Psychiatry 精神病学 Wang Keqin Jining Medical College 济宁医学院精神卫生学院KQ
17.Physical treatments in psychiatry tENDEP Radioactive cobalt 50m8 75 mg Gamma rays Target 100m8 150m8 amitriptyline HCl Helmet Roche
1.Classification of psychotropic drugs Table 21.1 Classification of clinical psychotropic drugs Class of drug Examples of classes Indications Antipsychotic Phenothiazines Acute treatment of schizophrenia and mania, prophylaxis of schizophrenia Butyrophenones Substituted benzamides Antidepressant Tricyclic antidepressants Major depression(acute treatment and prophylaxis), MAOIs anxiety disorders,obsessive-compulsive disorder SSRIs (SSRIs) Mood stabilizer Lithium Acute treatment of mania Carbamazepine Prophylaxis of recurrent mood disorder Anxiolytic Benzodiazepines Generalized anxiety disorder Azapirones(buspirone) Hypnotic Benzodiazepines Insomnia Cyclopyrrolones(zopiclone) Psychostimulant Amphetamine Hyperkinetic syndrome of childhood Narcolepsy
2.Antidepressants Effective Rapid across range of age onset of action Efficacy groups Effective in short-term and Once-daily long-term dosage treatments Effective across range Cost-effective of depressive The ideal disorders antidepressant Safe in overdose Well-tolerated Tolerability and safety Free from No interactions behavioral with food or drugs Suitable in toxicity physically ill
2.1.The Classes of Antidepressants Classification of antidepressants by mode of action Monoamine-oxidase inhibitors (MAOIs) Original Most used Unselective MAOIs Iproniazid Phenelzine Selective reversible inhibitors of Isoniazid Moclobemide monoamine-oxidase type A(RIMA) Monoamine reuptake inhibitors UInselective Selective More serotonin than noradrenaline Clomipramine Venlafaxine More noradrenaline than serotonin Imipramine Desipramine Amitriptyline Nortriptyline Selective serotonin reuptake inhibitors Citalopram (SSRIs) Fluoxetine Fluvoxamine Paroxetine Sertraline Selective noradrenaline reuptake inhibitors Reboxetine (NARIs) Serotonin receptor modulators(SRMs) Original Most used With serotonin reuptake inhibition Trazodone Nefazodone With alpha-2 adrenoreceptor inhibition Mianserin Mirtazapine
2.2.Acute mechanism of antidepressants 丁压才匹用件世工于T代
Neurotransmitters and behavior Norepinephrine Serotonin Anxiety Impulse Alertness Irritability Obsessions Concentration Compulsions Energy Memory Mood Cognitive Function Appetite Attention Sex Aggression Pleasure Reward Motivation/Drive Dopamine
Serotonin Pathways Neocortex Striatum Thalamus -BST Cerebellar cortex Amygdala Entorhinal cortex Hippocampus Hypothalamus Deep cerebellar nuclei Rostral raphe nuclei n
Serotonin and Drugs AADC- Tranylcypromine 5-HΠ1B,1D 5-HT 5-HIAA Reserpine Sumatriptan。 8MDMA↑ 。。Cisapride SSRI, Fenfluramine TCA 5HI46 5-HT Buspirone 。LSD Gs Na* Gi 5HΠ3 5-HTA 5-HT2x PLC-B a/
Norepinephrine Pathways Neocortex Striatum Thalamus BST Locus coeruleus Cerebellar cortex Amygdala Neocortex- Hippocampus Hypothalamus Deep cerebellar Tegmental fields nuclei 入0 To spinal cord