Lecture 19Outline of Last LectureI. Drugs for Treatment of SchizophreniaOutline of Current Lecture II. Drugs for Treatment of Mood Disordersa. Treatment of Depressionb. Treatment of Other Mood DisordersCurrent LecturePsychiatric drugs used to treat major depression are referred to as antidepressants. They fall into three categories: MAO inhibitors and tricyclic drugs (first-generation antidepressants), selective serotonin reuptake inhibitors or SSRIs (second-generation antidepressants—Prozac, Paxil, Zoloft, Lexapro, and Celexa) and the recently introduced third-generation antidepressants (Cymbalta, Remeron, Effexor, and Pristiq) that act upon not only serotonin in the brain but also affect the activity level of norepinephrine. MAO inhibitors are antidepressants that reduce the activity of monoamine oxidase (MAO), an enzyme that normally inactivates norepinephrine, dopamine, and serotonin at the synapse. Examples are Nardil and Parnate. Tricyclic antidepressants block the reuptake of norepinephrine and serotonin at the synapse. Examples are Tofranil, Elavil, and Norpramin. As the name suggests, selective serotonin reuptake inhibitors (SSRIs) are designed to selectively block the reuptake of serotonin at the synapse. Examples include Prozac, Paxil, Zoloft, Lexapro, and Celexa. There has been concern by health officials that SSRIs have been overprescribed and may incur an elevated risk of suicide among children and adolescents. Third-generation antidepressants slow down the reuptake of both norepinephrine and serotonin, acting similarly to tricyclic drugs. However, third-generation antidepressants are different in their chemical structure. Examples of drugs in this category are Effexor, Remeron, Cymbalta, and Pristiq. Symptoms of mania, as well as extreme swings between depression and mania (bipolar disorder), are treated with lithium carbonate, Depakote, and several second-generation antipsychotic medications (Risperdal,Geodon, Seroquel, and a combination of Zyprexa with Prozac [brand name: Symbyax]). Risperdal has been found to be useful in treating autism, a complex developmental disability that involves a severe impairment in the social connectedness that a person typically shares with others. Risperdal received FDA approval in 2006 asa treatment for aggressiveness, severe temper tantrums, and self-injury in autistic children and adolescents. In 2009, Abilify received FDA approval for use in treating irritability and aggressive behavior in autistic patients aged six to seventeen. Off-label usage refers to the practice of prescribing psychiatric drugs for purposes other than those specified by the FDA when they were first approved. Some antidepressants are useful in the BIOL 3303 1st Editiontreatment of anxiety, and vice versa. This kind of “crossover” pharmacotherapy is legally sanctioned for physicians and is an increasingly common practice.These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a
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