Psychobiology and psychotropic drugs order 4


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Mental health Fall '12

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Psychobiology and psychotropic drugs order 4

  1. 1. Biological Basis forUnderstandingPsychotropic drugs
  2. 2. Functions of the Brain Monitor Regulate Initiate and Maintain basic drives Mediate Store/Retrieve Think Language Process
  3. 3. Brain 101 Review• Neurons ▫ Neurotransmitters:  Dopamine: fine muscle movement, integration of emotion & thoughts, decision making  Norepinephrine: affects mood, fight/ flight response  Serotonin: sleep regulation, pain perception, sexual behavior & agression  Gamma-aminobutyric acid (GABA): plays role in inhibition, muscle relaxing properties  Acetylcholine: role in learning, memory, regulates mood, sexual drive
  4. 4. Anatomy of the brain• Major areas ▫ Brainstem ▫ Cerebellum ▫ Cerebrum ▫ Limbic System: This is the area that is located right above the brainstem which is responsible for controlling emotions
  5. 5. Cheat sheet• Serotonin: Depression or anxiety related• Norepinephrine: Bipolar (deals with flight or fight response), mania, anxiety• Dopamine: Schizophrenic disorders and ADHD• Acetylcholine: Alzheimers related• GABA: Anxiety disorders, Schizophrenia
  6. 6. Psychotropic Drugs• Basic Side Effects for Consideration: ▫ Changes in basic drives ▫ Sleep patterns ▫ Body movement ▫ Autonomic functions The ideal drug would relieve mental disturbance without inducing untoward mental or physical side effects!
  7. 7. On your own:• You may want to review the Brain Imaging Techniques (PET/ MRI/ CT) that are normally used for diagnostics.• Similarly your book describes the visual images that you can expect from the disorders we will be discussing.
  8. 8. Anti-AnxietyBenzodiazepine: binds GABAGABA: Primary inhibitory neurotransmitter in the brain that suppresses the ability of the neurons to fire. This results in CNS depression and reduction in anxiety, skeletal muscle spasms, alcohol withdrawal symptoms and seizures. -KLONOPIN -TRANXENE -VALIUM (diazepam) -ATIVAN (lorazepam) -XANAX (alprazolam)* NOT TO BE TAKEN WITH ALCOHOL & OTHER CNS DEPRESSANTSSide effects: sedation, drowsiness, dizziness, coordination problems BUSPAR (not a CNS depressant) ; has less sedative properties, much better tolerated than most benzos, no addictive potential
  9. 9. Bipolar DisorderManic Phase Drugs:Lithium-action is not fully understood but alters multiple neurotransmitters to normalize transmission of norepinephrine, dopamine, serotonin, acetylcholine*Lithium monitor for toxicity >2.5 can lead to death.ANTIEPILEPTIC DRUGS: Depakote (Divalproex)-alters GABA mediated neurotransmission Tegretol-anticonvulsant
  10. 10. Bipolar (con’t)Other Agents Valproate (Depakene)-antiepileptic Lamictal- antiepileptic Neurontin -antiepileptic Topamax- antiepileptic Klonopin (Clonazepam): a benzodiazepine used for anxiety, strong sedating properties; calms rapidly, used w/ Lithium ..however, clients can develop a tolerance and dependence
  11. 11. Typical Antipsychotic Drugs• Blocks attachment of Dopamine (typical)• Typical: phenothiazines becoming obsolete because of side effects and they only target Positive symptoms of Schizophrenia• Thorazine (most sedative)/ Haldol (least sedative)• Two Main Concerns: • The blockage of Dopamine can lead to extrapyramidal side effects such as; parkinsonism, dyskinesia, akathisia, muscle stiffness. • These agents cause severe anticholinergic effects
  12. 12. Atypical Antipsychotics• Binds to Dopamine receptors in the limbic system• Decrease motor side effects• Target positive and negative symptoms of Schizophrenia• Less side effects!!!- Clozapine (can cause agranulocytosis)- Risperidone- Olanzapine and Geodon
  13. 13. Antidepressant Drugs• Typical antidepressants:-Tricyclic (TCA’s)- Elavil- NortriptylineWork by blocking reuptake of norepinephrine and serotoninSide Effects: Anticholinergic in nature, this really affects compliance
  14. 14. Antidepressant Drugs• Selective Serotonin • Monoamine Oxidase Reuptake Inhibitors Inhibitors (MAOIs) (SSRIs) • -Marplan• -Prozac • -Nardil• -Zoloft • -Parnate• -Paxil* Effective yet: How this works: Monoamine*Less anticholinergic effects neurotransmitters are destroyed than TCA’s by the enzyme Monoamine oxidase; MAOI drugs inhibit the* Less sedative than TCA’s enzyme, so that the transmitters can get where they need to be.
  15. 15. Heterocyclic (Novel) Antidepressants• These differ structurally from the TCA’s, SSRI’s, and MAOI’s ▫ Wellbutrin (also used for smoking cessation by inhibiting the nicotinic acetylcholine receptors which cause the addiction) ▫ Effexor ▫ Cymbalta The novel antidepressants act differently because each acts on a different neurotransmitter or group of neurotransmitters