Psychopharmacology Review – Key Terms (Antipsychotics, Mood Stabilizers, Substance Use, Anxiety)

Vocabulary-style flashcards covering antipsychotics, mood stabilizers, antidepressants, and substance-use pharmacology.

First-generation antipsychotics (FGAs)

Conventional antipsychotics that strongly block CNS dopamine (D2) receptors and commonly cause extrapyramidal symptoms (EPS).

Extrapyramidal symptoms (EPS)

Movement disorders caused by D2 blockade: dystonia, parkinsonism, akathisia, tardive dyskinesia.

D2 receptor blockade

Dopamine D2 receptor inhibition, the primary mechanism of FGAs that reduces psychosis but can cause EPS.

Neuroleptic Malignant Syndrome (NMS)

Rare, life-threatening reaction with lead-pipe rigidity, high fever, autonomic instability; requires stopping the drug and supportive care.

Low-potency FGAs

FGAs with lower potency; tend to have more anticholinergic/sedative effects and fewer EPS than high-potency agents.

High-potency FGAs

FGAs with higher potency; more prone to EPS and NMS.

Tardive dyskinesia (TD)

Late-onset involuntary movements, often orofacial, associated with long-term FGA use.

Anticholinergic effects

Dry mouth, constipation, blurred vision due to muscarinic receptor blockade.

Second-generation antipsychotics (SGAs) / atypical antipsychotics

Antipsychotics with lower EPS risk; typically block D2 and 5-HT2 receptors; higher risk of metabolic effects.

Clozapine

A potent SGA effective in treatment-resistant schizophrenia; risks include agranulocytosis, seizures, weight gain; requires ANC monitoring.

5-HT2 receptor blockade

Serotonin receptor blockade that contributes to antipsychotic efficacy and reduces EPS but can cause weight gain.

D2 and 5-HT2 receptor blockade

Combined action of SGAs believed to underlie efficacy with lower EPS.

Clozapine receptor profile

In addition to D2/5-HT2, also blocks α1, histamine, and muscarinic receptors.

Weight gain (from H1 blockade)

Increased weight due to histamine H1 receptor blockade, common with SGAs.

Orthostatic hypotension

Drop in blood pressure on standing due to α1-adrenergic receptor blockade.

Serotonin syndrome

Potentially fatal reaction from excess serotonin: agitation, hyperreflexia, tremor, autonomic instability.

SSRI

Selective serotonin reuptake inhibitor; increases synaptic serotonin by blocking reuptake.

SNRI

Serotonin-norepinephrine reuptake inhibitor; increases both 5-HT and NE in synapses.

MAOI

Monoamine oxidase inhibitor; can cause hypertensive crisis with tyramine-containing foods; requires washout before SSRIs.

TCA

Tricyclic antidepressant; blocks reuptake of NE and 5-HT; diverse side effects and interactions.

Bipolar disorder

Mood disorder with manic and depressive episodes; treated with mood stabilizers, antipsychotics, and sometimes antidepressants.

Mood stabilizers

Drugs that prevent recurrence and stabilize mood in bipolar disorder (e.g., lithium, valproate, carbamazepine).

Lithium

Mood stabilizer with a very narrow therapeutic index; renal excretion; requires monitoring; possible thyroid and renal effects.

Valproate (divalproex)

Mood stabilizer effective for mania; risk of thrombocytopenia, pancreatitis, liver failure; not preferred in pregnancy.

Carbamazepine

Anticonvulsant mood stabilizer for mania; significant drug interactions and side effects.

Lamotrigine (Lamictal)

Mood stabilizer; risk of severe rash (SJS/TEN/DRESS), higher with valproate co-use.

SJS/TEN/DRESS

Severe cutaneous adverse reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS).

Narrow therapeutic index

Small margin between therapeutic and toxic doses (e.g., lithium); requires careful monitoring.

Lithium toxicity

Toxic effects from lithium at high levels; tremor, confusion, ataxia; requires monitoring and dose adjustment.

Thyroid effects of lithium

Lithium can cause goiter and hypothyroidism; requires thyroid function monitoring.

Naltrexone

Opioid antagonist used to reduce cravings and euphoria; used after detox for alcohol and opioid dependence.

Acamprosate

Medication that reduces withdrawal symptoms and supports abstinence from alcohol.

Disulfiram

Alcohol-aversive agent that causes acetaldehyde syndrome when alcohol is consumed.

Methadone

Opioid agonist used in maintenance therapy to replace illicit opioids and prevent withdrawal.

Buprenorphine

Partial mu-opioid agonist and kappa antagonist; reduces cravings with lower abuse risk; often combined with naloxone.

Naloxone

Pure opioid receptor antagonist that reverses opioid overdose; may require repeated dosing.

Nicotine patch

Nicotine replacement therapy; transdermal patch delivering nicotine to aid cessation; once daily.

Chantix (varenicline)

Partial agonist at nicotinic receptors; reduces withdrawal and cravings; may cause neuropsychiatric symptoms.

Benzodiazepines

Anxiolytics and sedative-hypnotics; rapid relief for anxiety/insomnia; risk of respiratory depression with other depressants; taper to discontinue.

Buspirone

Non-addictive anxiolytic for generalized anxiety disorder; slower onset; does not enhance CNS depressants.

Grapefruit juice interactions

Grapefruit can raise drug levels by inhibiting metabolism of certain psychotropic meds.