medicines in psychiatry

Question 1

how to classify psychiatric drugs

Answer 1

1.chemical structure
2.what illness they treat
3.pharmacology (neuroscience based nomenclature -NbN)

Question 2

types of treatment in psychiatry

Answer 2

1. chemical - ie. drugs for psychosis
2. electrical stimulation- ie. ECT for depression
3. structural rearrangement-surgery and orthopaedics- deep brain stimulation for severe depression
   4.CBT- for exposure for phobias

Question 3

where does medicine work on - targets:

Answer 3

receptors,
neurotransmitter reuptake site,
ion channels, enzymes

often in brain but can affect elsewhere like liver

Question 4

examples of enzyme targeting med

Answer 4

E.g. monoamine oxidase inhibitors [MAOIs] for anxiety and depression

E.g. acetylcholinesterase inhibitors for dementias

Question 5

Receptor targeting medicines examples- antagonist vs agonist

Answer 5

antagonist
Dopamine receptor antagonist-> psychosis

agonist
Dopamine receptor agonist->parkinsons

E.g. benzodiazepines enhance GABA -> sleep

Question 6

Reuptake site targeting medicines

Answer 6

e.g. citalopram – enhances serotonin (= serotonin reuptake inhibitor or SRI)– for depression and anxiety

Question 7

Ion channel targeting medicines

Answer 7

Sodium channels
E.g. sodium valproate- epilepsy and mood stabilisation

Question 8

NT- fast vs slow acting

Answer 8

FAST acting (on-off switch)
–Excitatory – glutamate = > 80% of all neurons - pyramidal cells.
–Inhibitory – GABA = 15% -

2. Slow acting (modulators) – about 5% of all neurons
   dopamine – serotonin – noradrenaline -acetylcholine

Question 9

what is a partial agonist

Answer 9

lower max efficacy than full agonist but safer.

Question 10

drug selectivity

Answer 10

very selective have less adverse effects compared to non-selective drugs

Question 11

what is inverse agonist

Answer 11

opposite effects to agonist

Question 12

glutamate excess leads to what and how to treat?

Answer 12

epilepsy
alcoholism

Acamprosate-blocker

Question 13

GABA deficiency leads to what and how to treat

Answer 13

anxiety

benzodiazepines- GABA enhancer

Question 14

5-HT deficiency- leads to what and how to treat

Answer 14

depression/anxiety

SSRI/MOXI- serotonin enhancers

Question 15

dopamine excess leads to what and how to treat

Answer 15

psychosis

dopamine receptor blockers

Question 16

noradrenaline excess leads to what and how to treat

Answer 16

nightmares

prazosin-blocker

Question 17

acetylcholine deficiency -leads to what and how to treat

Answer 17

dementia/impaired memory

acetylcholine esterase enzyme blockers