Psychotropic drugs

DEFINITIONS psychotropic drugs I: Chemical agents that affect the brain and nerv
ous system, alter the feelings, emotions and consciousness in various ways. Neur
otransmitters: Chemicals that allow transmission of electrical impulses from one
neuron to another across the synapse.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 2
DEFINITIONS III Neuroleptic malignant syndrome: rare, but potentially lethal, tr
eatment with antipsychotic drugs. Symptoms include severe muscle rigidity, hyper
thermia, hypertension, tachycardia, diaphoresis, and increased creatine. Electro
convulsive therapy (ECT): induction of a tonic-clonic seizure (generalized) by a
pplying an electric current to the brain.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 3
Extrapyramidal system DEFINITIONS II: Routes of motor neurons from the brain to
areas of the spinal cord, this system has complex relay and connections to areas
of the cerebral cortex, cerebellum, brainstem and thalamus. The extrapyramidal
system helps maintain balance and muscle tone.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 4
I FUNDAMENTAL CONCEPTS

Psychotropic medications are not used to cure mental illness, only relieve the p
hysical and behavioral symptoms. Biological therapies can induce healing by prod
ucing changes in cellular functions of the CNS. Such changes make the emergence
of new behaviors.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 5

FUNDAMENTAL CONCEPTS II
Some neurotransmitters, and their relationship to mental disorders are:
n
Dopamine: Excessive dopaminergic activity is associated with schizophrenia. Sero
tonin and norepinephrine: causal factors of depression and mania. Currently it i
s believed that mood disorders are the result of different chemicals such as neu
rotransmitters and hormones.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 6
n
BASIC CONCEPTS III
n
Gamma-aminobutyric acid (GABA): the creation of a inhibitory effect on anxiety.
Acetylcholine: it is postulated that the cognitive deficits of Alzheimer's disea
se are due to a reduction of acetylcholine. Monoamine oxidase: enzyme responsibl
e for the destruction of some neurotransmitters
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 7
n
n
FUNDAMENTAL CONCEPTS IV
Some depressed individuals improve with ECT, having failed other forms of treatm
ent. Classification of major psychotropic drugs: 1 .- 2 .- Antidepressants Antip
sychotics antimanic 3 .- 4 .- 5 .- Benzodiazepine Sedative-hypnotics
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 8
MAIN psychotropic drugs
Antipsychotic drugs

Antipsychotics Atypical Antipsychotics

Antipsychotic drugs I
Antipsychotic agents (neuroleptics) classical outlined in the following table:
Class Generic Name Trade Name Daily Dose of more frequent maintenance
Phenothiazines
Perphenazine Thioridazine Trifluoperazine Chlorpromazine Trifluopromazina mesoxi
dazina fluphenazine
Chlorpromazine Largactil Meleril Eskazine modecate --- Decent
50-400 mg 50-400 mg 2-30 mg 8-24 mg 60-150 mg 30-150 mg 2.5-20 mg
U.S. PSYCHOPHARMACOLOGY Walter Cortes
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butyrophenones thioxanthenes
thiothixene haloperidol chlorprothixene
--- haloperidol
50-400 mg 1-15 mg 6-30 mg
dihidroindolonas
molindone
40-225 mg
dibenzoxacepinas
loxapine
disconnection
25-250 mg
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
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Antipsychotic drugs II
Antipsychotic agents (neuroleptics) atypical outlined in the following table:
Class Generic Name Trade Name Daily Dose of more frequent maintenance 300-450 mg
300-450 mg 4-6 mg
Others
Pimozide Clozapine Risperidone
Orap Leponex Risperidal
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
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INDICATIONS I
1 .- Antipsychotics used to treat
positive symptoms of schizophrenia. The new atypical antipsychotics such as cloz
apine and risperidone, help reduce the negative symptoms of schizophrenia. 2 .-
Antipsychotics may also be used to treat symptoms of bipolar disorder and psycho
tic disorder, cognitive impairment
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 14
INDICATIONS II 3 .- They can also be treated with antipsychotics symptoms such a
s agitation, anger, hyperactivity, sensory stimuli, hallucinations, delusions, p
aranoia and aggressiveness. 4 .- Other indications include the treatment of vomi
ting, hiccups, and refractory vertigo.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 15
MECHANISM OF ACTION 1 .- Antipsychotics produce blockade of postsynaptic dopamin
e receptors in the limbic system, hypothalamus and cerebral cortex. 2 .- The sam
e blocking dopamine occurs at the level of the basal ganglia,€produce undesirabl
e extrapyramidal side effects and other types.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 16
MECHANISM OF ACTION
3 .- The atypical antipsychotics act through a combined dopaminergic and seroton
ergic antagonism. These new drugs are lacking in many of the side effects of cla
ssic antipsychotics.
18
GENERAL I
Antipsychotics PRINCIPLES:

Initial treatment may require parenteral doses. According recedes conduct disord
er is changed to oral tablets or concentrated preparations. The doses are calcul
ated according to the needs of each individual. To achieve symptomatic changes,
it is essential guideline doses carefully.

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18
GENERAL I

The divided doses are changed to single doses, primarily administered at bedtime
to maximize the sedative properties of these drugs.
To achieve sustained improvements, most clients need maintenance dose.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
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GENERAL II

In elderly clients recommended low-dose treatment. Adverse side effects and are
more common in elderly clients, which is due to their lower renal and hepatic fu
nction and to their smaller muscle mass compared with fat tissue. Its half-life
in serum is about 24 hours. The drug accumulates in fatty tissue. After stopping
the medication, fat is releasing the drug, so side effects may persist.

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GENERAL II

High therapeutic index and can be administered at high doses with minimal risk.
These drugs are not addictive and do not produce euphoria. Not recommended durin
g pregnancy.

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CONTRAINDICATIONS

In cases of severe CNS depression due to excessive use of alcohol, barbiturates

or narcotics when there is brain damage, or in case of injury. Do not administer
to clients with known hypersensitivity. Clients with Parkinson's disease may ex
perience an increase in their symptoms.

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CONTRAINDICATIONS

Probable development of blood dyscrasia side effect of pharmacotherapy clients w

ith a history of previous dyscrasia. Use with caution if there is a history of l
iver injury or jaundice. Clients with acute narrow-angle glaucoma or prostatic h
ypertrophy can experience increased intraocular pressure and urinary retention,
respectively, due to property anticholinergic drugs.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 23

SIDE EFFECTS I
Antipsychotics:
s d. e. f. s i. j. k. l. m.
Type cardiovascular: Hypotension. Orthostatic hypotension, tachycardia. Antichol
inergic Type: urinary retention and hesitancy. Constipation Blurred vision. Nasa
l congestion. Dry mouth
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 24
SIDE EFFECTS II
1. b.
c.
Extrapyramidal: Seudoparkinsonismo (mask facies, stooped, rigid posture, shuffli
ng gait, drooling, tremors, movement of "counting money"). Acute dystonic reacti
on (contractions of the tongue, face, neck and back; opisthotonos, where the who
le body arches so tetanus, and oculogyric crisis, in which the eyes are facing u
p).
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
25
SIDE EFFECTS II
b.
Acaticia (restlessness and excessive walking).
d.
Tardive dyskinesia (writhing movements and remove the tongue, puffs, pops and li
cking. Spastic distortion may also occur on the face and choreic or athetoid mov
ements of the limbs) irreversible symptom.
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SIDE EFFECTS III
1. b. c.
d. e.
f.
Other side effects: sedation. Skin disorders (hives or contact dermatitis). Phot
osensitivity endocrine disorders (moderate increase in breast and galactorrhea i
n women, gynecomastia in males, altered sex drive, loss of libido in both sexes
and possibly amenorrhea in females). Weight gain.
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27
SIDE EFFECTS IV
1. b. c.
d.
Serious side effects but rare: Agranulocytosis. Cholestatic jaundice (fever, nau
sea, abdominal pain and jaundice). Neuroleptic malignant syndrome
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SIDE EFFECTS V atypical antipsychotics:
s
Agranulocytosis: incidence of 1 to 2% in clients treated with clozapine. Idem se
izures that typical antipsychotics: sedation, orthostatic hypotension, constipat
ion, effects on the SEP, neuroleptic malignant syndrome).
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 29
5. s
Antidepressant drugs
TRICICLOS Monoamine Oxidase Inhibitors (MAOIs) NO INHIBITORS TRICICLOS ser
otonin reuptake inhibitors (SSRIs)

Antidepressant drugs
generic name brand name class daily maintenance dose Frequently 50-100 mg 50-150
mg 75-200 mg 75-100 mg 15-45 mg 75-150 mg 75-300 mg 150-225 mg
Tricyclic antidepressants (TCA)
Imipramine Amitriptyline Desipramine Nortriptyline Protriptyline Doxepin Clomipr
amine Maprotiline
Tofranil-Martimil Tryptizol, paxtibi - Ludiomil Sinequan Anafranil
Monoamine oxidase inhibitors (MAOIs)
Toranilcipromina isocarboxazid phenelzine
Parnate - Nardelzine
10-30 mg 10-30 mg 15-90 mg
31
U.S. PSYCHOPHARMACOLOGY Walter Cortes
Antidepressant drugs
No tricyclic Trazodone Venlafaxine bupropion (bupropion) Fluoxetine Paroxetine S
ertraline Dobupal, vandral Deprax - Prozac, Adolf Besitrán Frosinor, Seroxat 150
-375 mg 150-400 mg 200-450 mg 50-200 mg 20-40 mg 20-50 mg
Inhibitors of serotonin reuptake inhibitors (SSRIs), second-generation antidepre
ssants
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
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INDICATIONS
1.
Used in the treatment of depressive disorders, they can positively change the de
gree of withdrawal, the level of activity and vegetative signs of depression.
those of the
3.
Use in the treatment of anxiety disorders, enuresis and childhood hyperactivity,
and chronic pain.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 33
MECHANISM OF ACTION
2.
It depends on the type of antidepressant Tricyclic antidepressants (TCA): Increa
se the levels of neurotransmitters by blocking reuptake of norepinephrine and se
rotonin at the level of the presynaptic neuron.
4.
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34
MECHANISM OF ACTION
2.
Monoamine oxidase inhibitors (MAOIs) inhibit monoamine oxidase, which is the enz
yme responsible for metabolizing the neurotransmitters. Atypical antidepressants
or selective inhibitors of serotonin reuptake inhibitors (SSRIs) act selectivel
y on the neurotransmitter serotonin by blocking its reuptake at the presynaptic
cell.
4.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
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GENERAL I
1.
The TCAs are potentially lethal if taken in quantities of 10 to 30 times the rec
ommended daily dose. The client may not respond to antidepressants until after t
he three weeks of the first dose. Clients with severe depression and who have de
lusions or other psychotic symptoms, they may need the administration of an anti
psychotic with an antidepressant.
3.
5.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
36
GENERAL II
1.
Before TCAs were the drugs of choice for the treatment of nonpsychotic unipolar
depression. Currently, the drug of choice might be an SSRI. MAOIs are effective
antidepressants can be helpful to some clients who do not respond to TCAs and SS
RIs or who can not tolerate them. In clients who take antidepressants should be
monitored the emergence of suicidal ideation, and that the drugs increase levels
of energy consumption and its ability to carry out such plans.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 37
3.
5.
I CONTRAINDICATIONS AND PRECAUTIONS
2.
ATC: pre-existing cardiovascular disease. Background convulsionews. Narrow angle
glaucoma. Prostatic hypertrophy. Pregnancy and lactation.

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I CONTRAINDICATIONS AND PRECAUTIONS
2.
MAOI: Lack of compliance with the diet without food containing tyramine. History
of cerebrovascular defects or cardiovascular disease. Age (over 60 years). Live
r disease. Drugs that can precipitate hypertensive crisis.

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CONTRAINDICATIONS AND PRECAUTIONS II
1.
SSRIs: Impaired hepatic or renal function. Pregnancy and lactation. History of s
eizures. Concurrent treatment with MAOIs. Clients at risk of suicide.
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SIDE EFFECTS I
1.
b. c. d. e. f.

ATC:
Anticholinergic effects. Cardiovascular effects. Sedation. Photosensitivity. Oth
er uncommon:
Decreased seizure threshold. Decreased or increased libido and erectile dysfunct
ion ejaculation.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 41
SIDE EFFECTS II
1. b. c.
d.
e.
MAOI: They may cause diarrhea, abdominal pain, restlessness, insomnia and dizzin
ess. The worst are the hypertensive crisis, appear to consume foods with tyramin
e or with drugs that increase noradrenergic activity. Symptoms of hypertensive c
risis include generalized headache, nausea, vomiting, pallor, chills, stiff neck
, muscle twitching, palpitations and chest pain.€Treatment: slow administration
of phentolamine mesylate, hydration and electrolyte balance restoration.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 42
SIDE EFFECTS III
1. b. c.
SSRIs: Similar to the ATC. Customers treated with SSRIs have a lower incidence o
f anticholinergic side effects and have less cardiotoxicity.
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43
Antimanic drugs
LITHIUM CARBONATE LITHIUM CITRATE

INDICATIONS I
1.
Lithium carbonate and lithium citrate are used primarily antimanic agents:
Acute mania. Episodes of hypomania. Long-term prophylaxis of bipolar disorders.
Effective in preventing recurrent manic episodes.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 45

INDICATIONS II
1.
It is used experimentally to treat other psychiatric disorders that appear in mo
od disorders, such as:
Alcoholism. Drug Abuse. Premenstrual syndrome. Pathological sexual behaviors and
phobias.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 46

MECHANISM OF ACTION
1. 2.
3.
4.
The exact mechanism of action is not well known. Interferes with the metabolism
of norepinephrine, dopamine and serotonin. Electrolyte balance affect the brain
and alter sodium transport in nerve cells and muscle. Experts believe that lithi
um corrects an abnormality of ion exchange.
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GENERAL I
2.
Lithium is a natural salt found in the minerals, sea water, plants and animals.
Be absorbed rapidly after oral administration. Compete with sodium reabsorption
in renal proximal tubule.
4.
6.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
48
GENERAL I
2.
It has a success rate of 70-80% in the treatment of bipolar disorder. Lithium en
hances the effects of antidepressants and is effective in the resolution and pre
vention of recurrent major depression
4.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
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GENERAL II
2.
Antipsychotics can be used with lithium in acute manic episodes to treat behavio
ral and psychotic manifestations. The onset of lithium therapy is usually 300 mg
three times a day for several days, increasing the dose until reaching a stable
level.
4.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
50
GENERAL II
•
During stabilization, regularly measured serum levels of lithium to identify the
therapeutic level. After resolution of symptoms, decrease the lithium to achiev
e the maintenance dose. Check blood levels every 2 or 3 months.
•
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
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GENERAL III
1.
s h.
Before initiating treatment with lithium, make the client a medical history and
complete physical examination, with the following information: Renal function: c
reatinine 24 hours. Blood urea nitrogen (BUN). Electrolyte levels. Personal or f
amily history of kidney disease or diabetes mellitus. Use of diuretics or analge
sics. Thyroid function: Evaluation of thyroid function and hematological tests.
Personal or family history of thyroid disease
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 52
IV GENERAL
1.
The following are other anticonvulsant drugs that are used as antimanic: carbama
zepine (Tegretol), valproic acid (Depakine), clonazepam. Used when lithium is in
effective or not tolerated. They can also be used in combination with lithium. B
ecause anticonvulsant drugs, can not be stopped sharply, because it can trigger
an epileptic state.
c. d.
f.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
53
CONTRAINDICATIONS AND PRECAUTIONS
1.
2.
3.

Lithium has a narrow therapeutic window, the therapeutic dose is only slightly l
ower than toxic. Dehydration or sodium depletion may precipitate lithium toxicit
y. Administered with caution in clients:
Elderly or debilitated. Kidney or thyroid disease. With seizure disorder. Take m
edications incompatible
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 54
POTENTIAL DRUG INTERACTIONS LITHIUM
DRUG EFFECT Antidepressants Antipsychotics Neurotoxicity with lithium manic rela
pse
Aminophylline or theophylline decreased serum levels of lithium sodium bicarbona
te or sodium chloride Diuretics Tetracycline, streptomycin, or NSAIDs. Muscle re
laxants and anesthetics. Increases lithium reabsorption by the kidney, triggerin
g poisoning Increased serum lithium levels Extension neuromuscular blockade with
succinylcholine and pancuronium. Suspend lithium from 48 to 72 hours prior to a
dministration of these agents and to resume oral feeding after surgery.€Walter P
SYCHOPHARMACOLOGY 55 EU
G. Cortes
SIDE EFFECTS I
2.
Nausea, abdominal discomfort, diarrhea, loose stools (mild and temporary). Tremo
rs (fine to coarse). Sed. Weight gain.
or
4.
6.
8.
PSYCHOPHARMACOLOGY 56 EU Walter Cortes
SIDE EFFECTS I
2.
Temporary muscle weakness).
and
fatigue
(Benign
and
4.
Hair loss (temporary). Polyuria (benign but progress to diabetes insipidus). pos
sibility
6.
8.
Lithium intoxication (serum lithium levels higher than 2.0 mEq / L).
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 57
SIDE EFFECTS II

Mild intoxication (serum level approx. 1.5 mEq / L): Slight apathy, lethargy, de
creased concentration, muscle weakness, mild ataxia, coarse tremor of hands, sli
ght muscle contractions. Moderate intoxication (serum level between 1.5 and 2.5
mEq / L): severe diarrhea, nausea, vomiting, mild to moderate ataxia, incoordina
tion, slurred speech, tinnitus, blurred vision, muscle twitching frank, ataxia,
tremors, irregular.

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SIDE EFFECTS II
Severe intoxication (serum level greater than 2.5 mEq / L): nystagmus, muscle tw
itching, deep tendon hyperreflexia, visual or tactile hallucinations, oliguria o
r anuria, severe impairment of consciousness, grand mal seizures, coma, death.

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And sedative-hypnotics anxiolytic drugs
Anxiolytic drugs
generic name brand name class daily maintenance dose most often used as a hypnot
ic 5-25 mg 2-10 mg 10-30 mg 15-60 mg 2-6 0.5-1.5 mg 1.5-10 mg 30-60 mg mg
benzodiazepines
Oxazepam Diazepam Flurazepam Chlordiazepoxide Clonazepam Clorazepate Prazepam Al
prazolam Lorazepam
Valium Librium Dormodor overshadowing, aplakil Tranxilium Orfidal, Rivotril Tran
kimazin idalprem Demetrin
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61
Anxiolytic drugs
Diphenylmethane Hydroxyzine hydrochloride Hydroxyzine pamoate Atarax 200-400 mg
buspirone
Antihistamines
---
200-400 mg
others
buspar
15-30 mg
Beta adrenergic blockers
propranolol
sumial
30-80 mg
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Sedative-hypnotic DRUGS
generic class Butalbital Phenobarbital Secobarbital Amobarbital Pentobarbital Th
iopental Methohexital trade name normal sedative dose (3-4 times / day) 30 mg 30
-50 mg 30-50 mg 15-30 mg 16-32 mg 30-90 mg Used as an anesthetic, a period ultar
corto action hypnotic dose 100-200 mg 100-200 mg 100-200 mg 100-200 mg 100-200 m
g 100-200 mg 100-200 mg
Barbiturates
Isoamitil ---- - --- Luminal Sodium Pentothal
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Sedative-hypnotic DRUGS
Glutethimide nonbarbiturate methyprylon -------- Chloral hydrate 500 mg Ethchlor
vynol - 250 mg - 0.5 to 2 mg 250-500 mg 200-400 mg 500-750 mg
Benzodiazep INAS (used as hypnotics)
Flurazepam Temazepam Triazolam Zolpidem
Halcion Dasuén Dormodor Stilnox
---------
0.25 to 0.5 mg 5-10 mg 15-30 mg 15-30 mg
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64
INDICATIONS I
2.
Treatment for anxiety and sleep disorders. The anxiety that requires drug treatm
ent and has no connection with any more specific syndrome is usually treated wit
h a benzodiazepine. Sedative-hypnotics can be used to relieve anxiety or induce
sleep.
4.
6.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
65
INDICATIONS I
2.
Use in the treatment of alcohol withdrawal syndrome and drugs, as preoperative m
edication or muscle relaxants and anticonvulsants. Barbiturates may be used for
treatment of seizure disorders or as a preoperative sedative. Beta blockers used
to treat stress or anxiety is leading to vegetative symptoms such as tremors, p
alpitations, diaphoresis, or tachycardia.
4.
6.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
66
MECHANISM OF ACTION
2.
It is believed that benzodiazepines enhance the neurotransmitter gamma-aminobuty
ric acid (GABA), causing muscle relaxation and relief from anxiety. Barbiturates
barbiturate sedative-hypnotics produce CNS depression. and
4.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
67
MECHANISM OF ACTION
2.
Beta blockers induce a beta-adrenergic blockade and probably an effect on the CN
S. Antihistamines are used as anxiolytics act as CNS depressants subcortical lev
el.
4.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
68
GENERAL I
2.
Benzodiazepines are the drug of choice for anxiety and sleep disorders. Benzodia
zepines and sedative hypnotic tolerance to their effects occur within days and m
ay also have cross-tolerance between drugs.
4.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
69
GENERAL I
2.
Continued use can lead to emotional and physical dependence;€abrupt suspension w
ithdrawal symptoms may occur. Barbiturates, have narrow safety margin, there let
hality with increasing doses.
4.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
70
GENERAL II
2.
It is recommended to treat anxiety and sedative hypnotics are of short duration.
Benzodiazepines are administered orally or intramuscularly.
4.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
71
GENERAL II
2.
All benzodiazepine treatment should be discontinued gradually, independent of th
eir lifetime. Sedative-hypnotics are taken at bedtime. May be repeated if the cl
ient does not sleep in the required time.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 72
4.
CONTRAINDICATIONS AND PRECAUTIONS
2.
Avoid benzodiazepines to manage clients with a history of alcohol or drug abuse
by the possible cross-tolerance and increased risk of abuse. Customers with urem
ia or hepatic insufficiency should not take or barbiturates or benzodiazepines.
4.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
73
CONTRAINDICATIONS AND PRECAUTIONS
2.
No sedation pregnancy and lactation.
or
anxiolytics
in
4.
Propranolol is contraindicated in heart and lung diseases.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
74
SIDE EFFECTS
2.
CNS depression by combining benzodiazepines with other CNS depressants, particul
arly alcohol. Benzodiazepine withdrawal symptoms: tremors, insomnia, headache, t
innitus, anorexia and dizziness. Side effects of barbiturates: suppression of th
e phase of rapid eye movement (REM) sleep, sleepiness during the day and morning
hangover effect.
4.
6.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
75
SIDE EFFECTS
3.
Propranolol can induce insomnia, hallucinations, impaired metabolism of other dr
ugs, lethargy and depression. Antihistamines may cause sedation, anticholinergic
side effects and decreased seizure threshold.
5.
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76
Electroconvulsive therapy (ECT)
INDICATIONS
1.
Treatment of severe depression, high suicide risk, who refuse to eat that do not
respond to or can not tolerate antidepressant medication. Indicated in lithium-
resistant manic customers and antipsychotics and customers whose body quickly cy
cles drugs.
3.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
78
MECHANISM OF ACTION
1.
It is unknown the exact mechanism of action. Electrical stimulation leads to inc
reased circulating levels of various neurotransmitters.
3.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
79
CONTRAINDICATIONS AND PRECAUTIONS
1.
The only absolute contraindication to ECT is the increased intracranial pressure
. Conditions that pose a high risk to the client are:
Cardiovascular disorders. Aortic aneurysm or stroke. Severe hypertension. Osteop
orosis intense. Acute or chronic lung disorders. Pregnancy.
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes 80
3.

END OF SUBMISSION
U.S. PSYCHOPHARMACOLOGY Walter G. Cortes
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