1 / 69

Psychotropic Medications

Psychotropic Medications. What are they? What do they treat? What should you know?. What are Psychotropic Medications. Psychotropic drugs is a term used to describe psychiatric medicines that alter chemical levels in the brain which impact mood and behavior

nedra
Download Presentation

Psychotropic Medications

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Psychotropic Medications What are they? What do they treat? What should you know?

  2. What are Psychotropic Medications • Psychotropic drugs is a term used to describe psychiatric medicines that alter chemical levels in the brain which impact mood and behavior • Typically these drugs interact with the release and reuptake or absorption of neurotransmitters in the brain and central nervous system

  3. Neurotransmitters in action

  4. What are Neurotransmitters anyway? • Norepinephrine • Serotonin • Dopamine • Gamma amino-butyric acid (GABA) • Acetylcholine • Glutamate

  5. What do Neurotransmitters control? • Anxiety • Mood • Learning • Memory • Appetite • Sleep • Pain • Pleasure • Anger • Aggression

  6. Disorders • Anxiety • PTSD • OCD • Mood Disorders • Depression • Bipolar • ADHD • Psychotic spectrum disorder

  7. Types of Anxiety Disorders • Generalized anxiety disorder (GAD) • Social phobia • Panic disorder • Agoraphobia • Adjustment Disorder (AD) • Obsessive-Compulsive Disorder (OCD) • Posttraumatic Stress Disorder (PTSD)

  8. Obsessive-Compulsive Disorder • Chronic condition, often incapacitating, characterized by persistent thoughts and compulsions

  9. Posttraumatic Stress Disorder • Developed after surviving unusual and severe mental or physical trauma. Person may feel fear, helplessness, or that they are in danger

  10. Antianxiety Medication SSRIs • Zoloft (sertraline) • Paxil (paroxetine) • Prozac (fluoxetine) • Anafranil (clomipramine) • Luvox (fluvoxamine)

  11. What is an SSRI • SSRIs increase effectiveness of serotonin • Regulating mood • Decreased anxiety • Regulate sleep and appetite • Reduce primitive OCD-like urges • Preferred for treatment of OCD

  12. How safe are SSRIs? • Death by overdose is incredibly rare, occurring about two for every one million people using them

  13. SSRI side effects • Increased anxiety • Sedation • Insomnia • Sexual dysfunction • Weight gain

  14. Antianxiety Medication Benzodiazepines • Valium (diazepam) • Klonopin (clonazepam) • Xanax (alprazolam) • Ativan (Lorazepam)

  15. What do Benzodiazepines do? • Acting through the central nervous system • Muscle relaxation • Sedative • Anxiolytic • anti convulsant • Do not repress obsessions in OCD

  16. Benzodiazepine side effects • Significant risk for dependence • Dangerous overdose risk when mixed with alcohol • Drowsiness, dizziness, potential for physical and psychological dependence

  17. Antianxiety medications and children • About 13 out of 100 children and adolescents, ages 9-17, have some sort of anxiety disorder • There are few conclusive studies or guidelines for the use of antianxiety medications in pediatrics • Therapy, however, has been shown to be effective among children and adolescents with anxiety disorders

  18. Mood Disorders

  19. Types of Depression • Unipolar depression is synonymous with clinical depression and major depressive disorder

  20. Types of Depression • Atypical depression is the most common and typically coexists with an anxiety disorder • Dysthymic depression differs from Unipolar depression in that the symptoms are long lasting and milder

  21. Antidepressants: Cyclics • Tofranil (imipramine) • Elavil (amitriptyline) • Anafranil (clomipramine) • Desyrel(trazodone)

  22. Antidepressants:What do cyclics do? • Cyclics increase effectiveness of both serotonin and norepinephrine • Decreased anxiety • Decreased anger/aggression • Increase positive feelings • Increased ability to learn and concentrate

  23. Strattera (atomoxetine) Vestra (reboxetine) Remeron (mirtazapine) Antidepressants: NRIs

  24. Antidepressants:What do NRIs do? • NRIs increase effectiveness of norepinephrine. • Provide an energy boost and increase attention span • Decrease anxiety • Increased positive feelings

  25. Antidepressants: SSRIs • Prozac (fluoxetine) • Zoloft (sertraline) • Paxil (paroxetine) • Celexa (citalopram) • Lexapro (escitalopram) • Luvox (fluvoxamine)

  26. Antidepressants:A review of SSRIs • SSRIs selectively increase effectiveness of serotonin • Decreased anxiety • Decreased anger/aggression • Increased ability to learn and concentrate

  27. Antidepressants: SNRIs • Cymbalta (duloxetine) • Effexor (venlafaxine) • Pristiq (desvenafaxine)

  28. Antidepressants:What do SNRIs do? • SNRIs increase effectiveness of both serotonin and norepinephrine • Decreased anxiety • Decreased anger/aggression • Increase positive feelings • Increased ability to learn and concentrate

  29. Antidepressants: Atypical • Wellbutrin (bupropion HCL) • Zyban (bupropion HCL) • Aplenzin (bupropion hydrobromide) • Oleptro (trazodone ER)

  30. Antidepressants:What do atypicals do? • Atypical antidepressants increase effectiveness of both dopamine and norepinephrine • Decrease anxiety • Increased positive feelings • Increased ability to concentrate and learn • Increased motivation and desire • Increased pleasure

  31. Antidepressants: MAOIs • Parnate (tranylcypromine) • Nardil (phenelzine) • Emsam patch (selegline)

  32. Antidepressants:What about MAOIs? • Side effects • Orally, rarely used due to many serious drug-drug and drug-food interactions • Patch is associated with fewer side effects • MAOIs should NEVER be combined with SSRIs as this may result in a coma or even death

  33. What do antidepressants do? • Used to restore normal biological functioning • Studies suggest that with quality care, the same outcomes may be achieved with a primary care physician as with a psychiatrist

  34. Side effects of antidepressants • Cyclics • Dangerous in overdose and enhance effects of alcohol, very sedating, dry mouth, constipation, drop in blood pressure, rapid hear rate, weight gain, decreased libido • Atypical • Anxiety and insomnia

  35. Side effects of antidepressants • SSRIs • Increased serotonin activity, weight gain, decreased libido, anxiety, sedation, insomnia • NRIs • Weight gain, rare decreased white blood cell count (Remeron)

  36. Action times • How long does it take for Zoloft, Paxil, Effexor, and Wellbutrin to take effect? • At least 50% of those who will eventually respond to the above mentioned antidepressants will begin to demonstrate improvement within one week of beginning treatment.

  37. Antidepressants and children • According to the NIMH one in three children suffer from depression. • SSRIs are the choice treatment for pediatric depression. • All antidepressants carry a warning indicating possible risk of suicide with use in teens and children

  38. Are older cyclic antidepressants as effective as newer SSRIs, SNRIs and atypicals? • Most likely, yes. • Most cyclics are dual-action, meaning they assist at increasing the effectiveness of norepinephrine and serotonin to the “emotional brain”.

  39. Are certain ethnicities more likely to be depressed than others? • Apparently so… • Approximately 30% of Hispanics report suffering from depression compared to 26% for whites, 20% for blacks, and 16% for Asians.

  40. Bipolar Disorder • Characterized by intense mood swings (mania and depression) • Disruptive behaviors include delusional thinking, binges, recklessness • Classified as a mood disorder • Cyclothymia: mood swings lasting at least two years • Chronic disorder with less intense mood swings

  41. Discussion Point • Is Bipolar disorder underdiagnosed or over diagnosed in children and adolescents?

  42. Mood-Stabilizing Agents Anticonvulsants • Depakote (divalproex) • Lamictal (lamotrigine) • Tegretol (carbamazepine) • Topamax (topiramate)

  43. Mood-Stabilizing Agents Atypical Antipsychotics • Zyprexa (olanzapine) • Abilify (aripiprazole) • Symbyax (fluoxetine)

  44. Lithium • Lithium reduces suicide risk and attempts • Decreases anxiety and manic episodes • Lithium commonly causes nausea, diarrhea, vomiting, thirst, weight gain, acne and fine-hand tremors • Lithium may pose long term health risks. For this reason, children or adolescents should have blood drawn and analyzed several times a year

  45. What do mood-stabilizing agents do? • The exact way remains unclear, perhaps interaction with GABA • Decrease mania • Decrease disruptive behaviors • Stabilize mood • Depakote may work quicker than Lithium • Decreases rapid cycling mania • Decreases rage reactions • Topamax is more effective in treating migraines than as a mood stabilizer

  46. Side effects of mood-stabilizing agents • Depakote may cause sedation, dizziness, drowsiness, blurred vision, and coordination problems • Depakote may pose long term health risks. For this reason, children or adolescents should have blood drawn and analyzed several times a year • Lamictal may cause serious rash development

  47. Mood stabilizing agents and children • Lithium and Depakote are most often used in this age group • Both drugs require frequent blood tests to monitor thyroid and kidney functioning • The use of mood stabilizers in children is a balancing act between possible impact of side effects and the severity of the disorder

  48. Is the diagnosis of pediatric bipolar disorder on the rise? • Absolutely. • According to the December 2007 Harvard Mental Health Letter, office visits by children diagnosed with bipolar disorder multiplied 40-fold from 1994 to 2003.

  49. Diagnosing children vs. adults • Is bipolar disorder more difficult to diagnose in children than in adults? • Yes, bipolar disorder is actually very hard to diagnose in children. This is mainly due to the high incidence of multiple co-existing disorders, often with symptom overlap.

  50. ADHD • Effects 5-8% of all children in the USA • Characterized by difficulty focusing, sitting still and often impulsive tendencies • 4-9 times more common in boys

More Related