Antipsychotic and MAOI Medications Quiz

Psychotherapeutic Drugs

• Psychotherapeutic drugs, also called psychotropics, alter mental and emotional processes.
• Current theories suggest neurotransmitter imbalances are key in many disorders, diagnosed according to DSM-V criteria.
• Drugs are often used to treat mental health conditions by blocking or stimulating neurotransmitter release, but need to be combined with non-pharmacological treatments like counseling.
• The goal is to improve quality of life, social and occupational functioning, and ability to carry out ADLs.
• Some drugs initially approved for one condition might later be approved for treating other conditions.
• Children and older adults are more sensitive to drugs and at a higher risk of adverse effects.
• Response to medication varies between patients and often requires a trial-and-error approach to find what works.
• Stigma and fear of adverse effects may prevent patients from accepting and adhering to treatment.

Antipsychotic Drugs (Neuroleptics)

• Used to treat psychosis associated with schizophrenia (positive symptoms).
• They also treat severe mania, bipolar disorder, autism, and other medical conditions.
• These drugs, like antipsychotics, are effective in reducing schizophrenic symptoms such as visual hallucinations, auditory hallucinations, delusions, and disorganized behavior.
• Two main generations of antipsychotic drugs exist: the first (conventional) generation, and the second (atypical) generation.
• 1st generation antipsychotics include Phenothiazines (Chlorpromazine, Fluphenazine), Thioxanthenes (Thiothixene), and Phenylbutylpiperidines (Haloperidol).
• 2nd generation antipsychotics include Dibenzodiazepines (Clozapine, Olanzapine, Risperidone), and Benzisoxazoles (Quetiapine, Aripiprazole).

Antipsychotic Drugs – GEN 1

• Conventional antipsychotics primarily block dopamine receptors in the brain and decrease overall dopamine concentration.
• They also influence brain stem activity, leading to anti-anxiety effects and potentially antiemetic effects on the GIT through vagus nerve inhibition.
• Side effects include hypotension and sedative effects, as well as a higher risk of extrapyramidal symptoms (EPS)
• Phenothiazines such as Chlorpromazine, Fluphenazine, and Perphenazine are categorized by their “azine” suffix in their generic name.
• Thiothixene is in a different class (Thioxanthenes), similar enough phenothiazines in terms of potency and extrapyramidal side effects.
• Phenylbutylpiperidines like Haloperidol and Pimozide are structurally different but also associated with a higher risk of extrapyramidal side effects (EPS).
• Admin considerations include gradual tapering of the drug.

Antipsychotic Drugs – GEN 2

• Atypical antipsychotics, more potent, target both dopamine and serotonin receptors.
• They generally have lower risks of EPS compared to 1st-generation antipsychotics.
• Dibenzodiazepines like Clozapine, Olanzapine, Quetiapine, block receptors in the limbic system, as well as serotonin and histamine receptors.
• Olanzapine and Quetiapine also block dopamine and serotonin receptors.
• Second-generation antipsychotic drugs like Risperidone and Aripiprazole primarily work by altering dopamine and serotonin levels.

Antipsychotic Drugs – CNS Adverse Events

• Extrapyramidal symptoms (EPS) are involuntary movements similar to Parkinson's disease.
• Types include Akathisia (restlessness), Tardive Dyskinesia (uncontrollable movements), and Acute Dystonia (muscle spasms).
• Neuroleptic malignant syndrome (NMS) is a life-threatening adverse effect characterized by muscle rigidity, altered thermoregulation, and autonomic instability, which can lead to serious complications, including coma.
• Treatment for EPS and NMS involves medication discontinuation, anticholinergic medication, or dopamine-replacing agents.

Antipsychotic Drugs – Other Adverse Effects

• Cardiovascular, gastrointestinal, endocrine, and skin side effects are possible, such as low white blood cell count and anemia.
• Orthostatic hypotension, weight gain, and gynecomastia are also potential side effects of antipsychotic medications.
• The use of antipsychotic drugs in individuals with preexisting heart conditions or who are on other medications may require careful monitoring for interaction.

Anxiety / Anxiolytic Drugs

• Benzodiazepines are commonly used anti-anxiety drugs. They enhance the effects of GABA, reducing CNS activity, causing an immediate effect on mood.
• Buspirone is an alternative that does not depress the CNS as much.
• Benzodiazepines exist as short, intermediate, and long acting forms.
• Only used for short-term conditions, but can be associated with tolerance.
• Anxiolytic drugs are not equally effective in all patients and sometimes have contradictory effects.
• Adverse effects include CNS depression, hypotension, and potential for dependence and addiction.
• Precautions should be taken regarding use in elderly, with liver or kidney disease, or in pregnancy.

Mood Stabilizer Drugs

• Lithium carbonate and lithium citrate are common mood stabilizers, primarily used in bipolar disorder.
• The mechanism of action for lithium is not fully understood, but it's thought to affect sodium ion transport and GABA function.
• Lithium is often administered to manage acute episodes or as a maintenance treatment.
• The drug must be taken regularly, to keep serum sodium levels normal, as it has a very narrow therapeutic range. This makes it highly toxic if not correctly administered.
• Lithium can cause significant side effects if levels are too high.
• Side effects can include tremors, confusion, and poor coordination.

Antidepressant Drugs

• Antidepressant drugs are often used for major depression and other mental health conditions.
• Two main generations exist: first generation include Tricyclic anti-depressants, MAOI, and Tetracyclic anti-depressants.
• Second generation (more recent) include SSRI (Selective Serotonin Reuptake Inhibitors).
• There is a black box warning for all types of antidepressants because suicide risk can be elevated when first starting treatment.
• Side effects include gastrointestinal effects, cardiac effects, and central nervous system effects.

Antidepressant Drugs - First Generation

• Tricyclic anti-depressants are named based on their three ring structures. They function by preventing the reuptake of important neurotransmitters, such as norepinephrine and serotonin.
• MAOIs prevent the breakdown of norepinephrine and serotonin, allowing these neurotransmitters to have a more pronounced effect.
• First generation drugs generally have more side effects than second generation drugs

Antidepressant Drugs - Second Generation

• SSRIs are generally considered safer and are well tolerated to treat various psychiatric conditions. They work by increasing serotonin levels in the brain.
• SNRIs work in a similar way but affect norepinephrine and serotonin instead of just serotonin.
• These newer kinds of medications are often used when the first generation antidepressants are not effective.

Test your knowledge on MAOI overdose, antipsychotic drugs, and their side effects with this comprehensive quiz. Questions cover drug interactions, classifications, and treatment strategies related to psychiatric medications. Perfect for students studying pharmacology or psychiatry.