antipsycho, antidep, anxiolytics
TRANSCRIPT
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
1/18
Dr.U.P.RathnakarMD. DIH. PGDHM
Psycho pharmacologyAntipsychotics
AntidepressantsAnxiolytics
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
2/18
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(Extremesuffering)
In touch with reality
ANXIOLYTICS
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
3/18
Antipsychotics
Classical:
1. Phenothiazines Aliphatic---Chlorpromazine
Triflupromazine
Piperidine---Thioridazine PiperazineTrifluperazine,
Fluphenazine2. Butyrophenones
Haloperidol, Trifluperidol,Penfluperidol,
3. ThioxanthinesFlupenthixol4. OthersPimozide, Loxapine
Atypical Clozapine Risperidone Olanzapine
Quetiapine Aripiprazole Ziprasidone
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
4/18
Antipsychotics
Chlorpromazine[CPZ]
Beneficial
D2 Blockade
ADEs D2 Blockade
Muscarinic block
Adrenergic block
H1 Block
Direct on heart
Beneficial
Antipsychotic effect
ADEs Extrapyramidal effect
Galactorrhoea,
Gynaecomastia
Anticholinergic Hypotension
Weight gain,sedation
Arrhythmia
MOA & Pharmacological actions
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
5/18
Actions of CPZ
In Normal person:
Indifference tosurroundings,
Psychomotorslowing,
Drowsiness,
Unpleasant effects- Neuroleptic
syndrome*
In psychotics
Reduces irrationalbehaviour
Aggression andagitation
Psychotic symptoms
Sedation-Tolerancedevelops
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
6/18
ADEs effects of CPZ
Extrapyramidal effects1. Parkinsonism
2. Acute muscle dystonia3. Akathisia
4. Malignant neuroleptic syndrome
5. Tardive dyskinesia Other ADEs
Cholestatic jaundice, Agranulocytosis,
Myocarditis
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
7/18
Uses of antipsychotics
Psychoses
[Scizophrenia]
a. Atypical
preferred[Less adverseeffects, more effective
in negative symptoms]
Antiemetic
Intractable hiccough
Mania
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
8/18
Antipsychotics
Classical
More action on DA
receptors
Effective in positivesymptoms
More adverse effects
Atypical
Less. More in 5HT
Effective in negativesymptoms
Less ADEs
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
9/18
Antidepressants
MAO-inhibitors
Moclobemide
Tricyclic antidepressants
Imipramine, Amitriptyline,
Selective Serotonin Reuptake Inhibitors
Fluoxetine, Fluvoxamine Atypical
Trazodone, mianserin
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
10/18
Antidepressants ADEs
Anticholinergic effect
Sedation
Weight gain
Postural hypotension
Cardiac arrhythmias
No extrapyramidal effects!
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
11/18
Antidepressants- uses
Endogenous depression
Obsessive compulsive- neurosis[OCN]
Phobias
Neuropathic pain
Enuresis
Migraine
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
12/18
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]
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
13/18
Anxiolytics -ADEs
1. Benzodiazepines
Dependence, sedation, vertigo, confusional
states
Flumazenil-effective antagonist available
2. Azapirones
Nausea, dizziness, sedation3. Betablocker
Bradycardia, bronchospasm, masking of
symtoms of hypoglycemia
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
14/18
Anxiolytics -uses
Benzodiazepines
Anxiolytics,
Sedative-
hypnotics,
Anticonvulsants
Pre anaesthetic
Muscle relaxant
Azapirones
[Buspirone]
Anxiolytics,
Beta blockers
Syptoms of
anxiety[tremors,
intestinal motility]
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
15/18
Fight or Flight reaction
Fear and worry
Anxiety
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
16/18
Anxiety- Disorder
Excessive fear or worry
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
17/18
-
7/30/2019 Antipsycho, Antidep, Anxiolytics
18/18
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]