Pharmacological Interventions in Psychiatry: Revolutionizing Treatment

The treatment of psychiatric disorders has evolved with the introduction of psychopharmacology, leading to significant advancements in scientific medicine. Explore the classification and effectiveness of psychotropic drugs such as antipsychotics and antidepressants, along with their indications and potential side effects. Gain insights into the ideal qualities of a psychotropic drug and how they are used in various psychiatric and medical conditions.

• Psychiatry
• Pharmacological Interventions
• Psychotropic Drugs
• Antipsychotics
• Antidepressants

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1. TREATMENT METHODS IN PSYCHIATRY Pharmacological Interventions

2. INTRODUCTION The treatment of psychiatric disorders in the past constituted mere institutionalization (asylum) The arrival of psychopharmacology in the last five and a half decades has brought the treatment of psychiatric disorders in to the territory of scientific medicine Introduction of chlorpromazine in 1952 revolutionized the treatment of psychiatric disorders

3. IDEAL PSYCHOTROPIC DRUG Should cure underlying pathology. Should benefit all patients suffering from that disorder. No side effects or toxicity. Rapid onset of action. No dependence or withdrawal symptoms on stopping. No tolerance to the drug on longer duration. Should not be lethal in overdoses. used in both inpatient and outpatient settings

4. CLASSIFICATION OF PSYCHOTROPIC DRUGS Antipsychotics. Antidepressants. Mood stabilizing agents. Anti anxiety and hypnotics. Anti epileptics. Antiparkinsonians.

5. ANTIPSYCHOTICS Used for: Organic psychiatric disorders (delirium, dementia) Functional disorders (schizophrenia , paranoid schizophrenia) Child psychiatric disorders (ADHD , autism, enuresis, conduct disorder) Mood disorder (mania) Neurotic and other psychiatric disorder Medical disorders(sever pain in malignancy)

6. SIDE EFFECTS OF ANTIPSYCHOTICS Autonomic side effects: dry mouth, constipation, urinary retention, impotence, orthostatic hypotension. EPSE (extrapyramidal side effects): parkinsonian syndrome, dystonia (muscles contract involuntarily), akathisia (movement disorder), neuroleptic malignant syndrome. Other CNS effects: seizures, sedation, depression or pseudo-depression. Metabolic and endocrine side effect: weight gain, diabetes. Allergic side effects: cholestatic (obstructive) jaundice. Cardiovascular and dermatological side effects.

7. ANTI DEPRESSANTS Indication: Depression, Child Psychiatric disorders (ADHD, Enuresis etc.), Other Psychiatric disorders (OCD, PTSD, alcohol dependence panic attack, etc.), Medical disorders (chronic pain, migraine, peptic ulcer disease).

8. SIDE EFFECTS OF ANTI-DEPRESSANTS Autonomic side effects: dry mouth, constipation, delirium, urinary retention. Sexual side effects: impotence CNS effects: sedation, withdrawal syndrome, seizures. Cardiac side effects Allergic side effects Metabolic and endocrine side effects Toxicity

9. MOOD STABILIZING DRUGS Indication: acute mania, prophylaxis for bipolar affective disorder neurological disorders seizures schizo - affective disorders paroxysmal pain syndrome.

10. SIDE EFFECTS OF MOOD STABILIZERS Neurological (tremor, muscular weakness, neurotoxicity) Cardiovascular endocrine (goiter, hypothyroidism, abnormal thyroid function, weight gain) G I effects (nausea, vomiting, diarrhea, metallic taste and abdominal pain) Valproate : nausea, sedation, tremor, weight gain, menstrual disturbances, hair loss. hepatic toxicity, acute hemorrhagic pancreatitis. Dialysis management during overdose Drowsiness, dizziness, photosensitivity, hypertension etc. The most dangerous side effects include bone marrow suppression and cardiovascular collapse

11. ANTI ANXIETY AND HYPNOSEDATIVES: INDICATION Generalized Anxiety disorder, Panic disorder, Insomnia, Narco analysis, Premedication in anesthesia etc. SIDE EFFECTS Nausea, vomiting, weakness, vertigo, impotence, sedation, dry mouth, irritability, dis-inhibited behavior, dependence and withdrawal.

12. ANTI EPILEPTICS Indication: Seizures. Side effects of anti epileptics Delirium, nystagmus, ataxia, in coordination, dysarthria, hand tremors Skin rash, toxic epidermal necrolysis. Cerebellar atrophy, peripheral neuropathy, Gingival hyperplasia (overgrowth of gum tissue around the teeth)

13. ANTI PARKINSONIAN Indication: Parkinson's disease, Extrapyramidal side effects (EPS). Side effects of anti parkinsonian THP (tetrahydropalmatine): Drowsiness, head ache, vertigo, sleep disturbance, mydriasis with or without photo phobia, blurred vision, dry mouth. Levodopa: hypotension, arrhythmias, nausea, hair loss, G I bleed, disorientation and confusion.