Psychopharmacology Psychopharmacology Department of Psychiatry Department of Psychiatry 1 1 st st Faculty of Medicine Faculty of Medicine Charles University, Prague Charles University, Prague Head: Prof. MUDr. Jiří Raboch, DrSc. Head: Prof. MUDr. Jiří Raboch, DrSc.
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Psychopharmacology Department of Psychiatry 1 st Faculty of Medicine Charles University, Prague Head: Prof. MUDr. Jiří Raboch, DrSc.
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PsychopharmacologyPsychopharmacologyDepartment of PsychiatryDepartment of Psychiatry
11stst Faculty of Medicine Faculty of MedicineCharles University, PragueCharles University, Prague
Head: Prof. MUDr. Jiří Raboch, DrSc.Head: Prof. MUDr. Jiří Raboch, DrSc.
Main Psychopharmacological Main Psychopharmacological DrugsDrugs
AntipsychoticsAntipsychoticsof the 2of the 2ndnd Generation Generation
EfficacyEfficacy1.1. Positive symptoms are influenced significantly better than Positive symptoms are influenced significantly better than
placebo, and equally or more then by the classical placebo, and equally or more then by the classical antidopaminergic neuroleptics.antidopaminergic neuroleptics.
2.2. Negative symptoms are reduced significantly better than by Negative symptoms are reduced significantly better than by placebo or classical antidopaminergic neuroleptics.placebo or classical antidopaminergic neuroleptics.
3.3. Affective symptoms are influenced better than by placebo or Affective symptoms are influenced better than by placebo or classical antidopaminergic neuroleptics.classical antidopaminergic neuroleptics.
4.4. They significantly reduce or prevent the cognitive They significantly reduce or prevent the cognitive impairment. The reduction is higher in comparison to impairment. The reduction is higher in comparison to classical antidopaminergic neuroleptics.classical antidopaminergic neuroleptics.
5.5. The treatment resistant patients with schizophrenia are The treatment resistant patients with schizophrenia are improved significantly better than by placebo and at least improved significantly better than by placebo and at least equally as by clozapine.equally as by clozapine.
6.6. Maintenance treatment is more effective than maintenance Maintenance treatment is more effective than maintenance on placebo and at least as effective as maintenance on on placebo and at least as effective as maintenance on classical neuroleptics.classical neuroleptics.
Antipsychotics of the 3Antipsychotics of the 3rdrd generationgeneration
Generic Name Generic Name názevnázev Trade MarkTrade Mark Dose (mg)Dose (mg) Mechanism of EfficacyMechanism of Efficacy
1st Generation of Antidepressants (TCA, TeCA)1st Generation of Antidepressants (TCA, TeCA)
Generic NameGeneric Name Trade MarkTrade Mark Doses (mg)Doses (mg) Mechanism of Mechanism of EfficacyEfficacy
amitriptyline amitriptyline AMITRIPTYLINAMITRIPTYLIN 75-20075-200Inhibition of Inhibition of Serotonin Serotonin and/or and/or Norepinephrine Norepinephrine Reuptake Reuptake Followed by Followed by Increase of Increase of their their Concentrations Concentrations in Synaptic in Synaptic CleftCleft
11stst Generation of Antidepressants Generation of Antidepressants
Mechanism of action:Mechanism of action: Blockade of muscarine receptorsBlockade of muscarine receptors Histamine H1 receptorsHistamine H1 receptors Alpha 1 Adrenergic ReceptorsAlpha 1 Adrenergic Receptors Alpha 2 Adrenergic ReceptorsAlpha 2 Adrenergic Receptors
Many Side EffectsMany Side Effects Danger of IntoxicationDanger of Intoxication Many InteractionsMany Interactions Prolonged Effect (after 3-6 Weeks)Prolonged Effect (after 3-6 Weeks)
22ndnd Generation of Antidepressants Generation of Antidepressants
22ndnd Generation of Antidepressants Generation of Antidepressants
Generic NameGeneric Name Trade MarkTrade Mark Mean Doses Mean Doses (mg)(mg)
60-9060-90 Increasing Synthesis Increasing Synthesis and Releasing of and Releasing of Norepinephrine, Norepinephrine, Blockade Alpha-2 Blockade Alpha-2 Adrenoceptors on Adrenoceptors on Serotonergic Neurons Serotonergic Neurons and Increasing and Increasing Production and Production and Releasing of Serotonin Releasing of Serotonin
Action Profiles of BenzodiazepinesAction Profiles of Benzodiazepines
Relief of anxiety
Anticonvulsant Sedationaction Induction of sleep
Muscle relaxation
Ansseau, M., Doumont, A., Diricq, S.: Methodology required to show clinical differences between benzodiazepines. Curr Med Res Opin 8, Suppl. 4, 108-114 (1984). (Except <Dormicum> and <Dalmadorm>)
Indication:Indication: States of AnxietyStates of Anxiety SleeplessnessSleeplessness Withdrawal SymptomsWithdrawal Symptoms Depressive StatesDepressive States EpilepsyEpilepsy ConvulsionsConvulsions Tetanus NeonatorumTetanus Neonatorum Extrapyramidal Undesirable Side Effects of Extrapyramidal Undesirable Side Effects of
AntipsychoticsAntipsychotics Premedication in AnaestesiologyPremedication in Anaestesiology Panic States (Alprazolam, Bromazepam, Panic States (Alprazolam, Bromazepam,
Clonazepam in High Doses)Clonazepam in High Doses) Algidic Syndromes (Stomatodynie, Neuralgie Algidic Syndromes (Stomatodynie, Neuralgie
Trigemini, Cephalgia)Trigemini, Cephalgia)
AnxiolyticsAnxiolyticsGeneric NameGeneric Name Trade MarkTrade Mark FormForm Mean Doses (mg)Mean Doses (mg)
Propandiol DerivatesPropandiol Derivates
guaiphenesineguaiphenesine GUAJACURANGUAJACURAN drg. 200,400mgdrg. 200,400mginj. 1 ginj. 1 g
Anxiolytics Anxiolytics (Benzodiazepine Derivates)(Benzodiazepine Derivates)Generic NameGeneric Name Trade MarkTrade Mark FormForm Mean Doses Mean Doses
NootropicsNootropicsIndication: Organic Disturbances of Memory and Intellect, Primary Indication: Organic Disturbances of Memory and Intellect, Primary
States, Efficacy after 2-3 MonthsStates, Efficacy after 2-3 Months
Nootropics and VasodilatorsNootropics and Vasodilators(Improve Rheologic Blood Quality and Cerebral Perfusion)(Improve Rheologic Blood Quality and Cerebral Perfusion)