Psychotropic Agents

1
Psychotropic Agents

• Unit 21

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Objectives

• Describe the four classes of psychotropic drugs
• Define stress
• Describe symptoms of anxiety
• State five diseases or conditions that my be
  implicated in stress

3
Health

• State of complete physical, mental, and social
  well-being
• Mental health state of well-being of the mind

4
Psychotropic Drugs

• Drugs that affect psychic function, behavior, or
  experience
• Classified as
• 1. Antianxiety
• 2. Antidepressant
• 3. Antimanic
• 4. Antipsychotic
• Can cause physical/psychological dependence

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Symptoms of Anxiety

• Physical dry mouth, nausea, fast heart rate,
  shortness of breath
• Emotional problems sleeping, feelings or worry
  or doom, inability to concentrate
• Tension restlessness, fatigue, trembling

6
Stress Overload

• Symptoms of stress overload
• Headache
• Stomachache
• Backache
• Irritability
• forgetfulness

7
Guidelines for Reducing Stress

• Take control
• Reach out to others
• Develop healthy habits
• Avoid negative thoughts
• Be realistic
• Get a pet

8
Antianxiety Agents

• Chemical substances that relieve anxiety and
  muscle tension
• Use is indicated when anxiety interferes with a
  persons ability to function properly
• Most widely prescribed drugs for treatment of
  anxiety are the benzodiazepines

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Benzodiazepines

• Exert action on the limbic system of the brain
  suppress the response to conflict and aggression
• Used for anxiety disorders, withdrawal symptoms
  of acute alcoholism, and preoperative anxiety
• Side effects drowsiness, fatigue, nausea,
  insomnia
• Ex. Valium, xanax, ativan

10
Antidepressant Agents

• Chemical substances that relieve the symptoms of
  depression
• When feelings of depression occur every day and
  persists for weeks, patient may have an
  affective disorder.
• Affective disorder is characterized by a
  disturbance of mood, accompanied by a manic or
  depressive syndrome

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Depression

• One of the most common illnesses in America today
• 18 million Americans are affected by clinical
  depression every year

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Classification of Antidepressants

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinepherine reuptake inhibitor
  (SNRI)
• Tricyclic antidepressants (TCAs)
• Monamine oxidase inhibitors (MAOIs)

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Selective serotonin reuptake inhibitors

• Drugs that block reabsorption of serotonin
• Ex. Prozac, Zoloft
• Paxil, Luvox

14
Serotonin-norepinepherine reuptake inhibitors

• Drugs that inhibit both the reabsorption of both
  serotonin and norepinepherine
• Ex. Effexor

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Tricyclic antidepressants

• Drugs that raise the level of norepinepherine and
  serotonin in the brain by slowing the rate at
  which they are reabsorbed by nerve cells
• Ex. Tofranil

16
Monoamine oxidase inhibitors

• Drugs that act by blocking the breakdown of two
  potent neurotransmitters-and allow them to bathe
  the nerve endings for a prolonged period of time

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Antidepressants and Suicide Warnings

• Drugs of concern include
• Prozac
• Paxil
• Zoloft
• Effexor
• Celexa
• Lexapro
• Luvox
• Wellbutrin

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SSRIs

• Action block reabsorption of serotonin
• Uses depression, anxiety disorders, OCD, panic
  disorder
• Adverse Reactions dizziness, drowsiness,
  insomnia, agitation, weight loss, loss of
  appetite, fever

19
SNRIs

• Action inhibits both serotonin and
  norepinepherine
• Uses depression, generalized anxiety disorder,
  social anxiety disorder
• Adverse reactions weakness, nausea, dizziness,
  nervousness, anxiety
• Dosage starting dose is 75 mg/day may be
  increased up to 150 mg/day

20
TCAs

• Actions precise mechanism is unknown seem to
  block serotonin and norepinepherine shortly after
  administration
• Seem to elevate mood, increase physical activity
  and mental alertness, and improve appetite and
  sleep
• Uses depression

21
TCAs

• Adverse Reactions hypotension, tachycardia,
  heart palpitations, and confusion

22
MAOIs

• Actions inhibit the oxidase enzyme that breaks
  down monoamine transmitters in the body
• Uses agoraphobia or in patients who have not
  responded to treatment with TCAs
• Adverse Reactions hypotension, drowsiness,
  insomnia, weakness, nausea, tachycardia, muscle
  twitching

23
Antimanic Agents

• Bipolar disorder major affective disorder that
  is characterized by periods of mania and
  depression
• Subdivided into 3 main types
• Manic excitement, hyperactivity
• Depressed profound sadness
• mixed

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Lithium

• Actions not completely known
• Counteracts mood changes without causing marked
  sedation
• Uses treatment of bipolar disorder
• Warnings may cause fetal harm when administered
  during pregnancy
• Adverse Reactions tremors, polyuria, general
  discomfort

25
Lithium

• Implications for patient care include
• Lithium toxicity (blood levels)
• Metallic taste in the mouth
• Maintain normal intake of fluids and sodium as
  the drug may enhance sodium depletion

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Antipsychotic Agents

• Modify psychotic behavior
• Aka neuroleptics
• Thorazine first antipsychotic agent to be
  introduced in the early 1950s

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Neuroleptics

• Actions precise mechanism is unknown
• Appear to reduce excessive dopamine activity by
  blocking dopamine receptors in the cerebral
  cortex, brain stem, and hypothalamus
• Uses acute and chronic schizophrenia, psychoses,
  manic phase of bipolar disorder, psychotic
  disorders

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Neuroleptics

• Adverse Reactions sedation, convulsive seizures,
  hypotension, tachycardia, dystonia,
  photosensitivity, jaundice
• Other reactions include
• Dystonia extreme muscle spasms
• Akathisia inability to sit down
• Pseudo-parkinsonism tremors, rigidity, postural
  abnormalities, hypersalivation

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Tardive dyskinesias

• Tardive lateness
• Dyskinesia difficult movement
• Characterized by the following
• Involuntary movement of the tongue, face, mouth,
  trunk, and extremities
• Most common in older women
• No known effective treatment