Questions and Answers
Which of the following antidepressants is a selective serotonin reuptake inhibitor?
What is the primary mechanism of action of antipsychotic drugs in treating schizophrenia?
Which of the following is NOT a hallmark symptom of schizophrenia?
What is the term for drug-induced movement disorders caused by antipsychotic medications?
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Which of the following is an example of an atypical antipsychotic?
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What is the estimated prevalence of schizophrenia in the world's population?
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Which of the following antidepressants is a monoamine oxidase inhibitor?
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What is the term for emotional disturbances characterized by mood that is consistently low?
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What is the outcome of continued blockade of dopamine neurotransmission by antipsychotic drugs?
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What is the approximate percentage of patients treated with antipsychotics who develop neuroleptic malignant syndrome (NMS)?
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What is the therapeutic effect of typical antipsychotics mainly attributed to?
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What is the outcome of dopamine receptor up-regulation and supersensitivity to dopamine agonists?
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What is the primary mechanism of action of antipsychotic drugs in treating positive symptoms?
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What is the typical time frame for the subsidence of positive symptoms with antipsychotic treatment?
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What is the primary treatment for neuroleptic malignant syndrome (NMS)?
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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?
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What is a common adverse effect of typical antipsychotics like fluphenazine and haloperidol?
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Which atypical antipsychotic has a similar chemical structure to clozapine but does not cause agranulocytosis?
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What is a unique property of aripiprazole compared to other atypical antipsychotics?
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What is a common use of haloperidol beyond schizophrenia?
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What is a significant advantage of long-acting depot preparations of antipsychotics like fluphenazine and haloperidol?
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Which receptor does olanzapine block to a lesser extent compared to clozapine?
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What is a unique use of aripiprazole compared to other atypical antipsychotics?
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What is a typical antipsychotic that is widely used and has properties similar to fluphenazine?
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What are the symptoms of a manic episode?
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What type of antidepressant drugs are often used as a second-line treatment for depression?
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What is the mechanism of action of tricyclic antidepressants (TCAs) in treating depression?
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Which of the following TCAs is a secondary amine formed by demethylation of imipramine?
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What is a potential side effect of tricyclic antidepressants (TCAs) due to their anticholinergic properties?
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Which of the following conditions is SSRIs and SNRIs often used to treat, in addition to depression?
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What is the primary difference between tertiary amines and secondary amines in terms of their mechanism of action?
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What is the potential consequence of taking tricyclic antidepressants (TCAs) excessively?
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Which class of anti-depressants has the least sedative and autonomic side effects?
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Which of the following is an advantage of SSRIs over TCAs?
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What is a common side effect of SSRIs?
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Which of the following is a characteristic of SNRIs?
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When are MAOIs typically used in treating depression?
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What is a potential concern with MAOIs?
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What is a difference between SNRIs and TCAs?
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Why are SSRIs usually given in the morning?
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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:
- Increase in dopamine synthesis, release, and metabolism
- Continued blockade leads to inactivation of dopaminergic neurons producing a depolarization blockade
- 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.
