1. Side Effects of Psychotropics
By
AHMED ALBEHAIRY,M.D
PSYCHIATRY CONSULTANT, MOH

2. Important items in S.E of
psycho tropics
 Acting on many neurotransmitters, localized to
many organs.
 Categorizations of side effects according to the
action on neurotransmitter system.
 ??? Several SE have nt been ,neurotransmitters,
specifically identified.
 Drug induced syndrome, movements.
 Expectation of SE , dec. trouble .
 Treatment of SE.
 Choose the treatment according to SE.

3. SE caused by blockade of
muscarinic Ach
 Blurred vision.
 Constipation.
 Decreased salivation, sweating.
 Delayed or retrograde ejaculation.
 Delirium.
 Exacerbation of asthmatic pts.
 Hyperthermia.
 Memory problems.
 Narrow angle glaucoma.
 photophobia,.
 Sinus tachycardia.
 Urinary retension.

4. Antdopaminergic SE
 Hyperprolactinemia.
 Menstrual dysfunction.
 Sexual dysfunction.
 Akathesia.
 Dystonia.
 Parkinsonism.
 T dyskinesia.

5. Antiadrenergic ( a1)
 Dizziness.
 Postural hypotension.
 Reflex tachycardia.

6. antihistaminergic
 Sedation
 Weight gain.

7. Excessive serottonergic
 Akathesia, agitation.
 Anxiety.
 GIT upset and diarrhea.
 Headache.
 Insomnia or somnolence.
 Nausea
 Sexual dysfunction

8. Multiple neurotransmitter
system
 Agranulocytosis .
 Allergic reactions.
 Anorexia.
 Cardiac conduction abnormalities.
 Seizures.

9. Monoamine receptors : review
 5HT1A-----AD,ANXIOLYTIC.
 5HT1B-----ANIMAL MODEL OF 5HT1DB
 5HT1Da---ANTIMIGRAINE
 5HT1DB,1F---ANTIMIGRAINE
 5HT2A------ATYPICAL ANTIPSYCHOTICS
 2B---- STOMACH CONTRACTION
 2C--- REGULATION OF APPETTITE,SEIZURE,
ANTIPSYHOTIC
 5HT3----ANTEMETIC,ANXIOLYTIC,COGNITIVE
ENHANCER
 5HT4----MODULATION OF COGNITION
 5HT6--- ATYPICAL ANTIPSYCHOTIC
 5HT7 --- REGULATION OF C RYTHM

10. Monoamine receptors : review
 H1 ANTAG---- SEDATION,WT GAIN.
 H2 ANTAG----TTT OF PEPTIC ULCER
 H3 ANAG-----INC
ARROUSAL,APPETITE SUPRESSION.

11. Monoamine receptors : review
 D1----D1 &D2 SYNERGISM, COCAINE
EFFECT
 D2---- EPS,ANTIPSYCHOTIC
 D3---UK
 D4---S-D ANTAGONIST, ATYPICAL
ANTIPSYCHOTICS.
 D5---- UK

12. Monoamine receptors : review
 A1,a,b,c antagonist---antihypertensive
 A2 agonist------sedative ,antihypertensive
 B1---- cardic function
 B2--- br athma
 B3--- adipose tissue function
 M1--- cognition,seizures
 M2---- cardiac function
 M3 --- smooth ms contraction
 M4---- antparkinsonism,anticholinergic

13. Treatment of common SE
 Sexual dysfunction.
 Anxiety, akathesia,insomnia.
 GIT upset.
 Headache.
 Anorexia.
 Wt gain
 Somnolence
 Dry mouth
 Blurred vision
 Constipation
 Othostatic hypotension
 EPS
 T DYSKINESIA

14. Common SE of lithium
 Tremors:--- dec dose, indral
 GIT UPSET– dec dose
 Wt gain---adj wt loss, warn in advance
 Cognitive imp--- check thyroid,treat depression
 D I--- SWITCH
 KIDNEY IMP--- DEC DOSE OR SWITCH
 PSORIASIS--- OMEGA 3
 ACNE—RETNOIC ,TETRACYCLINE
 HYPOTHYROIDISM--- ELTROXIN

15. THANK YOU