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AFFECTIVE DISORDERS

AFFECTIVE DISORDERS. Anxiety----uneasiness from apprehension and worry about possible events. Try psychotherapy first. benzodiazepenes: xanax/alprazolam valium/diazepam avitan/lorazepam equanil/meprobamate Adverse reactions: drug dependance, sedation, depression, possible birth defect,

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AFFECTIVE DISORDERS

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  1. AFFECTIVE DISORDERS Anxiety----uneasiness from apprehension and worry about possible events. Try psychotherapy first. benzodiazepenes: xanax/alprazolam valium/diazepam avitan/lorazepam equanil/meprobamate Adverse reactions: drug dependance, sedation, depression, possible birth defect, muscle relaxation

  2. Anti-anxiety agents: • Benzodiazepines=(lam/pam drugs) • Mechanism of Action • Benzodiazepines bind to benzodiazepine receptors in the CNS and act as agonists(activate). • 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=(barbital/tal drugs) • 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. • moa---like benzodiazepine but also help block glutamate, the principal excitatory CNS neurotransmitter. • Butalbital=Fiorinal, Fioricet • Phenobarbital=Lumina • Thiopental=Pentothal

  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,obsessive-compulsion • 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) 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

  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(real depression) • adverse effect---hypertension, avoid certain wines,yeast,cheese. avoid ephedrine,levopoda

  10. MAOI examples • phenelzine---Nardil • tranylcypromine---Parnate • selegiline-----Eldepryl

  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 Natural antidepressant—L-tryptophan or 5HTP Don’t combine. nat antidep+rx antidep=serotonin syndome

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