Test Two Psych Meds

SSRI’s

Selective Serotonin Reuptake Inhibitors, a class of antidepressants that increase serotonin levels in the brain by inhibiting its reabsorption in neurons

-Initial anxiety spike is common, 4-6 week onsent,

-Risk of serotonin syndrome

-BBW of suicide in ages 18-24

SNRI’s

Serotonin-Norepinephrine Reuptake Inhibitors, a class of antidepressants that increase serotonin and norepinephrine levels in the brain by inhibiting their reabsorption in neurons

-Similar to SSRI’s, side effect of htn

TCAs

Tricyclic Antidepressants, a class of older antidepressants that work by blocking the reuptake of serotonin and norepinephrine, often used for depression and certain anxiety disorders (nonselective)

-Extremely lethal in overdose due to cardiotoxicity, ortho hypo

MAOIs

Monoamine Oxidase Inhibitors, a class of antidepressants that work by inhibiting the enzyme monoamine oxidase, leading to increased levels of neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain

-Requires strict tyramine-restricted diet to prevent a severe hypertensive crisis

Why is serotonin targeted in depression patients

Serotonin is targeted in depression patients because it plays a crucial role in regulating mood, emotions, and overall mental well-being. By increasing serotonin levels, antidepressants aim to alleviate depressive symptoms and improve patients' overall mood

-UPTAKE INHIBITOR means that more is left in the blood

Norepinephrine in depression

Norepinephrine is targeted in depression because it influences attention, arousal, and mood regulation

-Increasing norepinephrine levels can help alleviate depressive symptoms and improve energy and motivation in affected individuals

-UPTAKE INHIBITION

Monoamine oxide

is an enzyme that breaks down neurotransmitters such as serotonin, norepinephrine, and dopamine, influencing mood and emotional regulation

Lithium

First-line gold standard for acute mania / Bipolar I

-Alters sodium transport and second-messenger pathways

-Narrow therapeutic index; monitor for fine tremors, hypothyroidism, renal toxicity, and maintain stable sodium / fluid intake

Valproate / Divalproex Sodium

Increases GABA and blocks sodium channels

-first-line for acute mania and rapid-cycling bipolar

-BBW of hepatotoxicity, pancreatitis, and severe teratogenicity

Carbamazepine (Tegretol)

Stabilizes inactivated sodium channels, second one for ithium-refractory acute mania

-Risk of agranulocytosis and a stron CYP450 enzyme inducer

Lamotrigine (Lamictal)

Blocks sodium channels and decreases glutamate release;used for bipolar depression maintenance

-Steven’s-Johnson Syndrome , strict multi-week slow dosage titration

First-Generation Antipsychotics

Strong postsynaptic Dopamine D2 receptor antagonists targeting positive symptoms of shzophrenia

-High EPS symptoms \

Second-Generation Antipsychotics

Dual blockade of D2 and 5-HT2A receptors;treats positive and negative symptoms of schizophrenia

Clozapine

Gold standard for treatment-resistant schizophrenia, monitor ANC for agranulocytosis

Olanzaine

Highly effective for psychosis / mania but carries the highest risk of metabolic syndrome

Ziprasidone and Lurasidone Administration Rule

Must be administered with food (Zip > 500 Lur >350)

Ziprasidone and Lurasidone

Are atypical antipsychotics used to treat schizophrenia and bipolar disorder

Benzotropine and Diphenhydramine

Centrally acting Anticholinergics that block muscarinic receptors to treat energy EPS and acute dystonic reactions

Anticholinergic Medications

Medications that block the action of acetylcholine on muscarinic receptors, commonly used to manage side effects of antipsychotic medications and treat various movement disorders

Spirolactone

Directly blocks androgen receptors and inhibits testosterone synthesis in feminizing care