Psychopharmacology- Gregory Koslov

Antipsychotics

Drugs used to treat psychiatric conditions such as schizophrenia and acute psychosis.

Typical antipsychotics

Old generation antipsychotics that work primarily by blocking dopamine receptors, leading to more side effects.

Atypical antipsychotics

New generation antipsychotics that generally have fewer extrapyramidal side effects and can affect both positive and negative symptoms of schizophrenia.

Dopamine Receptor Antagonists (DRA)

Medications that block dopamine receptors in the brain, particularly D2 receptors, to lower dopamine levels.

Extrapyramidal symptoms

Movement disorders such as tremors, rigidity, and akathisia caused by antipsychotic medications.

Neuroleptic Induced Acute Dystonia

A side effect of antipsychotic medications characterized by muscle spasms or contractions.

Neuroleptic Malignant Syndrome (NMS)

A life-threatening reaction to antipsychotic drugs characterized by high fever, muscle rigidity, and altered mental status.

Lithium

A mood stabilizer used primarily for bipolar disorder, known for its narrow therapeutic range.

Range is 0.6-1.2 mEq/L

Serotonin Reuptake Inhibitors (SSRIs)

A class of antidepressants that work by increasing serotonin levels in the brain.

Tricyclic Antidepressants (TCAs)

An older class of antidepressants that prevent the reuptake of norepinephrine and serotonin but have many side effects.

Monoamine Oxidase Inhibitors (MAOIs)

A class of antidepressants that inhibit the breakdown of monoamines, effective but require dietary restrictions.

Electroconvulsive Therapy (ECT)

A psychiatric treatment that involves inducing seizures through electrical stimulation to alleviate severe depression.

Mood stabilizers

Medications used to treat mood disorders, especially bipolar disorder, including lithium and anticonvulsants.

Tardive Dyskinesia

A late occurring side effect of antipsychotic medications that involves involuntary muscle movements.

Agranulocytosis

A potentially life-threatening side effect of some antipsychotic medications, especially clozapine, characterized by a dangerously low white blood cell count.

Dopamine

A neurotransmitter that plays a role in mood and behavior, which is often affected by antipsychotic medications.

Benzodiazepines

A class of medications primarily used for treating anxiety and agitation, known for their sedative effects.

Selective Norepinephrine Reuptake Inhibitors (NRIs)

Antidepressants that specifically increase norepinephrine levels in the brain.

Serotonin Syndrome

A potentially life-threatening condition caused by excessive amounts of serotonin in the brain.

Akathisia

A movement disorder characterized by inner restlessness and an uncontrollable urge to be in constant motion.

Haloperidol (Haldol)

A high potency typical antipsychotic known for strong EPS, sedation, and QT prolongation.

Fluphenazine (Modecate)

Typical antipsychotic- Used to treat schizophrenia, associated with a risk of tardive dyskinesia.

Perphenazine (Perphenan)

A moderate potency typical antipsychotic with a risk of EPS.

Zuclepenthixol (Clopixol)

Typical antipsychotic- Used for aggression, known for strong sedation.

Chlorpromazine (Taroctyl)

A low potency typical antipsychotic, causing sedation and anticholinergic effects.

Thioridazine (Melleril)

Typical antipsychotic- Known for high sedation, QT prolongation, and risk of retinal deposits.

Clotiapine (Etumine)

Sedative typical antipsychotic used for acute psychosis.

Sulpiride (Modal)

Typical Antipsychotic- A selective dopamine antagonist used primarily for schizophrenia.

Penfluridol (Semaphore)

A long-acting oral typical antipsychotic.

Levomepromazine (Nozinan)

Typical antipsychotic- Has high sedation and strong anticholinergic effects.

Risperidone (Risperdal)

An atypical antipsychotic with increased prolactin levels and EPS risk at high doses.

Olanzapine (Zyprexa)

An atypical antipsychotic associated with weight gain, metabolic syndrome, and sedation.

Quetiapine (Seroquel)

Atypical antipsychotic known for orthostatic hypotension, sedation and weight gain

Ziprasidone (Geodon)

Atypical antipsychotic- Known for less weight gain but risk of QT prolongation.

Amisulpride (Solian)

Atypical antipsychotic- A selective D2/D3 antagonist that can elevate prolactin.

Aripiprazole (Abilify)

Atypical antipsychotic with minimal metabolic effects.

Clozapine (Leponex)

The most effective atypical antipsychotic, noted for agranulocytosis risk and sedation.

Biperiden (Dekinet)

An anticholinergic used to manage EPS caused by antipsychotics.

Trihexyphenidyl (Artane)

An anticholinergic medication that helps reduce rigidity and tremors associated with EPS.

Procyclidine (Kemadrin)

Anticholinergic- Treats EPS but may cause dry mouth and constipation.

Amantadine (Symmetrel)

A dopamine enhancer that carries a risk of psychosis.

Fluoxetine (Prozac)

A long-acting SSRI known for its activating effects.

Fluvoxamine (Favoxil)

SSRI- Effective in OCD treatment and a strong CYP inhibitor.

Paroxetine (Paxxet)

An SSRI associated with sedation, weight gain, and withdrawal risk.

Sertraline (Lustral)

Well-tolerated SSRI with minimal weight gain.

Citalopram (Cipramil)

An SSRI that can cause QT prolongation at high doses.

Escitalopram (Cipralex)

More selective SSRI with fewer side effects.

Reboxetine (Edronax)

An NRI that can be activating but may cause dry mouth and insomnia.

Venlafaxine (Efexor)

An SNRI that can induce hypertension at high doses.

Duloxetine (Cymbalta)

SNRI- Used for neuropathic pain with a need for liver monitoring.

Milnacipran (Ixel)

SNRI- Offers dual reuptake inhibition with minimal sexual dysfunction.

Bupropion (Wellbutrin)

A DNRI used for smoking cessation that lowers seizure threshold.

Mirtazapine (Remeron)

An atypical antidepressant resulting in sedation and weight gain.

Trazodone (Trazodil)

A sedative antidepressant with a risk of priapism.

Esketamine

An NMDA receptor antagonist used for treatment-resistant depression.

Clonazepam (Clonex)

Long-acting benzodiazepine utilized for panic disorder.

Diazepam (Valium)

Benzodiazepine muscle relaxant with a long half-life.

Alprazolam (Xanax)

Short-acting benzodiazepine with high addiction potential.

Lorazepam (Lorivan)

Intermediate-acting benzodiazepine known for less hepatic metabolism.

Oxazepam (Vaben)

Short-acting benzodiazepine recommended for elderly patients.

Nitrazepam (Numbon)

A benzodiazepine sedative used for insomnia.

Brotizolam (Bondormine)

Strong short-acting sedative/hypnotic for sleep

Midazolam (Dormicum)

Short-acting benzodiazepine used in anesthesia.

Triazolam (Halcion)

Short-acting benzodiazepine for sleep onset insomnia.

Flunitrazepam (Hypnodorm)

A potent sedative with a high dependence risk.

Promethazine (Phenergan)

Antihistamine used for sedation and nausea relief.

Propranolol (Deralin)

A beta blocker for performance anxiety that lowers heart rate.

Buspirone (Sorbon)

A non-benzodiazepine anxiolytic that is non-sedating and requires weeks to take effect.

Carbamazepine (Tegretol)

Mood stabilizer with the risk of agranulocytosis and liver enzyme induction

Therapeutic Range is 4-12 mcg/ml

Valproic Acid (Depalept)

A mood stabilizer that is hepatotoxic and teratogenic.

Therapeutic Range is 50-100 mcg/ml² (some sources up to 150)

Lamotrigine (Lamictal)

A mood stabilizer that carries a risk of Stevens-Johnson Syndrome and requires slow titration.

Start dose at 25mg and increase by 25mg every 2 weeks