Professional Documents
Culture Documents
Electroconvulsive Therapy
- was used to treat psychosis and
depression before the introduction of
antipsychotics and antidepressants.
St.John’s wort – can decrease
reuptake of the neurotransmitters
serotonin, norepinephrie, and
dopamine.
Gingko biloba
Four groups (4):
tricyclic antidepressants (TCAs)
selective serotonin reuptake
inhibitors (SSRIs)
atypical antidpressants that affect
various neurotransmitters
monoamine oxidase inhibitors
(MAOIs)
are used to treat major depression,
because they are effective and less
expensive than SSRIs and other drugs.
Imipramine was the first TCA marketed in
the 1950s.
The action is to block the uptake of the
neurotransmitters norepinephrine and
serotonin in the brain.
This group of drugs elevates mood ,
increased interest in daily living and
activity and decreases insomia.
Given at night to minimize problems
caused by their sedative action.
When discontinuing TCAs, the drugs
should be gradually decreased to
avoid withdrawal syndrome such as
nausea, vomiting, anxiety, and
akathisia.
Examples are:
Amitriptyline (Elavil)
doxepin (Sinequan)
trimipramine (Surmontil)
imipramine
desipramine
nortriptyline
EXAMPLE OF SSRIs
Fluoxetine ( Prozac )
Fluvoxamine ( Luvox )
Sertraline ( Zoloft )
Paroxetine ( Paxil )
Citalopram ( Celexa )
Escitalopram ( Lexapro )
Dry mouth
Blurred vision
Insomnia
Headache
Nervousness
Anorexia
Nausea
Diarrhea
Suicidal ideation
Some clients may experience sexual dysfunction
also called second-generation antidepressants
became available in the 1980s and have been used
for major depression, reactive depression and anxiety
They affect 1 or 2 of the 3 neurotransmitters:
› Serotonin
› Norepinephrine
› Dopamine
should not be taken with MAOIs and should not be
used within 14 days after discontinuing MAOIs.
Examples:
amoxapine (Asendin)
bupropion (Wellbrutin)
maprotiline (Ludiomel)
nefazodone (Serzone)
trazodone (Desyrel)
mirtazipine (Remeron)
venlafaxine (Effexor)
Manic episodes in persons with bipolar disorder
(If not combined with a mood-stabilizing drug,
atypical antidepressants may induce manic
episodes in individuals with bipolar disorder.)
Seizures (Atypical antidepressants may lower
the threshold for seizures; that is, seizures may
occur more easily. Caution is advised for
individuals prone to seizures or those who have
a history of seizures.)
Drowsiness (Caution is advised when operating
machinery, driving, or performing other tasks
that require alertness.)
relieve depression by preventing the
enzyme monoamine oxidase from
metabolizing the neurotransmitters
norepinephrine, serotoninand dopamine in
the brain
are currently not the antidepressants of
choice and are usually prescribed when the
client does not repond to TCAs or second-
generation antidepressants.
Should not be taken together with TCA
when treating depression
MAO- A – inactivates dopamine in
the brain
MAO- B
– inactivates
norepinephrine and serotonin
1. tranyclypromine sulfate
(Panate)
2. isocarboxazid (Marplan)
3. phenelzine sulfate (Nardil)
Orthostatic hypotension
CNS stimulation (agitation,
restlessness, insomnia)
Anticholinergic effects
MAO inhibitors may cause serious and possibly
life-threatening reactions, such as sudden high
blood pressure, when taken with certain foods,
beverages, or medicines.
The dangerous reactions may not begin until
several hours after consuming these items.
Aged cheeses, red wines, smoked or pickled
meats, chocolate, caffeinated beverages, and
foods containing monosodium glutamate (MSG)
are among the foods and drinks to be avoided
Anyone who is taking MAO inhibitors should not
use any other medicine unless it has been
approved or prescribed by a physician who
knows that they are taking MAO inhibitors, this
includes:
› nonprescription (over-the-counter)
medicines such as
sleep aids; medicines for colds, cough,hay
fever, or asthma (including nose drops or
sprays); medicines to increase alertness or
keep from falling asleep; and appetite
control products.
also known as neuroleptics or
psychotropics
have been available since the mid-
1950s.
refers to any drug that modifies
psychotic behavior and exerts an
antipsychotic effect
Psychosis
or losing contact with reality
is manifested in a variety of mental or psychiatric disorders
is usually characterized by more than one symptom, but
these may include difficulty in processing information and
coming to a conclusion, delusions, hallucinations,
incoherence, catatonia, and aggressive or violent behavior
sometimes called dopamine antagonist
block D2 dopamine receptors in the brain, reducing
psychotic symptoms
many antipsychotics block the chemoreceptor trigger zone
and vomiting center in the brain, producing an antiemetic
effect
Schizophrenia
a chronic psychotic disorder
is the major category of psychosis in
which many of these symptoms are
manifested
symptoms usually develop in
adolescence or early adulthood
“Positive” symptoms
- may be characterized exaggeration of
normal function, incoherent speech,
hallucination, delusion, and paranoia
“Negative” symptoms
– are characterized by a decrease or loss in
function and motivation
- there is poverty of speech content, poor
self-care, and social withdrawal
- tend to be more chronic and persistent
Are divided into 2:
› Typical Antipsychotics
Division of typical antipsychotics
Phenotiazines
Nonphenotiazine