Psychopharmacology EPPP

Produce effects similar to the neurotransmitter. Direct agonists mimic the neurotransmitter at the receptor site. Indirect agonists attach to a binding site on a reception (other than the one used by the neurotransmitter) and facilitate the action of the neurotransmitter.

Produce an effect opposite of a neurotransmitter or agonist.

Produce effects similar but less than a neurotransmitter or agonist.

Produce no activity in the cell. Reduce or block neurotransmitter or agonist.

Changes in absorption distribution, metabolism and excretion. Start low and go slow.

Asians, and to a lesser degree AA, slower/poorer metabolizers of drugs. Start low and go slow.

Useful to alleviate positive symptoms, most often for schizophrenia, acute mania, hallucinations in MDD and psychosis. Alleviate positive symptoms by not effective for negative symptoms.

Extrapyramidial including tardive dyskensia neuroleptic malignant syndrome Anticholinergic Effects

(rapid onset muscle rigidity, autonomic instability, delirium. Stop drug immediately),

(blocks acetylcholine) including dry mouth, blurred vision, urinary retention/constipation, tachycardia. Develop early and tolerance in a few weeks.

Worst of extrapyramidial side effects. Similar to Huntington’s disease involuntary rhythmic movement of jaw, lips, extremities.

Typically irreversible, may be alleviated with benzo or GABA agonist.

Address both positive and negative symptoms, often work when traditionals have failed.

Address both positive and negative symptoms, often work when traditionals have failed. Disadvantage is may have slower onset than traditionals.

Anticholinergic effects, lowered seizure threshold, sedation. Extrapyramidial side effects are much less common and less likely to produce tardive dyskinesia. Can produce aranulocytosis/decrease in white blood cells so need blood monitoring. May cause neuroleptic malignant syndrome.