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PSYCHOPHARMACOLOGY. PSYCHOPHARMACOLOGY. Antipsychotics Antiparkinsonisms Antidepressants Mood stabilizers Sedative Hypnotics Others. Principles of psychopharmacotherapy. The diagnostic assessment is fundamental to our model Pharmacotherapy is insufficient for complete recovery.
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PSYCHOPHARMACOLOGY • Antipsychotics • Antiparkinsonisms • Antidepressants • Mood stabilizers • Sedative Hypnotics • Others
Principles of psychopharmacotherapy • The diagnostic assessment is fundamental to our model • Pharmacotherapy is insufficient for complete recovery. • The phase of an illness is of critical importance in terms of the initial intervention and the duration of treatment • The risks to benefit ratio must always be considered when developing a treatment strategy
Principles of psychopharmacotherapy • Prior personal history of good and bad response to a specific agent usually dictates the first line of choice for a subsequent episode. • It is important to target specific symptoms that serves as a marker for the underlying psychopathology. • Observe the development of adverse side effects.
Indications of antipsychotics • Brief psychotic disorders • Schizophreniform • Schizophrenia • Schizoaffective Disorders • Delusional disorders • Psychotic mood disorders • Organic psychoses
Antipsychotics • Phenothiazines • Aliphatic • Chlorpromazine ( Thorazine 25, 50,100mg) • Piperidines • Thioridazine ( Melleril 50, 100mg ) • Piperazines • Fluphenazine • Perphenazine ( Trilafon 4, & 8 mg.) • Trifluoperazine ( Stelazine 5 mg.) • Mesoridazine ( serentil 10mg.)
Antipsychotics • THIOXANTHENES • Thiothexenes – Navane • Zuclophentixol HCl – Clopixol 10, 25mg tab • Zuclophentixol decanoate – Clopixol depot • Zuclophentixol acetate – Clopixol Acuphase
Antipsychotics • Butyrophenones Haloperidol ( Haldol, 1, 2, 5, 10 mg/tab) ( Serenace 5, 10, 20mg/tab ) ( Serenace 5mg/ampule )
Antipsychotics • Benzamides • Sulpiride – Dogmatil • Amisulpiride - Solian
AntipsychoticsSerotonin-Dopamine Antagonists • Dibenzodiazepines • Clozapine - Leponex • Thiobenzodiazepines • Olanzapine - Zyprexa • Benzothiazepines • Quetiapine - seroquel • Benzisoxasoles • Risperidone - Risperdal • Benzisothiasole piperazine • Ziprasidone - Zeldox
Antiparkinsonism • Biperidin HCl – Akineton 2mg. • Diphenhydramine – Benadryl 50mg • Amantadine – Symmetrel 100mg • Benztropine mesylate – Cogentin 2mg • Trihexyphenidyl HCl – Artane 2mg
Antidepressants • Heterocyclics • MAOI’s • RIMA • Dopamine Agonists • SSRI • SNRI
AntidepressantsHeterocyclics • Tricyclics • Imipramine - Tofranil • Clomipramine - Anafranil • Tetracyclics • Maprotiline - Ludiomil • Dothiepine – Prothiaden • Mirtazapine - Remeron
AntidepressantsMonoamine Oxidase Inhibitors (MAOI) • Increases biogenic amines by inhibiting their degradation • Should not be taken with foods w/ tyramine • Examples • Tranylcypromine ( Parnate ) • Phenelzine ( Nardil ) • Iproniazid ( Marsilid )
AntidepressantsReuptake Inhibitor of Monoamine Oxidase Inhibitor type A (RIMA) • Moclobemide – Aurorix 150 mg • Brofaromine
AntidepressantsDopamine Agonists • Amineptine HCl – Survector 100mg/tab
AntidepressantsSelective Serotonin Reuptake Inhibitors (SSRI) • Paroxetine – Paxil, Seroxat 20/tab • Fluovoxamine – Luvox, Faverin 50mg/tab • Fluoxetine – Prozac 20mg/pulvules • Sertraline – Zoloft 50mg/tab
AntidepressantsSerotonin-Norepinephrine Reuptake Inhibitors • Venlafaxine – Effexor 50mg./tab
Mood Stabilizers • Lithium carbonate – Quilonium R 450mg/tab • Carbamazepine – Tegretol 200mg/tab • Oxcarbazepine – Trileptal 300 & 600mg • Depakene – Valproic Acid • Divalproate sodium – Epival 250mg/tab
Sedative - Hypnotics • Benzodiazepines • Imidazopyridines • Cyclopyrrolone derivatives
Imidazopyridines • Zolpidem – Stilnox 10mg/tab
Cyclopyrrolone derivative • Zopiclone – Imovane 7.5mg/tab