Ch 3 Psychotropic Meds

Benzodiazepines MOA

Enhance GABA-A activity

Benzos examples

Lorazepam (Ativan), alprazolam (Xanax), clonazepam (Klonopin)

Benzos indications

Acute anxiety/panic; rapid calming. Sedation and dependence risk.

Buspirone MOA

Partial 5-HT1A agonist

Buspirone examples

Buspirone (BuSpar)

Buspirone indications

Generalized anxiety. Takes weeks; not PRN; not controlled.

SSRIs moa

block serotonin reuptake

SSRIs examples

Sertraline (Zoloft), fluoxetine (Prozac), escitalopram (Lexapro)

SSRIs indications

First-line depression/anxiety. GI effects, sleep changes, se*ual dysfunction

SNRIs moa

Block serotonin + norepinephrine reuptake

SNRIs examples

Venlafaxine (Effexor), duloxetine (Cymbalta)

SNRIs indications

Depression/anxiety; duloxetine also used for some pain disorders. Watch BP/HR.

NDRI moa

Block norepinephrine + 

dopamine reuptake

NDRI example

Bupropion (Wellbutrin)

NDRI indications

Depression, smoking cessation. Less sexual dysfunction; avoid with seizure disorders.

NaSSA moa

Alpha-2 antagonist; also serotonin receptor antagonism

NaSSA examples

Mirtazapine (Remeron)

NaSSA indications

Depression with insomnia or low appetite. Sedation + weight gain

TCAs moa

Block serotonin + NE reuptake; also H1, alpha-1, M1 antagonism

TCAs examples

Amitriptyline, imipramine

TCAs indications

Depression/pain. More side effects; overdose can be dangerous.

MAOIs moa

Inhibit MAO enzyme

MAOIs example

Phenelzine (Nardil)

MAOIs indication

Last-line depression. Major drug/food interactions; hypertensive crisis risk.

Litihium moa

No simple agonist/antagonist action

Lithium indication

Mood stabilizer for bipolar disorder. Narrow therapeutic index; monitor levels/kidneys.

anticonvulsants indication

Stabilize neuronal firing; may increase GABA / reduce glutamate

anticonvulsants examples

Valproate (Depakote), lamotrigine, carbamazepine

anticonvulsants indications

Bipolar disorder. Valproate: mania; lamotrigine: maintenance

1st gen antipsychotics moa

D2 antagonists

FGA examples

Haloperidol (Haldol), chlorpromazine (Thorazine)

FGA indications

Psychosis/schizophrenia; mainly positive symptoms. Watch EPS.

SGA moa

Usually D2 + 5-HT2A antagonists

SGA examples

Risperidone, olanzapine, quetiapine, clozapine

SGA indications

Psychosis/bipolar; some depression uses. Watch metabolic effects/weight gain.

Apriprazole (TGA) moa

partial D2 agonist

Apriprazole (TGA) indications

Psychosis/bipolar; can reduce dopamine where high and stimulate where low.

ADHD stims moa

Block DA + NE reuptake; amphetamines also increase release

ADHD stims examples

Methylphenidate (Ritalin/Concerta), Adderall, Vyvanse

ADHD stims indications

First-line ADHD. Watch appetite, insomnia, BP/HR; controlled substances

ADHD nonstims moa

Atomoxetine: NE reuptake inhibitor; guanfacine/clonidine: alpha-2 agonists

ADHD nonstims examples

Atomoxetine, guanfacine, clonidine

ADHD nonstims indications

ADHD when stimulants are not preferred. Alpha-2 agonists may lower BP/HR.

alzheimer meds moa

Cholinesterase inhibitors OR NMDA antagonist

alzheimer meds examples

Donepezil (Aricept); memantine (Namenda)

alzheimer meds indication

Donepezil increases ACh; memantine reduces excess glutamate/NMDA activity