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AFFECTIVE DISORDERS
Anxiety----uneasiness from apprehension and worry about
possible events.
Try psychotherpay first.
Anti-anxiety agents:
xanax/aplrazolam
valium/diazepam
avitan/lorazepam
equanil/meprobamate
Adverse reactions:
drug dependance, sedation, depression, possible birth defect,
muscle relaxation
Anti-anxiety agents:


Benzodiazepines


Mechanism of Action
• Benzodiazepines bind to benzodiazepine
receptors in the CNS and act as agonists.
• They enhance the action of the inhibitory
neurotransmitter gamma-aminobutyric acid
(GABA).
• Reduce anxiety and panic.
• Cause sedation.
• Skeletal muscle relaxation
Uses
•The short-term treatment of anxiety, panic attacks, insomnia, and
•alcohol withdrawal.
•Some benzodiazepines are used to treat seizure disorders.
Anti-anxiety agents:


Barbiturates









These drugs are the original sedative-hypnotics.
They have been associated with a high rate of abuse
and complete respiratory and cardiovascular
depression.
They are lethal in an overdose.
Benzodiazepines have pretty much replaced
barbiturates in treating anxiety, insomnia and panic
because of their more acceptable safety profile.
Barbiturates are used to treat seizure disorders and
to induce general anesthesia.
like benzodiazepine but also help block glutamate,
the principal excitatory CNS neurotransmitter.
Depression


feelings of pessimism, worry, sadness,
reduced eating and sleeping,
concentration.
 Types of antidepressants---- SSRI
 Tricyclic
 MAOI
Anti-depressant---SSRI






SSRI--selective seratonin reuptake inhibitor
moa---blocks reuptake of seratonin(brain
neurotransmitter. reduced seratonin may affect
mood.
indications---major depression,obsessivecompulsion
adverse effect---takes 2-3weeks to work,
insomia, nervousness, diarrhea, weight loss,
reduced libido
SSRI antidepressants


celexa
 cymbalta
 prozac
 paxil
 zoloft
 effexor
Tricyclic antidepressant
(TCA)

10

11

9
8

1

B

C

5

N

moa--block reuptake of seratonin
or norepinephrine(hormone and
neurotransmitter most
responsible for alertness )
indications--depression, bedwetting children
adverse reactions---cardiotoxic in high dose,
drowsiness, several weeks to work
7

2

A
3

6

N
R2

R1
Tricyclic antidepressant (TCA)


Examples
 amytriptyline
 doxepin
 imipramine
 desipramine
MAOI antidepressant








monoamine oxidase inhibitor
catecholamines are monoamine---mostly
epinephrine (adrenaline), norepinephrine
(noradrenaline) and dopamine
MAOIs act by inhibiting the activity of
monoamine oxidase, thus preventing the
breakdown of monoamine neurotransmitters
and thereby increasing their availability.
indications--atypical depression
adverse effect---hypertension, avoid certain
wines,yeast,cheese. avoid ephedrine,levopoda
MAOI examples


phenelzine---Nardil
 tranylcypromine---Parnate
 selegiline-----Eldepryl
Bipolar disorder


swings between mania and depression
 lithium moa unknown….has sodium
properties to generate action potentials,
also enhance seratonin.watch salt diet.
 use carbamezepine more severe cases
but interferes with many many drugs
 adverse reactions--bloating, abnomral
fetus, increased weight, acne
Psychosis


not living in reality,hallucinations, bizarre
behavior
 dose varies drug to drug
 moa--affects neurotransmitters
 adverse reactions---sedation, bone
marrow suppression, pseudoparkinson’s
 allow 6-12 weeks for improvement
Anti-psychotics


haldol
 abilify
 compazine
 risperdal
 geodon
 prolixin

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Antidepressants

  • 1. AFFECTIVE DISORDERS Anxiety----uneasiness from apprehension and worry about possible events. Try psychotherpay first. Anti-anxiety agents: xanax/aplrazolam valium/diazepam avitan/lorazepam equanil/meprobamate Adverse reactions: drug dependance, sedation, depression, possible birth defect, muscle relaxation
  • 2. Anti-anxiety agents:  Benzodiazepines  Mechanism of Action • Benzodiazepines bind to benzodiazepine receptors in the CNS and act as agonists. • They enhance the action of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). • Reduce anxiety and panic. • Cause sedation. • Skeletal muscle relaxation Uses •The short-term treatment of anxiety, panic attacks, insomnia, and •alcohol withdrawal. •Some benzodiazepines are used to treat seizure disorders.
  • 3. Anti-anxiety agents:  Barbiturates       These drugs are the original sedative-hypnotics. They have been associated with a high rate of abuse and complete respiratory and cardiovascular depression. They are lethal in an overdose. Benzodiazepines have pretty much replaced barbiturates in treating anxiety, insomnia and panic because of their more acceptable safety profile. Barbiturates are used to treat seizure disorders and to induce general anesthesia. like benzodiazepine but also help block glutamate, the principal excitatory CNS neurotransmitter.
  • 4. Depression  feelings of pessimism, worry, sadness, reduced eating and sleeping, concentration.  Types of antidepressants---- SSRI  Tricyclic  MAOI
  • 5. Anti-depressant---SSRI     SSRI--selective seratonin reuptake inhibitor moa---blocks reuptake of seratonin(brain neurotransmitter. reduced seratonin may affect mood. indications---major depression,obsessivecompulsion adverse effect---takes 2-3weeks to work, insomia, nervousness, diarrhea, weight loss, reduced libido
  • 6. SSRI antidepressants  celexa  cymbalta  prozac  paxil  zoloft  effexor
  • 7. Tricyclic antidepressant (TCA) 10 11 9 8 1 B C 5 N moa--block reuptake of seratonin or norepinephrine(hormone and neurotransmitter most responsible for alertness ) indications--depression, bedwetting children adverse reactions---cardiotoxic in high dose, drowsiness, several weeks to work 7 2 A 3 6 N R2 R1
  • 8. Tricyclic antidepressant (TCA)  Examples  amytriptyline  doxepin  imipramine  desipramine
  • 9. MAOI antidepressant      monoamine oxidase inhibitor catecholamines are monoamine---mostly epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine MAOIs act by inhibiting the activity of monoamine oxidase, thus preventing the breakdown of monoamine neurotransmitters and thereby increasing their availability. indications--atypical depression adverse effect---hypertension, avoid certain wines,yeast,cheese. avoid ephedrine,levopoda
  • 11. Bipolar disorder  swings between mania and depression  lithium moa unknown….has sodium properties to generate action potentials, also enhance seratonin.watch salt diet.  use carbamezepine more severe cases but interferes with many many drugs  adverse reactions--bloating, abnomral fetus, increased weight, acne
  • 12. Psychosis  not living in reality,hallucinations, bizarre behavior  dose varies drug to drug  moa--affects neurotransmitters  adverse reactions---sedation, bone marrow suppression, pseudoparkinson’s  allow 6-12 weeks for improvement
  • 13. Anti-psychotics  haldol  abilify  compazine  risperdal  geodon  prolixin