• First-Generation or Conventional
Antipsychotic Drugs
• Strong antagonists (blocking agents)
– Bind to D2 receptors
– Block attachment of dopamine
– Reduce dopaminergic transmission
First-Generation or Conventional
Antipsychotic Drugs
Continued
• Antagonists of receptors for
– Acetylcholine
– Norepinephrine
– Histamine
Atypical Antipsychotics
(Second-Generation)
• Bind to dopamine receptors in the
limbic system
– Preferentially over dopamine receptors
in neostriatal areas of basal ganglia
– Decrease motor side effects
Atypical Antipsychotics
Continued
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Clozapine (Clozaril)
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Ziprasidone (Geodon)
Aripiprazole (Abilify)
Paliperidone (Invega)
Other Drugs
• For Attention Deficit Hyperactivity
Disorder (ADHD)
– Methylphenidate (Ritalin)
– Dextroamphetamine (Adderall)
– Atomoxetine hydrochloride (Strattera)
Other Drugs
Continued
• For Alzheimer's Disease
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Tacrine (Cognex)
Donepezil (Aricept)
Galantamaine (Razadyne)
Revastigmine (Exelon)
Memantine (Namenda)
Herbal Medicine
• Major concerns
– Potential long-term effects
Nerve damage
Kidney damage
Liver damage
– Possibility of adverse chemical
reactions
With other substances
With conventional medications
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