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Psychopharmacology

Psychopharmacology. Department of Psychiatry 1 st Faculty of Medicine Charles University, Prague Head: Prof. MUDr. Jiří Raboch, DrSc. Main Psychopharmacological Drugs. Antipsychotics Antidepresants Anxiolytics Hypnotics Cognitiv e s Psychostimulants. Overview of Antipsychotics.

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Psychopharmacology

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  1. Psychopharmacology Department of Psychiatry 1st Faculty of Medicine Charles University, Prague Head: Prof. MUDr. Jiří Raboch, DrSc.

  2. Main Psychopharmacological Drugs • Antipsychotics • Antidepresants • Anxiolytics • Hypnotics • Cognitives • Psychostimulants

  3. Overview of Antipsychotics

  4. Overview of Antipsychotics

  5. Antipsychoticsof the 2nd Generation

  6. Antipsychoticsof the 2nd Generation Efficacy • Positive symptoms are influenced significantly better than placebo, and equally or more then by the classical antidopaminergic neuroleptics. • Negative symptoms are reduced significantly better than by placebo or classical antidopaminergic neuroleptics. • Affective symptoms are influenced better than by placebo or classical antidopaminergic neuroleptics. • They significantly reduce or prevent the cognitive impairment. The reduction is higher in comparison to classical antidopaminergic neuroleptics. • The treatment resistant patients with schizophrenia are improved significantly better than by placebo and at least equally as by clozapine. • Maintenance treatment is more effective than maintenance on placebo and at least as effective as maintenance on classical neuroleptics.

  7. Antipsychotics of the 3rd generation

  8. Depot Antipsychotics

  9. Rapid Tranquilizers

  10. Indication of Antidepressants • Depressive Disturbances • Affective Disorders • Obsessive-Compulsive Disorders • Panic Disorders • Eating Disorders • Psychosomatic Disorders • Posttraumatic Stress Disorder • Alcohol and Drugs Withdrawal Symptoms • Pain Syndromes • Enuresis • Narcolepsy

  11. Neurotransmitter Reuptake Inhibition and Binding Affinity to Receptors Receptors: SE Serotonergic NE Noradrenergic M Muscarinic H Histaminic -N alpha noradrenergic

  12. Antidepressants:Monoamine Reuptake Inhibitors

  13. 1st Generation of Antidepressants Mechanism of action: • Blockade of muscarine receptors • Histamine H1 receptors • Alpha 1 Adrenergic Receptors • Alpha 2 Adrenergic Receptors Many Side Effects • Danger of Intoxication • Many Interactions • Prolonged Effect (after 3-6 Weeks)

  14. 2nd Generation of Antidepressants

  15. 3rd Generation of Antidepressants

  16. 3rd Generation of Antidepressants

  17. 4th Generation of AntidepressantsDual acting antidepressantsMixed reuptake inhibitors

  18. 4th Generation of Antidepressants

  19. MAO Inhibitors

  20. Other Psychotropics with Antidepressant Effect

  21. Thymoprophylactics

  22. Action Profiles of Benzodiazepines Relief of anxiety Anticonvulsant Sedation action Induction of sleep Muscle relaxation Ansseau, M., Doumont, A., Diricq, S.: Methodology required to show clinical differences between benzodiazepines. Curr Med Res Opin 8, Suppl. 4, 108-114 (1984). (Except <Dormicum> and <Dalmadorm>)

  23. Benzodiazepine Anxiolytics Indication: • States of Anxiety • Sleeplessness • Withdrawal Symptoms • Depressive States • Epilepsy • Convulsions • Tetanus Neonatorum • Extrapyramidal Undesirable Side Effects of Antipsychotics • Premedication in Anaestesiology • Panic States (Alprazolam, Bromazepam, Clonazepam in High Doses) • Algidic Syndromes (Stomatodynie, Neuralgie Trigemini, Cephalgia)

  24. Anxiolytics

  25. Anxiolytics (Benzodiazepine Derivates)

  26. Anxiolytics

  27. Hypnotics

  28. Cognitives

  29. Nootropics

  30. Psychostimulants

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