SCL6002 - Session 4.pdf

SESSION 4 MEDICATIONS FOR MENTAL HEALTH DISORDERS PSYCHIATRIC MEDICATIONS • AKA… Psychotropic medications • Affect the way the brain works • Mood, Anxiety, Psychosis • Neurotransmitters • Transmit messages between neurons • Excitatory • Inhibitory • Modulatory HOW DO MEDICATIONS WORK? PSYCH...

SESSION 4 MEDICATIONS FOR MENTAL HEALTH DISORDERS PSYCHIATRIC MEDICATIONS • AKA… Psychotropic medications • Affect the way the brain works • Mood, Anxiety, Psychosis • Neurotransmitters • Transmit messages between neurons • Excitatory • Inhibitory • Modulatory HOW DO MEDICATIONS WORK? PSYCHIATRIC MEDICATIONS • Antidepressants • Depression/Anxiety/OCD • Antipsychotics • Psychosis • Mood stabilisers • Bipolar disorders • Anxiolytics (aka. anti-anxiety) • Anxiety symptoms/disorders, GAD, panic disorder, agoraphobia, PTSD • Stimulants • Attention Deficit Hyperactivity Disorder (ADHD) ANTIDEPRESSANT MEDICATIONS • Selective serotonin reuptake inhibitors (SSRIs) • Serotonin/noradrenergic reuptake inhibitors (SNRIs) • Tricyclics Antidepressants (TCAs) • Monoamine oxidase inhibitor drugs • Others – Mirtazapine SSRI’S SIDE EFFECTS • Nausea, dyspepsia, abdominal pain, diarrhoea • Sexual dysfunction • (rare) Psychomotor arousal, extrapyramidal syndromes, hyponatraemia • Relatively safe • First line antidepressant choice • Also given to people with OCD SNRI’S • Often used second line • Similar side effects to SSRIs • Discontinuation syndrome • Anxiety, mood change, gastro disturbance, dizziness, sleep disturbance TRICYCLIC ANTIDEPRESSANTS (TCAS) • Increase synaptic concentrations of both noradrenaline and serotonin by inhibiting their uptake to the presynaptic neuron. (similar to SSRIs) • Side effects • Anticholinergic – dry mouth, constipation, dry eyes, blurred vision • Antiadrenergic – Dizziness, postural hypotension • Antihistaminergic - sedation • Not commonly used because of overdose risk MIRTAZAPINE • Noradrenergic and specific serotonergic antidepressant - NaSSA • Increases synaptic concentration of both serotonin and noradrenaline • Side effects include Drowsiness, dry mouth, increased appetite, weight gain ANTIPSYCHOTICS Typical – high affinity for blocking dopamine type 2 (D2) receptors Atypical – low affinity for blocking dopamine type 2 (D2) receptors. High serotonin and dopamine receptor binding ratios = less side effects SIDE EFFECTS….COMPLEX!…. OTHER SIDE EFFECTS • Fatigue • Blunted affect • Constipation BIPOLAR DISORDER • Treat with mood stabilisers, anticonvulsants, antipsychotics • Usually (but not always) avoid antidepressants – risk of mania LITHIUM – SIDE EFFECTS • Gastrointestinal upset • Tremor (fine hand shakes) • Weight gain • Polyuria/Polydipsia (more urine/more thirst) • Diarrhea • Toxicity • Drowsiness, muscle twitching, confusion, disorientation, seizures OTHER MOOD STABILISERS – EPILEPSY MEDICATIONS • Sodium Valproate • Carbamazepine • Lamotrigine • nausea, weight gain, slow thinking, fatigue, tremors ANXIOLYTIC MEDICATIONS • Panic attacks, phobias, GAD, etc. • Nausea, blurred vision, confusion, fatigue, headaches • Prescribed for short time… dependency/ addiction ANXIOLYTICS – BENZODIAZEPINES - GABA • GABA agonist • Relaxing/Sedative • Similar effect as alcohol BENZODIAZEPINE ISSUES • Side effects – drowsiness, sedation, dizziness, ataxia • Dependence/ addiction • Withdrawal • Seizures/death – like alcohol • Overdose/respiratory issues when mixed with other drugs (e.g., alcohol) STIMULANTS • Methylphenidate (Ritalin) • Lisdexamfeatime (Vyvanse) • Side effects • Decreased appetite • Insomnia • Nausea/dizziness/headaches • Heart issues • Growth retardation • Weight loss • Propensity for dependence and addiction