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Benzodiazepines: © SPMM Course Benzodiazepines: Drug Duration of action Effect Diazepam, chlordiazepoxide, clonazepam, flurazepam Long-acting Can have more than 200hrs t1/2 in genetically slow metabolizers. Also, toxicity can take 1 – 2 weeks to be evident whe...

1. Introduction © SPMM Course Introduction The term pharmacodynamics refers to the study of the mechanism of action of drugs (the effect of drugs on the body). Most psychotropics affect neurotransmitters of the brain. This effect can occur at various levels....

2. Receptor mechanisms © SPMM Course 2. Receptor mechanisms The ‘receptor’ of a drug can be defined generally as the cellular component to which the drug binds and through which the drug initiates the pharmacodynamic effects on the body. There are 2 major supe...

3. Modes of therapeutic action for psychotropics

Antipsychotic drugs © SPMM Course 3. Modes of therapeutic action for psychotropics Antipsychotic drugs In general all antipsychotics act via varying degrees of D2 blockade. Aypical drugs show selectivity for D2 receptors and also show high 5HT2: D2 blocking ra...

Antidepressant drugs © SPMM Course Antidepressant drugs DRUG MECHANISM Agomelatine Agomelatine enhances norepinephrine and dopamine neurotransmission through 5HT2C antagonism. It is also a direct agonist at melatonin (MT1 and MT2) receptors. GABA interneurons ...

Mood stabilizers © SPMM Course Mood stabilizers DRUG MECHANISM Carbamazepine Prolongs sodium channel inactivation. As a consequence, calcium channel inactivation is prolonged. It also reduces glutamate neurotransmission, adenosine A1 receptor antagonism and in...

Sedatives & Hypnotics © SPMM Course Sedatives & Hypnotics DRUG MECHANISM Benzodiazepines Act via a particular site called omega site in GABA-A complex. All are agonists except clonazepam, which is a partial agonist. They facilitate GABA action on GABA-A comple...

Addiction pharmacology © SPMM Course Addiction pharmacology DRUG MECHANISM Alcohol Intercalates into the fluid cell membrane; decreases NMDA sensitivity; increases GABA sensitivity; down-regulates calcium channels; up-regulates nicotine receptor gated sodium c...

Anti dementia drugs © SPMM Course Anti dementia drugs DRUG MECHANISM Donepezil, Galantamine, Rivastigmine Cholinesterase Inhibitors. The act by inhibiting acetyl cholinesterase enzyme that breaks down acetylcholine centrally. Rivastigmine inhibits both the ace...

Miscellaneous drugs © SPMM Course Miscellaneous drugs DRUG MECHANISM Amantadine Used in Parkinsonism. It augments dopaminergic neurotransmission through an unknown mechanism. Dextroamphetamine Methylphenidate Methylphenidate, dextroamphetamine, and amphetamine...

4. Neurochemical effects of ECT © SPMM Course 4. Neurochemical effects of ECT  Repeated subconvulsive electrical stimulation in animals reduces the seizure threshold – this process is called kindling. ECT does NOT produce a kindling effect; in fact it protect...

5. Psychopharmacogenetics © SPMM Course 5. Psychopharmacogenetics Psychopharmacogenetics focuses on how polymorphisms in genes affecting the mechanism of action of a drug’s effect and/or metabolism (both peripheral and central) can influence an individual’s cl...

6. Ethnopharmacology © SPMM Course 6. Ethnopharmacology Ethnicity is defined as a self-ascribed belongingness to a group with common geographical origins, race, language, religion, etc., which transcends kinship and neighbourhood. Ethnic categories retain a st...

Gender differences in psychopharmacology © SPMM Course Gender differences in psychopharmacology  Antipsychotic response is shown to be superior in women  In chronically ill population, men are found to require twice as high a dose as women for effective main...

1. Types of adverse reactions © SPMM Course Types of adverse reactions Type of reaction Mnemonics Features A: dose-related Augmented e.g., Lithium toxicity – ataxia, coarse tremors, vomiting. B: non-dose related Bizarre Idiosyncratic e.g. malignant hyperther...

2. Mechanism of adverse effects © SPMM Course 2. Mechanism of adverse effects Side effect Receptor Agitation α  2 blockade, 5HT2A/2C stimulation, DRI Akathisia D2 blockade, 5HT2A stimulation (hence some data on mirtazapine, 5HT2A antagonist, reducing akathisia...

3. Antipsychotics - adverse effects