Pharmacological Interventions in Psychiatry: Revolutionizing Treatment

 
TREATMENT METHODS IN PSYCHIATRY
Pharmacological
Interventions
 
 
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
 
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
 
CLASSIFICATION OF PSYCHOTROPIC DRUGS
Antipsychotics.
Antidepressants.
Mood stabilizing agents.
Anti anxiety and hypnotics.
Anti epileptics.
Antiparkinsonians.
 
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)
 
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.
 
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).
 
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
 
MOOD STABILIZING DRUGS
 
Indication:
 
• acute mania,
 
• prophylaxis for bipolar affective
disorder
 
• neurological disorders
 
• seizures
 
• schizo - affective disorders
 
• paroxysmal pain syndrome.
 
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
 
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.
 
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)
 
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.
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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.

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