Lecture _2 - Psychopharmacology - History, Neurotransmitters Etc.may 2013

8/18/2019 Lecture _2 - Psychopharmacology - History, Neurotransmitters Etc.may 2013

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PsychoPharmacology CourseHISTORY

Presenter: Novlette Mattis-RobinsonMPH!HP!H"# $Pharm% RPh%&


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Partici'ants shoul( be able to:explain how psychiatric illnesses were handledin the past

describe current treatment strategiesemployed in mental illnesses

identify neurotransmitters found in the CNS

describe the role of the variousneurotransmitters in the management ofpsychiatric disorders


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Prior to Psychotropic agents, management /treatment of mentally challenged included; Tortured in an attempt to drive out the

demon

solation !hidden cellars" #ails$ome for the insanePhysical restraints e%g% Tran&uili'er chair

Shoc( therapy)rugs * barbiturate, paraldehyde, chloralhydrate


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Treatment of psychotic conditionsrevolutioni'ed in early +-.s

)iscovery o* +rst anti'sychotic agentin ,./

)rug * Chlorproma'ine !typical agent" )rug success, resulted in a variety of

structurally diverse antipsychotic drugs

0esulted in decline of hospitali'ed patients%


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)iscovery of 0ty'ical antipsychotics in thelate +1.s

2irst 3typical * Clo'apine !approved andmar(eted in the 4S in +."

3typicals shown to be more e5ective in

managing negative symptoms ofschi'ophrenia


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3ntipsychotic drugs do not providepermanent cure

4sed in con6unction with supportivetherapy

7any cases * resumption to functionin community versus prolonged orpermanent hospitali'ation


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New trends also exist for antidepressants

7ostly Tricyclics used in earlier times *

+-.s

Selective Serotonin 0eupta(e nhibitorsintroduced in the +8.s *now prescribed

more fre&uently


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Serotonin and Norepinephrine0eupta(e nhibitors9 +.s

:enerally, newer drugs showevidence of fewer side e5ectsand less fre&uent dosing andgreater cost


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Non9dopamine approach

:lutamatergic agents e%g%, :lycine

Cholinergic agents e%g%, 3chesterase

nh%/nicotinic receptor modulator Neuroprotective targets e%g%, C

inhibitors or antioxidants !anti9apoptotic"


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@rain and spinal cord;

The human brain highly complexstructure and is hailed the mostcomplex ob6ect in the universe *Aorgan of the mind


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0esponsible for consciousness,behaviour, memory, recognition,learning and more highly developed

attributes such as imagination,abstract reasoning, and creativethought%

Serves also, to coordinate vitalregulatory functions such as $0, @P,respiration, salivary and gastricsecretions, muscular activity andbody temperature%


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2unctions depends on 3ction of certain neuronal agents!neurotransmitters" located inthe brain and peripheral tissues

Neurotransmitters exert their

action by interacting withspeciBc receptors


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Communication in CNS occurs vianerve impulses andneurotransmitters

3 Neurotransmitter !NT" 9 achemical substance synthesi'ed and

stored primarily in nerve terminalsuntil released by a nerve impulse%


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%


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The Neurotransmitter ◦ is released from nerve ending

◦ di5uses across synaptic cleft

◦ interacts with suitable receptors

◦ produces its e5ect !s"

◦ 7etaboli'ed / deactivated

see example of 3drenergic neuron


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%


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Norepinephrine )opamine Serotonin :amma 3mino @utyric acid 3cetylcholine $istamine :lycine 3spartate and :lutamate


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Neurotransmitters Implications

Norepinephrine Sensory perception and sleep pattern

Dopamine Arousal and dreaming ; flight or fight

hormone

Gamma AminoButyric acid(GABA)

Responsible for emotion, cognitionand motor function

Serotonin (!") #ating , sleeping, se$ual beha%iour andmemory alteration

&thers' 3cetylcholine ogniti%e function


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The scientiBc study of theactions of drugs and their

e5ects on mood, sensation,thin(ing, and behavior%


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Pharmacotherapy plays signiBcant role inapproaches to the management ofpsychiatric illnesses%

◦ 0educes or alleviates symptoms

◦ 3llow client/patient an opportunity to participatemore easily with other types of therapy

◦ 7odiBes behaviour temporarily !biochemicalchanges"


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Psychotherapy actions of drugs!exogenous agents" reect variousbloc(ade or stimulating actions atreceptors of endogenousneurotransmitters e%g%,

9 )opamine

9 Serotonin

9 Norepinephrine9 3cetylcholine


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?5ects of Pharmacotherapy depend on thenature and directions of the e5ects◦ 3dditive

◦ Potentiative

◦

3ntagonistic

Choice of psychotropic agents is inuencedby how clients symptoms match with

therapeutic advantages


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2rom restraints to pharmacologic agents

Newer agents being discovered

The central nervous system * the mind

Neurotransmitters in the CNS

Pharmacotherapy as support * not acure%


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0ang and )ale Pharmacology , >nd ?d% Churchhill $arvey, 0ichard %3; Champe Pamela C% etal Pharmacology

>nd , Dippincotts Eiliams F Eil(in, +>

Craig, Charles 0%; Stit'el, 0obert ?% 7odern pharmacology,Gth ed, Dibrary of Congress Cataloging * Publication )ata,

+G )ipiro, #oseph T% etal Pharmacotherapy; 3 Pathophysiologic

3pproach, Hth ed ; 7cgraw9 $ill, medical publishing)ivision , >..-

ttp//pubs%acs%org/subscribe/6ournals/mdd/v.G/i.-/html/.-timeline%html

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Lecture _2 - Psychopharmacology - History, Neurotransmitters Etc.may 2013