This document discusses psychopharmacology and summarizes key points about various classes of psychotropic drugs. It begins by explaining how the field of psychopharmacology has revolutionized psychiatric treatment since the 1950s with the introduction of drugs like chlorpromazine. It then outlines ideal characteristics for psychotropic drugs and classifies common types, including antipsychotics, antidepressants, mood stabilizers, anti-anxiety drugs, antiepileptics, and antiparkinsonians. For each class, it lists indications, examples of drugs, and common side effects.

1. PSYCHOPHARMA
COLOGY
Presenter
Ms Neha Bhatt
Ppt By Neha Bhatt

2. INTRODUCTION
 The treatment of psychiatric disorder's in past
constituted mere institutionalization then called the
asylums.
 At that time use of medicines were considered as
ridiculous. The arrival of psychopharmacology in
the last five and a half decades has brought the
treatment of psychiatric disorders in the territory of
scientific medicine.
 Introduction of chlorpromazine in 1952
revolutionized the treatment of psychiatric
disorders . Ppt By Neha Bhatt

3. IDEAL PSYCHOTROPIC DRUG
• Should cure underlying pathology.
• Should benefit all patients suffering from that
disorder.
• No side effects or toxicity.
• Rapid onset of action.
• No dependence or withdrawal symptoms on stopping.
• No tolerance to the drug on longer duration.
• Should not be lethal in overdoses.
• used in both inpatient and outpatient settings
Ppt By Neha Bhatt

4. CLASSIFICATION OF
PSYCHOTROPIC DRUGS
 Antipsychotics.
 Antidepressants.
 Mood stabilizing agents.
 Anti anxiety and hypnotics.
 Anti epileptics.
Antiparkinsonians.
Ppt By Neha Bhatt

5. PHARMACOLOGICAL ACTION
OF PSYCHOTROPIC DRUGS
• Agonist action at a receptor.
• Antagonist action at a receptor.
• Partial agonist action at a receptor.
• Action via second messengers.
• Altered neurotransmitter storage.
• Increased neurotransmitter release.
• Inhibition of neurotransmitter reuptake.
• Inhibition of endogenous metabolism.
Ppt By Neha Bhatt

6. ANTIPSYCHOTICS
Indications:
• organic psychiatric disorders ( delirium, dementia)
• functional disorders (schizophrenia , paranoid
schizophrenia )
• child psychiatric disorders( ADHD , autism, enuresis,
conduct disorder )
• Mood disorder ( mania)
• Neurotic and other psychiatric disorder(anorexia
nervosa )
• medical disorders( eclampsia , sever pain in
malignancy )
Ppt By Neha Bhatt

7. ANTIPSYCHOTICS
Classes of drugs:
• Phenothiazine (CPZ),
• Thioxanthines (Thiothixene),
• Butyrophenones (Haloperidol),
• Di-phenyl-butyl-piperidines (Pimozide),
• Indolic-derivatives (Molindone),
• Di-benzoxa-zepines(loxapine),
• Atypical Antipsychotics ( Clozapine, Amisulpride,
Risperidone, Olanzapine, Quetiapine, Aripiprazole)
Ppt By Neha Bhatt

8. SIDE EFFECTS OF ANTIPSYCHOTICS
• Autonomic side effects: dry mouth, constipation, urinary
retention, impotence, orthostatic hypotension.
• EPSE : parkinsonian syndrome, dystonia, akathesia,
neuroleptic malignant syndrome.
• Other CNS effects: seizures, sedation, depression or
pseudo-depression.
• Metabolic and Endocrine side effect: weight gain,
diabetes, galactorrhea with or without amenorrhea
• Allergic side effects: cholestatic ( obstructive) jaundice,
agranulocytosis.
• Cardiac , Ocular and Dermatological side effects.Ppt By Neha Bhatt

9. ANTI DEPRESSANTS
Indication:
• Depression,
• Child Psychiatric disorders ( ADHD, Enuresis etc.),
• Other Psychiatric disorders ( OCD, PTSD, alcohol
dependence panic attack , etc.),
• Medical
disorders ( chronic
pain, migraine, peptic ulcer disease).
Ppt By Neha Bhatt

10. ANTI DEPRESSANTS
Class of drugs:
–Tricyclic antidepressants
(imipramine,amitriptylline),
–SSRIs (fluoxetine, sertraline),
–Dopaminergic antidepressants ( fluvoxamine )
–Atypical antidepressants (amineptine)
–MAOIs -monoamine oxidase inhibitors ( trazodone)
Ppt By Neha Bhatt

11. SIDE EFFECTS OF ANTI-
DEPRESSANTS
• Autonomic side effects: dry mouth, constipation,
delirium, urinary retention.
• Sexual side effects: impotence .
• CNS effects: sedation, withdrawal syndrome, seizures.
• Cardiac side effects: Tachycardia, Arrhythmias.
• Allergic side effects: Agranulocytosis.
• Metabolic and Endocrine side effects.
• Toxicity
Ppt By Neha Bhatt

12. MOOD STABILIZING DRUGS
Indication:
• acute mania,
• prophylaxis for BPAD,
• neurological disorders,
• seizures,
• schizo - affective disorders
• paroxysmal pain syndrome.
• Class of drugs: Lithium , Valproate, Carbamazepine.
Ppt By Neha Bhatt

13. SIDE EFFECTS OF MOOD
STABILIZERS
• LITHIUM: therapeutic level – 0.6-1.2 mEq/L
prophylaxis – 0.6-1 mEq/L
toxic -- >2 mEq/ L
• Neurological (tremor, muscular weakness, neurotoxicity),
renal (polyuria, polydipsia),
• cardiovascular (T- wave depression: coronary ischemia)
• endocrine (goiter, hypothyroidism, abnormal thyroid
function, weight gain),
• G I effects (nausea, vomiting, diarrhea, metallic taste and
abdominal pain),
• side effect during pregnancy and lactation (teratogenicity,
secreted through milk)
Ppt By Neha Bhatt

14. SIDE EFFECTS COnT.….
•Valproate : nausea, sedation, tremor, weight
gain, thrombocytopenia, menstrual
disturbances, hair loss.
• Most serious but relatively uncommon side
effects include hepatic toxicity, acute
hemorrhagic pancreatitis.
•Dialysis is the management during overdose
Ppt By Neha Bhatt

15. SIDE EFFECTS COnT.…..
• Carbamazepine: diplopia, drowsiness, dizziness,
photosensitivity, hypertension, leucopenia etc.
• The most dangerous side effects include bone
marrow suppression and cardiovascular
collapse
Ppt By Neha Bhatt

16. AnTI AnXIETY AnD HYPnOSEDATIVES
Indication:
• generalized anxiety disorder,
• panic disorder,
• insomnia,
• narcoanalysis,
• premedication in anesthesia etc.
Ppt By Neha Bhatt

17. AnTI AnXIETY AnD HYPnOSEDATIVES
• Classification:
• barbiturates (phenobarbital, thiopentone),
• Non barbiturates,
• Non-benzodiazepine anti anxiety agents(ethanol,
chloral hydrate, propranolol),
• benzodiazepines( midazolam, alprazolam,
diazepam, clonazepam)
Ppt By Neha Bhatt

18. SIDE EFFECTS
• Nausea, vomiting, weakness, epigastric pain,
vertigo, impotence, sedation, dry mouth, irritability,
dis-inhibited behavior, dependence and
withdrawal.
• Commonly abused drugs are from this group
Ppt By Neha Bhatt

19. ANTI EPILEPTICS
• Indication: seizures.
• Drugs: phenytoin sodium, clonazepam,
diazepam, lorazepam, carbamazepine,
valproate sodium, lamotrigine, gabapentin.
Ppt By Neha Bhatt

20. SIDE EFFECTS OF ANTI EPILEPTICS
Phenytoin sodium:
•Delirium, nystagmus, ataxia, incoordination,
dysarthria, hand tremors
•Skin rash, toxic epidermal necrolysis.
•Cerebellar atrophy, peripheral neuropathy,
•Gingival hyperplasia.
Ppt By Neha Bhatt

21. SIDE EFFECTS OF ANTI EPILEPTICS
• Phenytoin sodium:
Ppt By Neha Bhatt

22. ANTI PARKINSONIAN
• Indication: Parkinson's disease, prevent
EPS.
• Class of drugs: THP ( tetrahydropalmatine),
Levodopa and carbidopa, selegiline,
pramipexole.
Ppt By Neha Bhatt

23. SIDE EFFECTS OF ANTI PARKINSONIAN
• THP: Drowsiness, head ache, vertigo, sleep disturbance,
mydriasis with or without photo phobia, blurred vision,
dry mouth.
• Levodopa: hypotension, arrhythmias, nausea, hair loss, G
I bleed, dis orientation and confusion. Chronic use leads
to on/off oscillation, dyskinesia, freezing during
movement, drug resistance.
Ppt By Neha Bhatt

24. Ppt By Neha Bhatt