Psychiatric Medication Overview

Alex Hish, MD www.youtube.com

Brief Summary

This video provides an overview of the major classes of psychiatric medications (psychotropics), which affect a person's mental state. It covers antidepressants, anxiolytics, mood stabilizers, antipsychotics, sedative hypnotics, stimulants for ADHD, medication-assisted treatment for substance use disorders, and anti-dementia medications. The video also discusses subtypes within each class and examples of specific medications. Additionally, it addresses secondary medications used to manage the side effects of primary psychiatric drugs.

  • Antidepressants: SSRIs, SNRIs, atypical antidepressants, serotonin modulators, TCAs, and MAOIs.
  • Anxiolytics: Antidepressants (daily use), antihistamines, beta blockers, and benzodiazepines (as needed).
  • Mood Stabilizers: Lithium, lamotrigine, valproate, and carbamazepine.
  • Antipsychotics: First and second-generation antipsychotics, with clozapine as a distinct category.
  • Sedative Hypnotics: Melatonin agonists, trazodone, doxepin, and benzo receptor agonists.
  • ADHD Medications: Stimulants, norepinephrine reuptake inhibitors, and alpha-2 agonists.
  • Substance Use Disorder Medications: Medications that agonize or antagonize receptors of abused substances.
  • Anti-Dementia Medications: Acetylcholinesterase inhibitors and NMDA antagonists.
  • Secondary Medications: Used to treat side effects of primary psychiatric medications.

Introduction to Psychiatric Medications

The lecture introduces the major classes of psychiatric medications, also known as psychotropics, which are defined as medications that affect a person's mental state. The main categories to be discussed include antidepressants, anxiolytics, mood stabilizers, antipsychotics, sedative hypnotics, stimulants and related medications for ADHD, medication-assisted treatment for substance use disorders, and anti-dementia medications. The presentation will further outline subtypes within each class and provide specific examples.

Antidepressants

The different types of antidepressants are outlined. These include Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs), atypical antidepressants, and serotonin modulators. Additionally, the older classes of antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), are mentioned.

Anxiolytics

Anxiolytics are discussed, noting that anxiety disorders are often treated with the same medications used for depressive disorders, namely antidepressants, on a daily basis. For acute anxiety or panic attacks, as-needed medications like antihistamines, beta blockers, and benzodiazepines may be required to provide immediate relief.

Mood Stabilizers

The class of mood stabilizers includes lithium and anti-epileptic drugs such as lamotrigine, valproate, and carbamazepine. These medications are primarily used to manage mania and stabilize mood fluctuations.

Antipsychotics

Antipsychotics are categorized into first and second-generation antipsychotics. Clozapine, while technically a second-generation antipsychotic, is placed in a separate category due to its unique characteristics, including higher efficacy and the need for intensive side effect monitoring.

Sedative Hypnotics

Sedative hypnotics are a diverse group of medications used to promote sleep, with various mechanisms of action. Examples include the melatonin agonist ramelteon, trazodone, the tricyclic antidepressant doxepin, and zolpidem, which is a benzo receptor agonist.

Stimulants and ADHD Medications

Stimulants and related non-stimulant medications are used to treat ADHD symptoms. These include norepinephrine reuptake inhibitors and alpha-2 agonists, which help manage attention and hyperactivity.

Medication-Assisted Treatment for Substance Use Disorders

Medications used to treat substance use disorders, often referred to as medication-assisted treatment, exert their therapeutic effects by agonizing or antagonizing receptors that substances of abuse typically bind to. Examples include medications targeting nicotine and opioid receptors.

Anti-Dementia Medications

Anti-dementia medications include acetylcholinesterase inhibitors and NMDA antagonists. These medications aim to manage cognitive symptoms associated with dementia.

Secondary Medications

Secondary medications are used to treat the side effects of primary psychiatric medications. Examples include antihistamines and VMAT inhibitors for the extrapyramidal side effects of antipsychotics, metformin for antipsychotic-induced weight gain, levothyroxine for lithium-induced thyroid toxicity, and levocarnitine for valproate-induced hyperammonemia.

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Transcript

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0:00 this talk is an overview of psychiatric medications this talk will outline the major classes of psychiatric medications also known as psychotropics a psychotropic is defined as any medication that has an effect on a person's mental state the major classes of psychotropics include anti-depressants mainly used to treat depression anxiolytics mainly used to treat anxiety mood stabilizers mostly used for Mania antis psychotics mostly used for psychosis sedative hypnotics for insomnia stimulants and related medications for ADHD medication assisted treatment for substance use disorders and anti-dementia medications for dementia next for each of these classes I'll outline subtypes along with examples for

0:45 the anti-depressants there are the selective serotonin reuptake Inhibitors or ssris serotonin and norepinephrine reuptake Inhibitors or snris atypical anti-depressants and serotonin modulators there are also two older classes of anti-depressants the tricyclic anti-depressants or tcas and the monoamine oxidase Inhibitors or MAOI next are the anxiolytics on a daily basis anxiety disorders are treated with the same medications used to treat depressive disorders that is the anti-depressants however patients with severe anxiety or panic attacks may require as needed in the- moment medications to abort acute anxiety or Panic these medications include antihistamines beta blockers and benzodiazapines among others next are

1:33 the mood stabilizers including lithium and the anti-epileptic drugs lamotrin Val and carbamazapine next are the antis psychotics which include the first and second generation antis psychotics clapene is a second generation Anis psychotic but I place it in a separate class due to its distinct characteristics particularly its higher efficacy and need for intensive side effect monitoring next are the sedative hypnotics a heterogeneous class of medications with various mechanisms of action that are used to promote sleep these include the Melatonin Agonist remelon Trazodone and atypical anti-depressant Doxepin a tricyclic anti-depressant and zadam a benzo receptor Agonist next are the stimulants and related non-stimulant medications used to treat ADHD symptoms

2:19 norepinephrine reuptake Inhibitors and Alpha 2 agonists next are medications used to treat substance use disorders commonly referred to as medication assisted treatment these medic Pati exert their therapeutic Effects by agonizing or antagonizing receptors that substances of abuse typically bind to such as nicotine and opioid receptors last are the anti-dementia medications including acetyl colon esteras Inhibitors and nmda antagonists these are the major classes of psychiatric medications but there's one more type of medication that psychiatrist should be familiar with which I call secondaries these include any medications used to treat the side effects of a primary psychiatric medication hence they are secondary medications these include antihistamines and vmat inhibitors for

3:05 the extra paramal side effects of antic psychotics but can also include medications such as metformin for antis psycotic induced weight gain Leo thyroxine for lithium induced thyroid toxicity and levocarnitine for valpro induced hyper aminia among others that's the end of this talk I hope this is a useful framework to organize your knowledge of psychiatric medications thank you

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