Psychopharmacology Archives

A Simplified Guide to Oral Antipsychotic Medications – Mechanism of Action, Side Effects and Need to Know Points

April 29, 2018

A conventional, typical or first-generation antipsychotic is defined by the ability to block dopamine (D2) receptors. They also have in, varying degrees, M1, Alpha-1 and H1 receptor blockade. Typical antipsychotics: Chlorpromazine Flupenthixol (depot) Fluphenazine (depot) Haloperidol Sulpiride Trifluoperazine How does dopamine blockade treat psychosis? Blocking…

Clinical Assessment and Management of Bipolar Disorder – Summary of Evidence Based Guidelines

April 28, 2018

Bipolar disorders are defined by the presence or history of mania/hypomania, which distinguishes them from depressive disorders. Not all patients experience mania/hypomania and hence the DSM-5 has attempted to subtype the various presentations. Please see the criteria and diagnostic interview questions for a manic episode. …

What’s Different about Agomelatine’s Mechanism of Action – Prof Hopwood and Dr Stephen Stahl

March 31, 2018

Dr Stahl, MD, is a practicing Psychiatrist in Carlsbad, USA, and author of the best-selling textbook, Essential Psychopharmacology. Dr Stahl has held faculty positions at Stanford University, the University of California at Los Angeles, the Institute of Psychiatry London, the Institute of Neurology London, and,…

Meet the Big 21 from the Largest Ever Study on Antidepressants – Mechanisms of Actions, Side effects and Indications

March 26, 2018

Need to know: Dose – 25-50 mg nocte Metabolised by CYP1A2 – therefore inhibitors like fluvoxamine and ciprofloxacin are contraindications Monitor Liver function tests at 3,6,12 and 24 weeks. Discontinue if ALT or AST exceed 3 times normal range. We covered a detailed summary of…

Efficacy and Acceptability of Antidepressants in Acute Depression – What Does the Largest Ever Research Study on Antidepressants Tell Us?

March 23, 2018

Systematic reviews and meta-analyses of Randomised controlled trials (RCT’s) lie at the top of the hierarchy of evidence-based medicine and are essential tools in highlighting the effectiveness of interventions. You can view a video about how to appraise a systematic review and meta-analysis. The purposes…

Schizophrenia in Women – Role of Estrogen and Novel Treatments

February 26, 2018

Prof Jayashri Kulkarni, Professor of Psychiatry and Director of Monash Alfred Psychiatry Research Centre, discusses the unique aspects of schizophrenia in women. Estrogen is a gonadal hormone that can exert powerful effects in numerous regions of the brain, consequently affecting mood, cognition, and behaviour. We…

Obsessive Compulsive Disorder (OCD) – A Primer on Neurobiology, Diagnosis and Treatment

January 28, 2018

Obsessions: Persistent, unwanted, repetitive, intrusive thoughts, images, and urges which are ego-dystonic and cause anxiety and distress Compulsions: Repetitive behaviours or mental acts performed in response to an obsession to reduce the anxiety or distress to prevent a feared consequence. Screening Recently validated screening…

The Dopamine Hypothesis of Schizophrenia – Advances in Neurobiology and Clinical Application

January 27, 2018

Dopamine is synthesised from the amino acid tyrosine. Tyrosine is converted into DOPA by the enzyme tyrosine hydroxylase. DOPA is converted into dopamine (DA) by the enzyme DOPA decarboxylase (DOPADC). This dopamine is packed and stored into synaptic vesicles via the vesicular monoamine transporter (VMAT2)…

Post Traumatic Stress Disorder (PTSD) – A Primer on Neuropsychiatry and Treatment

November 29, 2017

The Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) recognises several criteria for a PTSD diagnosis. The PTSD criteria are as follows: Exposure to stressor – The individual was either directly or indirectly (witnessing, learning, or exposure to aversive details) exposed to trauma.…

A Focus on Vortioxetine – Mechanism of Action and Efficacy

October 27, 2017

Traditionally, antidepressant research has focused on the development of drugs that bind to the serotonin transporter (SERT). SERT transports serotonin from the synaptic cleft to the presynaptic neuron and inhibition of this transporter causes an increase in serotonin in the synaptic cleft. However, many…

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