Psychotropic Pharmacology - Vocabulary Flashcards

Vocabulary flashcards covering major psychotropic drug classes, mechanisms, indications, and key safety considerations.

SSRIs

Selective serotonin reuptake inhibitors that block the serotonin transporter (SERT) to increase synaptic 5-HT; downstream BDNF/neuroplasticity effects with minimal H1/M1/α1 binding.

SNRIs

Serotonin-norepinephrine reuptake inhibitors that block SERT and NET to raise 5-HT and NE levels; venlafaxine may be weak NET at low doses and duloxetine inhibits CYP2D6 moderately.

TCAs

Tricyclic antidepressants that inhibit SERT and NET with variable selectivity and also block muscarinic, histaminic, and α1 receptors; notable for overdose risk and anticholinergic effects.

5-HT2 receptor modulators

Antidepressants that modulate the serotonin system via 5-HT2A antagonism (and often 5-HT1A activity); includes trazodone, nefazodone, and vortioxetine.

Tetracyclic/Unicyclic antidepressants

A class including bupropion (weak NET/DAT inhibitor), mirtazapine (α2 antagonist with 5-HT2/5-HT3 blockade and strong H1 activity), amoxapine/maprotiline (NET-predominant, TCA-like), and vilazodone (SERT inhibitor with 5-HT1A activity).

MAOIs

Monoamine oxidase inhibitors that irreversibly inhibit MAO-A/B, increasing levels of 5-HT, NE, and DA; require tyramine restrictions and careful washout with other serotonergic drugs.

NMDA antagonists

Noncompetitive antagonists of the NMDA receptor (e.g., ketamine, esketamine, dextromethorphan-bupropion) with rapid antidepressant effects and monitoring needs; can interact with other CNS depressants.

First-generation antipsychotics (FGAs)

Conventional antipsychotics (e.g., haloperidol, chlorpromazine) that predominantly block D2 receptors; higher risk of EPS, TD, hyperprolactinemia, and sometimes QT prolongation.

Second-generation antipsychotics (SGAs)

Atypical antipsychotics with 5-HT2A blockade often greater than D2 blockade; lower EPS risk but higher metabolic syndrome risk; includes risperidone, olanzapine, quetiapine, aripiprazole, clozapine.

Clozapine

A highly effective SGA with agranulocytosis risk requiring regular blood monitoring; notable metabolic risks and seizure potential.

Lithium carbonate

Mood stabilizer that modulates IP3/DAG signaling and ion transport; reduces mania and suicide risk but has a narrow therapeutic window and significant renal/thyroid implications.

Valproic acid

Anticonvulsant mood stabilizer that increases GABA and blocks Na+ channels; hepatotoxicity and teratogenicity (NTDs) are important considerations.

Carbamazepine

Anticonvulsant mood stabilizer that blocks Na+ channels and induces multiple CYP enzymes; risks include agranulocytosis, hyponatremia, and drug interactions.

Lamotrigine

Anticonvulsant mood stabilizer that blocks Na+ channels and reduces glutamate release; notable for rash risk, including SJS/TEN.

Benzodiazepines

GABA-A receptor agonists at the benzodiazepine site; provide anxiolysis and sedation but carry risks of dependence, withdrawal, and CNS depression.

Buspirone

5-HT1A partial agonist with D2 antagonism properties; slower onset, used for generalized anxiety disorder and as SSRI/SNRI augmentation; low abuse potential.

Bupropion

Atypical antidepressant (tetracyclic/unicyclic) that weakly inhibits NET/DAT to increase catecholamines; fewer sexual side effects but risk of insomnia, agitation, and seizures.

Mirtazapine

Atypical antidepressant that antagonizes α2 receptors (increasing NE/5-HT) and blocks 5-HT2/5-HT3 receptors with strong H1 blockade leading to sedation and weight gain.

Trazodone

5-HT2A antagonist with 5-HT1A agonist activity (SARI); used for depression and often for sleep; associated with sedation and rare priapism.

Nefazodone

5-HT2A antagonist with SARI properties; limited use due to hepatotoxicity concerns.

Vilazodone

SSRI with 5-HT1A partial agonist activity (multimodal) intended to improve efficacy and tolerability with unique pharmacodynamics.

Tyramine diet (MAOI context)

Dietary tyramine restriction required with nonselective MAOIs to prevent hypertensive crisis; some patch formulations have relaxed restrictions.

Serotonin syndrome

Potentially life-threatening reaction from excess serotonergic activity (e.g., SSRI/SNRI/MAOI combos, tramadol, meperidine); characterized by autonomic instability, confusion, hyperreflexia.

QT prolongation

Prolonged QT interval risk with certain antidepressants (notably citalopram at higher doses) and antipsychotics; can predispose to torsades de pointes.

Agranulocytosis

Severe reduction in neutrophil count, most notably a significant risk with clozapine requiring regular monitoring.

Extrapyramidal symptoms (EPS)

Drug-induced movement disorders (parkinsonism, dystonia, akathisia) commonly associated with D2 blockade from FGAs and some SGAs.

Orthostatic hypotension

Drop in blood pressure on standing, a potential side effect of certain antipsychotics and antidepressants with α1 blockade.

Therapeutic window (antipsychotics)

Concept describing achieving sufficient dopamine receptor blockade in mesolimbic pathways (>65%) while avoiding excessive nigrostriatal blockade (<80%) to minimize EPS (quantal balance with 5-HT2A effects in SGAs).

5-HT1A partial agonist (buspirone)

Partial agonism at 5-HT1A receptors contributing to anxiolytic effects; slower onset and minimal dependence risk.

Serotonergic drug interactions

Combining serotonergic medications (SSRIs, SNRIs, MAOIs, TCAs, tramadol, meperidine) can increase risk of serotonin syndrome; requires careful washout and monitoring.