Psychopharmacology example is some anticonvulsant drugs
(approved to prevent seizures)that are
Psychotropic drugs - drugs used to treat prescribed for their effects in stabilizing
mental disorders the moods of clients with bipolar disorder
➢ Antipsychotics (off-label use)
➢ Antidepressants
➢ mood stabilizers The Pathology of Mental Illness
➢ Anxiolytics
A. Our brain is not simple organ
➢ Stimulants
➢ The brain is a complicated and
intricate organ.
Efficacy– refers to the maximal
therapeutic effect that a drug can achieve. ➢ It governs the operations of every
system and organ in our body,
Potency- describes the amount of the drug that why even a minor impairment
needed to achieve that maximum effect of the brain can cause devastating
● low-potency drugs require higher damage to the whole body.
dosages to achieve efficacy ➢ The brain performs 3 major
● high-potency drugs achieve functions: Information
efficacy at lower dosages. processing, Coordination and
balancing and Commanding
Half-life- is the time it takes for half of actions
the drug to be removed from the ➢ Our brain dictates our emotional
bloodstream. Drugs with a shorter half- experiences through the way it
life may need to begiven three or four processes and classifies
times a day Drugs with a longer half-life information. If the brain system
may be given once a day responsible for our emotions is
out of order, our emotions will
The U.S. Food and Drug fluctuate, or we will display
Administration (FDA) is responsible for emotions that are not congruent
supervising the testing and marketing of with our internal emotions making
medications for public safety. us appear awkward to others
- These activities include clinical
drug trials for new drugs and B. How do the nerves in the brain
monitoring the effectiveness and works
side effects of medications. ➢ Nerves cover the entire brain and
- The FDA approves each drug for are interconnected to form web
use in a particular population and like information exchange work.
for specific diseases. ➢ A nerve cell (Neuron) looks like a
Off-Label Use – when a drug will prove leafless tree – it has a branch, a
effective for a disease that differs from the trunk and roots
one involved in original testing and FDA
approval.
, ➢ The branches, trunk and roots of a ➢ It plays an important role in
neuron are called dendrites, axon anxiety and mood disorders and
and nerve endings schizophrenia
➢ When a neuron receives a ➢ It is inhibitory.
message (via electrical
impulses), it transfer them along Development of Psychopharmacology
the axon to the nerve endings, ➢ The period of scientific study and
which transmit them to the treatment of mental disorders
dendrites or another axon. began with Sigmund Freud
(1856 - 1939) and other theorists.
The study of psychiatry and the
diagnosis and treatment of mental
illness started.
➢ Began in 1950s - w great leap in
the treatment of mental illness
began with the development of
Neurotransmitters – are the chemical psychotropic drugs.
substances manufactured in the neuron ★ Chlorpromazine (Thorazine) -
that aid in the transmission of information antipsychotic drug, and Lithium
throughout the body. – antimanic agent – the first to be
developed
● Dopamine – a neurotransmitter ★ Over the following 10 years –
located primarily in the brainstem, MAOIs, Haloperidol, TCAs and
has been found to be involved in Benzodiazepines
the control of complex ➢ Hospital stays were shortened and
movements, motivation cognition, many people were well enough to
and regulation of emotional go home.
responses.
➢ Implicated in schizophrenia and Principles That Guide Pharmacologic
other psychoses. Treatment
➢ Generally excitatory or stimulate The following are several principles that
an action in the cells. guide the use of medications to treat
psychiatric disorders:
● Serotonin – involved in the ➢ A medication is selected based on
control of food intake, sleep and its effect on the client’s target
wakefulness, temperature symptoms such as delusional
regulation, pain control, sexual thinking, panic attacks, or
behavior and regulation of hallucinations. The medication’s
emotion. effectiveness is evaluated largely
by its ability to diminish or
eliminate the target symptoms.
,➢ Many psychotropic drugs must be number of medications prescribed
given in adequate dosages for and the number of daily doses.
some time before their full effect
is realized. For example, tricyclic
antidepressants can require 4 to
6 weeks before the client Antipsychotic
experiences optimal therapeutic ➢ Antipsychotic drugs, also known
benefit. as neuroleptics
➢ The dosage of medication often is ➢ Used to treat the symptoms of
adjusted to the lowest effective psychosis, such as the delusions
dosage for the client. Sometimes a and hallucinations seen in
client may need higher dosages to schizophrenia, schizoaffective
stabilize his or her target disorder, and the manic phase of
symptoms, whereas lower dosages bipolar disorder
can be used to sustain those ➢ Used to modify behavior
effects over time. ➢ Affect the CNS and ANS
➢ As a rule, older adults require ➢ Do not cure mental illness but
lower dosages of medications than relieve symptoms
do younger clients to experience
therapeutic effects. It also may Mechanism of Action
take longer for a drug to achieve ➢ Major action of all antipsychotics
its full therapeutic effect in older in the nervous system is to block
adults. receptors for the neurotransmitter
➢ Psychotropic medications often dopamine.
are decreased gradually (tapering) ➢ Dopamine receptors are classified
rather than abruptly. This is into subcategories (D1, D2, D3,
because of potential problems D4, and D5)
with rebound (temporary return of
➢ D2, D3, and D4 have been
symptoms), recurrence of the
associated with mental illness.
original symptoms, or withdrawal
➢ Effective in treating target
(new symptoms resulting from
symptoms
discontinuation of the drug).
➢ But also produces many
➢ Follow - up care is essential to
extrapyramidal side effects
ensure compliance with the
because of the blocking of the D2
medication regimen, to make
receptors.
needed adjustments in dosage,
and to manage side effects.
Types of Antipsychotics
➢ Compliance with the medication
regimen often is enhanced when
1. Typical antipsychotic or
the regimen is as simple as
Conventional antipsychotic
possible in terms of both the
, ➢ drugs are potent antagonists d. Tardive dyskinesia - syndrome
(blockers) of D2, D3, and D4. of permanent involuntary
➢ Dopamine Antagonist movement, is most commonly
➢ Target the positive signs of caused by long term used of
schizophrenia such as delusion, conventional antipsychotics.
hallucination, disturbed - Involuntary movements of the tongue
thinking, and other psychotic facial and neck muscles, upper and lower
symptoms but have no observable extremities and truncal musculature.
effect on the negative signs. - Tongue trusting and protruding, lip
- Phenothiazines: smacking, blinking, grimacing, and other
1. Chlorpromazine (Thorazine) excessive unnecessary facial movements
2. Thioridazine (Mellaril) are characteristics.
- Butyrophenones
1. Haloperidol
2. Atypical antipsychotic
➢ Reduce positive symptoms of
schizophrenia as well as lessen
the negative symptoms
➢ Decrease Extra Pyramidal
Symptoms (EPS)
➢ Both dopamine and serotonin
antagonist
1. Clozapine (Clozaril)
2. Risperidone (Risperdal)
Side Effects of Antipsychotic
1. Extrapyramidal symptoms (EPS) 2. Anticholinergic side effects
- Serious Neurologic Symptoms - Orthostatic hypotension
a. Acute dystonia – acute muscular - Dry mouth
rigidity and cramping, stick or - Constipation
thick tongue with dysphagia, and - Urinary retention
in severe cases laryngospasm and - Blurred near vision
respiratory difficulties. - Dry eyes
b. Pseudoparkinsonism – drug - - Photophobia
induced parkinsonism - Nasal congestion
c. Akathisia – reported by the client - Decreased memory
as an intense need to move about.
The client appears restless or 3. Depression Hypothalamic
anxious or agitated, often with Functioning
rigid posture or gait and a lack of - Symptoms:
spontaneous gestures. - Increase appetite
(approved to prevent seizures)that are
Psychotropic drugs - drugs used to treat prescribed for their effects in stabilizing
mental disorders the moods of clients with bipolar disorder
➢ Antipsychotics (off-label use)
➢ Antidepressants
➢ mood stabilizers The Pathology of Mental Illness
➢ Anxiolytics
A. Our brain is not simple organ
➢ Stimulants
➢ The brain is a complicated and
intricate organ.
Efficacy– refers to the maximal
therapeutic effect that a drug can achieve. ➢ It governs the operations of every
system and organ in our body,
Potency- describes the amount of the drug that why even a minor impairment
needed to achieve that maximum effect of the brain can cause devastating
● low-potency drugs require higher damage to the whole body.
dosages to achieve efficacy ➢ The brain performs 3 major
● high-potency drugs achieve functions: Information
efficacy at lower dosages. processing, Coordination and
balancing and Commanding
Half-life- is the time it takes for half of actions
the drug to be removed from the ➢ Our brain dictates our emotional
bloodstream. Drugs with a shorter half- experiences through the way it
life may need to begiven three or four processes and classifies
times a day Drugs with a longer half-life information. If the brain system
may be given once a day responsible for our emotions is
out of order, our emotions will
The U.S. Food and Drug fluctuate, or we will display
Administration (FDA) is responsible for emotions that are not congruent
supervising the testing and marketing of with our internal emotions making
medications for public safety. us appear awkward to others
- These activities include clinical
drug trials for new drugs and B. How do the nerves in the brain
monitoring the effectiveness and works
side effects of medications. ➢ Nerves cover the entire brain and
- The FDA approves each drug for are interconnected to form web
use in a particular population and like information exchange work.
for specific diseases. ➢ A nerve cell (Neuron) looks like a
Off-Label Use – when a drug will prove leafless tree – it has a branch, a
effective for a disease that differs from the trunk and roots
one involved in original testing and FDA
approval.
, ➢ The branches, trunk and roots of a ➢ It plays an important role in
neuron are called dendrites, axon anxiety and mood disorders and
and nerve endings schizophrenia
➢ When a neuron receives a ➢ It is inhibitory.
message (via electrical
impulses), it transfer them along Development of Psychopharmacology
the axon to the nerve endings, ➢ The period of scientific study and
which transmit them to the treatment of mental disorders
dendrites or another axon. began with Sigmund Freud
(1856 - 1939) and other theorists.
The study of psychiatry and the
diagnosis and treatment of mental
illness started.
➢ Began in 1950s - w great leap in
the treatment of mental illness
began with the development of
Neurotransmitters – are the chemical psychotropic drugs.
substances manufactured in the neuron ★ Chlorpromazine (Thorazine) -
that aid in the transmission of information antipsychotic drug, and Lithium
throughout the body. – antimanic agent – the first to be
developed
● Dopamine – a neurotransmitter ★ Over the following 10 years –
located primarily in the brainstem, MAOIs, Haloperidol, TCAs and
has been found to be involved in Benzodiazepines
the control of complex ➢ Hospital stays were shortened and
movements, motivation cognition, many people were well enough to
and regulation of emotional go home.
responses.
➢ Implicated in schizophrenia and Principles That Guide Pharmacologic
other psychoses. Treatment
➢ Generally excitatory or stimulate The following are several principles that
an action in the cells. guide the use of medications to treat
psychiatric disorders:
● Serotonin – involved in the ➢ A medication is selected based on
control of food intake, sleep and its effect on the client’s target
wakefulness, temperature symptoms such as delusional
regulation, pain control, sexual thinking, panic attacks, or
behavior and regulation of hallucinations. The medication’s
emotion. effectiveness is evaluated largely
by its ability to diminish or
eliminate the target symptoms.
,➢ Many psychotropic drugs must be number of medications prescribed
given in adequate dosages for and the number of daily doses.
some time before their full effect
is realized. For example, tricyclic
antidepressants can require 4 to
6 weeks before the client Antipsychotic
experiences optimal therapeutic ➢ Antipsychotic drugs, also known
benefit. as neuroleptics
➢ The dosage of medication often is ➢ Used to treat the symptoms of
adjusted to the lowest effective psychosis, such as the delusions
dosage for the client. Sometimes a and hallucinations seen in
client may need higher dosages to schizophrenia, schizoaffective
stabilize his or her target disorder, and the manic phase of
symptoms, whereas lower dosages bipolar disorder
can be used to sustain those ➢ Used to modify behavior
effects over time. ➢ Affect the CNS and ANS
➢ As a rule, older adults require ➢ Do not cure mental illness but
lower dosages of medications than relieve symptoms
do younger clients to experience
therapeutic effects. It also may Mechanism of Action
take longer for a drug to achieve ➢ Major action of all antipsychotics
its full therapeutic effect in older in the nervous system is to block
adults. receptors for the neurotransmitter
➢ Psychotropic medications often dopamine.
are decreased gradually (tapering) ➢ Dopamine receptors are classified
rather than abruptly. This is into subcategories (D1, D2, D3,
because of potential problems D4, and D5)
with rebound (temporary return of
➢ D2, D3, and D4 have been
symptoms), recurrence of the
associated with mental illness.
original symptoms, or withdrawal
➢ Effective in treating target
(new symptoms resulting from
symptoms
discontinuation of the drug).
➢ But also produces many
➢ Follow - up care is essential to
extrapyramidal side effects
ensure compliance with the
because of the blocking of the D2
medication regimen, to make
receptors.
needed adjustments in dosage,
and to manage side effects.
Types of Antipsychotics
➢ Compliance with the medication
regimen often is enhanced when
1. Typical antipsychotic or
the regimen is as simple as
Conventional antipsychotic
possible in terms of both the
, ➢ drugs are potent antagonists d. Tardive dyskinesia - syndrome
(blockers) of D2, D3, and D4. of permanent involuntary
➢ Dopamine Antagonist movement, is most commonly
➢ Target the positive signs of caused by long term used of
schizophrenia such as delusion, conventional antipsychotics.
hallucination, disturbed - Involuntary movements of the tongue
thinking, and other psychotic facial and neck muscles, upper and lower
symptoms but have no observable extremities and truncal musculature.
effect on the negative signs. - Tongue trusting and protruding, lip
- Phenothiazines: smacking, blinking, grimacing, and other
1. Chlorpromazine (Thorazine) excessive unnecessary facial movements
2. Thioridazine (Mellaril) are characteristics.
- Butyrophenones
1. Haloperidol
2. Atypical antipsychotic
➢ Reduce positive symptoms of
schizophrenia as well as lessen
the negative symptoms
➢ Decrease Extra Pyramidal
Symptoms (EPS)
➢ Both dopamine and serotonin
antagonist
1. Clozapine (Clozaril)
2. Risperidone (Risperdal)
Side Effects of Antipsychotic
1. Extrapyramidal symptoms (EPS) 2. Anticholinergic side effects
- Serious Neurologic Symptoms - Orthostatic hypotension
a. Acute dystonia – acute muscular - Dry mouth
rigidity and cramping, stick or - Constipation
thick tongue with dysphagia, and - Urinary retention
in severe cases laryngospasm and - Blurred near vision
respiratory difficulties. - Dry eyes
b. Pseudoparkinsonism – drug - - Photophobia
induced parkinsonism - Nasal congestion
c. Akathisia – reported by the client - Decreased memory
as an intense need to move about.
The client appears restless or 3. Depression Hypothalamic
anxious or agitated, often with Functioning
rigid posture or gait and a lack of - Symptoms:
spontaneous gestures. - Increase appetite
