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Psychiatry Pharmacology
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Information includes: - Name and class of medication - Indications for use - Mechanism of action - Side effects and interactions - Route of administration
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PSYCHIATRY DRUGSName Class Clinical Indications Receptor Action Mechanism of Action Adverse Effects and Interactions Administration + PK
Binds to and inhibits NET (noradrenaline transporter) and SERT (serotonin Side effects based on receptor action
transporter) inhibiting the reuptake of these compounds leading to increased levels in the H1: sedation, appetite stimulation
synaptic cleft, supposedly treating depression according to the monoamine theory. leading to weight gain
Muscarinic: blurry vision, dry mouth, Oral
Sedation
Amitriptyline Amitriptyline and imipramine have equal effect on NET and SERT urinary retention, constipation
Tricyclic Tricyclic Neuropathic pain Competitive NET and
Imipramine Lofepramine has a higher efficacy for NET than SERT Alpha-1: postural hypotension Titration required over
Antidepressants antidepressant Migraine prophylaxis SERT inhibitor
Lofepramine 1-2 weeks to minimise
Depression
Also act as muscarinic, alpha-1 and H1 receptor antagonists which does not affect Other side effects side effects
antidepressant action but does lead to side effects. Seizures, hyponatraemia and
cardiotoxicity in overdose
Nausea
Insomnia Oral
Depression
Citalopram Binds to and inhibits SERT (serotonin transporter) inhibiting the reuptake of these Anxiety
Anxiety
Selective Serotonin Fluoxetine Competitive SERT compounds leading to increased levels in the synaptic cleft, supposedly treating depression Drowsiness Avoid sudden
SSRIs Panic disorder
Reuptake Inhibitors Paroxetine inhibitor according to the monoamine theory. Sudden withdrawal syndrome withdrawal syndrome
OCD
Sertraline by reducing dose over
PTSD
Paroxetine has antimuscarinic side 4 weeks
effects
Binds to and inhibits NET (noradrenaline transporter) and SERT (serotonin Nausea
transporter) inhibiting the reuptake of these compounds leading to increased levels in the Appetite suppression
Serotonin and Mirtazapine synaptic cleft, supposedly treating depression according to the monoamine theory. Hypertension
Depression Competitive SERT and
Noradrenaline Duloxetine SNRIs QT prolongation (venlafaxine) Oral
Anxiety NET inhibitor
Reuptake Inhibitors Venlafaxine Both have a higher efficacy for SERT Insomnia
Venlafaxine has a weak efficacy for NET Drowsiness
Isocarboxazid Non-selective, Binds to and inhibits monoamine oxidase which is responsible for the breakdown of Tyramine cheese reaction
Monoamine Oxidase Phenelzine Depression competitive and amine neurotransmitters. Inhibiting the breakdown of these compounds leads to higher Postural hypotension
MAOIs Oral
Inhibitors Tranylcypromine Anxiety irreversible monoamine levels supposedly treating depression according to the monoamine theory. Antimuscarinic effects
Moclobemide oxidase inhibitor
Binds to an allosteric site on GABA receptors in the CNS, enhancing the actions of Drowsiness
Diazepam Anxiety Oral
Indirect GABA receptor GABA on the receptor. This leads to increased inhibitory effects of GABA which is used in Aggression
Benzodiazepines Lorazepam Benzodiazepines Alcohol withdrawal IM
agonist sleep induction, reduction in anxiety and epilepsy. Muscle weakness
Oxazepam Seizures IV
Dependance
Binds to an allosteric site on GABA receptors in the CNS, enhancing the actions of Metallic taste in mouth
Zopiclone Short term treatment of Indirect GABA receptor
Z-drugs Z-drugs GABA on the receptor. This leads to increased inhibitory effects of GABA, particularly Nausea and vomiting Oral
Zaleplon insomnia agonist
sleep induction. Depression
Haloperidol D2 receptor antagonist
D1 and D2 receptor Antagonises dopamine receptors, decreasing the effects of dopamine in the brain.
Trifluoperazine Schizophrenia is theorised to be caused by a hyperdopaminergic state within the limbic Extrapyramidal symptoms
antagonist
system, therefore decreasing the effects of dopamine will decrease symptoms
QT prolongation with haloperidol and
Typical D2 and D3 receptor chlorpromazine
Sulpiride Schizophrenia
antipsychotics antagonist
Sexual dysfunction
Antagonises D1 and D2 receptors, decreasing the effects of dopamine in the brain. Neuroleptic malignant syndrome
Antipsychotics D1, D2, 5HT1a and Schizophrenia is theorised to be caused by a hyperdopaminergic state within the limbic
Chlorpromazine 5HT2a receptor system, therefore decreasing the effects of dopamine will decrease symptoms.
antagonist Oral
Also inhibits 5HT1a and 2a receptors leading to antidepressant effects.
Risperidone Antagonises D2 receptors, decreasing the effects of dopamine in the brain. Schizophrenia is Sedation and weight gain most severe
Paliperidone theorised to be caused by a hyperdopaminergic state within the limbic system, therefore with olanzapine and clozapine
Lurasidone D2 and 5HT2a receptor decreasing the effects of dopamine will decrease symptoms.
Aripiprazole antagonist Extrapyramidal symptoms and sexual
Olanzapine Schizophrenia Also inhibits the 5HT2a receptor leading to antidepressant effects. dysfunction with amisulpride and
Asenapine risperidone
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