Psychotherapeutic Drugs: Antipsychotics and Antidepressants
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Questions and Answers

Which of the following antidepressants is a selective serotonin reuptake inhibitor?

  • Phenelzine
  • Fluoxetine (correct)
  • Bupropion
  • Amitriptyline

    • What is the primary mechanism of action of antipsychotic drugs in treating schizophrenia?

  • Inhibition of acetylcholine receptors
  • Blockage of dopamine and serotonin receptors (correct)
  • Activation of GABA receptors
  • Stimulation of dopamine and serotonin receptors

    • Which of the following is NOT a hallmark symptom of schizophrenia?

  • Disorganized thinking
  • Delusions
  • Hallucinations
  • Insomnia (correct)

    • What is the term for drug-induced movement disorders caused by antipsychotic medications?

    <p>Extra pyramidal symptoms</p> Signup and view all the answers

    Which of the following is an example of an atypical antipsychotic?

    <p>Clozapine</p> Signup and view all the answers

    What is the estimated prevalence of schizophrenia in the world's population?

    <p>1%</p> Signup and view all the answers

    Which of the following antidepressants is a monoamine oxidase inhibitor?

    <p>Phenelzine</p> Signup and view all the answers

    What is the term for emotional disturbances characterized by mood that is consistently low?

    <p>Depression</p> Signup and view all the answers

    What is the outcome of continued blockade of dopamine neurotransmission by antipsychotic drugs?

    <p>Inactivation of dopaminergic neurons producing a depolarization blockade</p> Signup and view all the answers

    What is the approximate percentage of patients treated with antipsychotics who develop neuroleptic malignant syndrome (NMS)?

    <p>0.5 to 1%</p> Signup and view all the answers

    What is the therapeutic effect of typical antipsychotics mainly attributed to?

    <p>D2 receptor antagonism</p> Signup and view all the answers

    What is the outcome of dopamine receptor up-regulation and supersensitivity to dopamine agonists?

    <p>Increased risk of tardive dyskinesia</p> Signup and view all the answers

    What is the primary mechanism of action of antipsychotic drugs in treating positive symptoms?

    <p>Blockade of dopamine receptors</p> Signup and view all the answers

    What is the typical time frame for the subsidence of positive symptoms with antipsychotic treatment?

    <p>1 to 3 weeks</p> Signup and view all the answers

    What is the primary treatment for neuroleptic malignant syndrome (NMS)?

    <p>Discontinuing antipsychotic treatment and administering dantrolene</p> Signup and view all the answers

    What is the term for the delayed type of extrapyramidal symptom that may occur due to dopamine receptor up-regulation and supersensitivity to dopamine agonists?

    <p>Tardive dyskinesia</p> Signup and view all the answers

    What is a common adverse effect of typical antipsychotics like fluphenazine and haloperidol?

    <p>Extrapyramidal symptoms (EPS)</p> Signup and view all the answers

    Which atypical antipsychotic has a similar chemical structure to clozapine but does not cause agranulocytosis?

    <p>Olanzapine</p> Signup and view all the answers

    What is a unique property of aripiprazole compared to other atypical antipsychotics?

    <p>It is a partial dopamine agonist</p> Signup and view all the answers

    What is a common use of haloperidol beyond schizophrenia?

    <p>Tourette syndrome</p> Signup and view all the answers

    What is a significant advantage of long-acting depot preparations of antipsychotics like fluphenazine and haloperidol?

    <p>Improved compliance in non-adherent patients</p> Signup and view all the answers

    Which receptor does olanzapine block to a lesser extent compared to clozapine?

    <p>Muscarinic receptor</p> Signup and view all the answers

    What is a unique use of aripiprazole compared to other atypical antipsychotics?

    <p>Treatment of irritability in autistic children</p> Signup and view all the answers

    What is a typical antipsychotic that is widely used and has properties similar to fluphenazine?

    <p>Haloperidol</p> Signup and view all the answers

    What are the symptoms of a manic episode?

    <p>Talking quickly, racing thoughts, increased social activity, and decreased need for sleep</p> Signup and view all the answers

    What type of antidepressant drugs are often used as a second-line treatment for depression?

    <p>Monamine oxidase inhibitors (MAOIs)</p> Signup and view all the answers

    What is the mechanism of action of tricyclic antidepressants (TCAs) in treating depression?

    <p>Blocking the reuptake of serotonin and norepinephrine by blocking norepinephrine transporter (NET) and serotonin transporter (SERT)</p> Signup and view all the answers

    Which of the following TCAs is a secondary amine formed by demethylation of imipramine?

    <p>Desipramine</p> Signup and view all the answers

    What is a potential side effect of tricyclic antidepressants (TCAs) due to their anticholinergic properties?

    <p>Dry mouth and constipation</p> Signup and view all the answers

    Which of the following conditions is SSRIs and SNRIs often used to treat, in addition to depression?

    <p>Eating disorders and anxiety disorders</p> Signup and view all the answers

    What is the primary difference between tertiary amines and secondary amines in terms of their mechanism of action?

    <p>Tertiary amines block serotonin reuptake more than secondary amines</p> Signup and view all the answers

    What is the potential consequence of taking tricyclic antidepressants (TCAs) excessively?

    <p>Severe toxicity</p> Signup and view all the answers

    Which class of anti-depressants has the least sedative and autonomic side effects?

    <p>SSRIs</p> Signup and view all the answers

    Which of the following is an advantage of SSRIs over TCAs?

    <p>They are safer in overdose and less likely to cause arrhythmia and seizures</p> Signup and view all the answers

    What is a common side effect of SSRIs?

    <p>Nervousness</p> Signup and view all the answers

    Which of the following is a characteristic of SNRIs?

    <p>They are selective for both serotonin and norepinephrine reuptake transporters</p> Signup and view all the answers

    When are MAOIs typically used in treating depression?

    <p>As an alternative therapy when patients fail to respond to other treatments</p> Signup and view all the answers

    What is a potential concern with MAOIs?

    <p>They have potentially serious drug and food interactions</p> Signup and view all the answers

    What is a difference between SNRIs and TCAs?

    <p>TCAs cause more autonomic side effects</p> Signup and view all the answers

    Why are SSRIs usually given in the morning?

    <p>Because they increase alertness</p> Signup and view all the answers

    Study Notes

    Psychotherapeutic Drugs

    • Antipsychotics:
      • Typical antipsychotics (e.g., haloperidol aka Haldol)
      • Atypical antipsychotics (e.g., clozapine aka Clozaril)
    • Antidepressants:
      • Tricyclic antidepressants (TCAs) (e.g., amitriptyline aka Elavil)
      • Selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine aka Prozac)
      • Serotonin and norepi reuptake inhibitors (SNRIs) (e.g., venlafaxine aka Effexor)
      • Monoamine oxidase inhibitor (MAOIs) (e.g., phenelzine aka Nardil)
      • Other antidepressants (e.g., bupropion aka Wellbutrin)
    • Mood stabilizers (e.g., lithium aka Lithobid)
    • CNS stimulants (e.g., methylphenidate aka Ritalin)

    Overview of Major Psychiatric Disorders

    • Psychoses (e.g., schizophrenia): exhibit gross disturbances in comprehension of reality, hallucinations, and delusions
    • Affective disorders (e.g., depression): emotional disturbances in which mood is low or high

    Schizophrenia

    • Most common form of psychosis (1% of the world's population)
    • Hallmark symptoms: delusions, hallucinations, disorganized thinking, and emotional abnormalities
    • Several forms: paranoid, disorganized, and catatonic forms

    Extrapyramidal Symptoms (EPS)

    • Drug-induced movement disorders with acute and tardive symptoms
    • Symptoms include:
      • Dystonia: continuous spasms and muscle contractions
      • Akathisia: motor restlessness
      • Parkinsonism: characteristic symptoms like rigidity, bradykinesia, and tremor
      • Tardive dyskinesia: irregular, jerky movements

    Pharmacologic Effects of Antipsychotics

    • Alleviate symptoms of schizophrenia by blocking dopamine and serotonin receptors
    • Receptors are blocked immediately, but the drug still takes a few weeks to improve symptoms
    • Antipsychotic drugs produce three time-dependent changes in dopamine neurotransmission:
      1. Increase in dopamine synthesis, release, and metabolism
      2. Continued blockade leads to inactivation of dopaminergic neurons producing a depolarization blockade
      3. Eventually leads to dopamine receptor up-regulation and supersensitivity to dopamine agonists

    Neuroleptic Malignant Syndrome (NMS)

    • Severe form of drug toxicity, occurs in 0.5 to 1% of patients treated with antipsychotics
    • Life-threatening, characterized by muscle rigidity, elevated T, AMS, and autonomic dysfunction
    • Managed by immediately discontinuing treatment and administering dantrolene to prevent further muscular abnormalities

    Typical Antipsychotics

    • Mechanism: exert therapeutic effect as a result of D2 receptor antagonism
    • Adverse effects:
      • Akathisia: motor restlessness
      • Pseudoparkinsonism: rigidity, bradykinesia, and tremor
      • Dystonia: abnormal muscle tension of neck and facial muscles

    Atypical Antipsychotics

    • Clozapine aka Clozaril
    • Olanzapine aka Zyprexa
    • Quetiapine aka Seroquel
    • Risperidone aka Risperdal
    • Aripiprazole aka Abilify

    Mechanism of Atypical Antipsychotics

    • Olanzapine: chemical analogue of clozapine, has similar properties but fewer autonomic side effects
    • Aripiprazole: partial dopamine agonist at dopamine and 5-HT1A receptors, but antagonizes 5-HT2A receptors

    Affective Disorders

    • Bipolar disorder:
      • Manic phase: elevated mood, inflated self-esteem, increased talking, racing thoughts, increased social or work activity, and decreased need for sleep
      • Occurs just before or just after a depressive episode
      • Episodes can last several weeks or months

    Antidepressant Drugs

    • Indications: depression, eating disorders, anxiety disorders, fibromyalgia, autism, and premenstrual dysphoric disorder
    • Mechanism:
      • TCAs: block neuronal reuptake of norepi and serotonin by blocking norepi transporter (NET) and serotonin transporter (SERT)
      • SSRIs: selectively block serotonin reuptake, increasing serotonin levels in the synapse
      • SNRIs: block both serotonin and norepi reuptake transporters
      • MAOIs: inhibit monoamine oxidase, increasing levels of serotonin, norepi, and dopamine in the synapse

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    Description

    This quiz covers different types of psychotherapeutic drugs including antipsychotics, antidepressants, and their subclasses. Learn about typical and atypical antipsychotics, tricyclic antidepressants, SSRIs, SNRIs, and MAOIs.

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