Psychiatric Pharmacology: Antidepressants, MAOIs, Lithium, and Mood Stabilizers

What neurotransmitter deficiency is associated with mood?

Serotonin

What neurotransmitter deficiency is associated with arousal?

Norepinephrine

Name the five categories of antidepressants.

1. SSRIs, 2. SNRIs, 3. Tricyclics, 4. MAOIs, 5. Atypical Antipsychotics

What is a major risk associated with Tricyclic Antidepressants (TCAs)?

Cardiac toxicity and toxicity in overdose

List three common Tricyclic Antidepressants.

1. Amitriptyline (Elavil), 2. Imipramine (Tofranil), 3. Doxepin (Sinequan)

What is the action of Monoamine Oxidase Inhibitors (MAOIs)?

They inhibit monoamine oxidase, interfering with the breakdown of norepinephrine, dopamine, and serotonin.

What dietary restrictions are necessary for patients on MAOIs?

Avoid aged foods, cheese, and soy sauce due to the risk of hypertensive crisis.

What are common side effects of MAOIs?

Anxiety/agitation, orthostatic hypotension, and potential hypertensive crisis.

What is a serious side effect of Trazodone?

Priapism

What is the therapeutic range for Lithium?

0.5 - 1.5 mEq/L

What are some common side effects of Lithium?

Nausea, polyuria, polydipsia, fine hand tremor, weight gain.

What should be monitored to prevent toxicity in patients taking Lithium?

Blood levels of Lithium, Valproic Acid, and Carbamazepine.

What is the normal blood level range for Valproic Acid?

50 - 100 mcg/mL

What is a potential severe skin reaction associated with Lamictal (lamotrigine)?

Stevens-Johnson Syndrome

What is the primary use of Seroquel (quetiapine)?

To treat drowsiness and weight gain.

What is the dietary requirement for Latuda (lurasidone)?

Must be taken with 350 calories of food.

What is a risk of using antidepressants in patients with undiagnosed bipolar disorder?

They can trigger mania.

What is the recommended fluid intake for patients on Lithium?

1.5 - 3 L/day

What are common withdrawal symptoms from antidepressants?

Flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, hyperarousal.

What should be done if Lithium toxicity symptoms occur?

Discontinue the medication and notify the physician.

What is the action of mood stabilizers in bipolar disorder?

They prevent norepinephrine and dopamine from being absorbed too quickly.

What should patients on anticonvulsants be asked?

Why are you taking it and do you regularly take this medication?