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Psychiatry pharmacology - Coggle Diagram
Psychiatry pharmacology
medication for selected psychiatric conditions
generalizad anxiety disorder: SSRIs, SNRIs
obsessive-compulsive disorder: SSRIs, venlafaxine, clomipramine
depression: SSRIs
panic disorder: SSRIs, venlafaxine, benzodiazepines
bulimia nervosa: SSRIs
PTSD: SSRIs, venlafaxine
bipolar disorder: lithium, valproic acid, carbamazepine, lamotrigine, atypical antipsdychotics
schizophrenia: atypical antipsychotics
alcohol withdrawal: benzodiazepine
social anxiety disorder: SSRIs, venlafaxine
ADHD: stimulants(methylphenidate, amphetamines)
Tourette syndrome: antipsychotics, tetrabenazine
central nervous system stimulants
↑ catecholamines
for ADHD, narcolepsy
methylphenidate, dextroamphetamine, methamphetamine
typical antipsychotics
block dopamine D₂ receptor (↑cAMP)
for schizophrenia, psychosis, bipolar disorder, delirium, Tourette syndrome, Huntington disease, obsessive compulsive disorder
haloperidol, trifluoperazine, fluphenazine(high); thioridazine, chlorpromazine(low); pimozide
adverse: lipid soluble→slow to removed from body; galactorrhea, oligomenorrhea, gynecomastia; dyslipidemia, weight gain, hyperglycemia; dry mouth, constipation; sedation; orthostatic hypotension; QT prolongation; neurologic symptom
EPS
days to months: akathisia, parkinsonism
months to years: tardive dyskinesia
hours to days: acute dystonia; treat with benztropine, diphenhydramine
atypical antipsychotics
for schizophrenia, bipolar disorder, OCD, anxiety disorder, depression, mania, Tourette syndrome
adverse: ↑QT, fewer EPS and anticholinergic effect
most are D₂ antagonist
lithium
for bipolar disorder, manic episode
adverse: hypothyroidism, DI, tremor; cause Ebstein anomaly in new born if taken by pregnant mother
related to inhibition phosphoinositol cascade
buspirone
for generalized anxiety disorder; takes 1~2 weeks to take effect
stimulate 5-HT receptor
antidepressants
tricyclic antidepressants(TCAs)
for major depression, OCD, peripheral neuropathy, chronic pain, migraine prophylaxis
adverse: sedation, α-blocking effect, anticholinergic side effect
inhibit 5-HT and NE reuptake
monoamine oxidase(MAO) inhibitors
for atypical depression, anxiety, Parkinson disease
adverse: CNS stimulation; contraindicated with SSRIs, TCAs, St.John's wort, mepridine, dextromethorphan
↑levels of amine neurotransmitters
serotonin-norepinephrine reuptake inhibitors(SNRIs)
for depression, general anxiety disorder, diabetic neuropathy, etc
adverse: ↑BP, stimulant effect, sedation, nausea
inhibit 5-HT and NE reuptake
atypical antidepressants
trazodone
block 5-HT, α-adrenergic, H₁receptor; for insomnia; toxicities are sedation, nausea, priapism, postural hypotension
varenicline
nicotinic ACh receptor partial agonist; for smoking cessation; toxicities are sleep disturbance, depression
mirtazapine
α₂-antagonist, 5-HT receptor antagonist, H₁antagonist; toxicities are sedation, ↑appetite, weight gain, dry mouth
vilazodone
inhibit 5-HT reuptake, 5-HT receptor partial agonist; for major depressive disorder; toxicities are headache, diarrhea, nausea, ↑weight, anticholinergic effects, serotonin syndrome
bupropion
inhibit NE and dopamine reuptake; also used for smoking cessation; toxicities are stimulant effects, headache, seizure
vortioxetine
inhibit 5-HT reuptake, 5-HT receptor agonist, antagonist; for major depressive disorder; toxicities are nausea, sexual dysfunction, sleep disturbance, anticholinergic effects, serotonin syndrome
selective serotonin reuptake inhibitors(SSRIs)
for depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social anxiety disorder, PTSD, premature ejaculation, premesenstrual dysphoric disorder
adverse: fewer, GI distress, SIADH, sexual dysfunction
inhibit 5-HT reuptake
opioid withdrawal and detoxification
buprenorphine + naloxone
naltrexone
methadone: long acting oral oiate used for heroin detoxification or long-term maintenance therapy