Defined by the presence of recurrent periods of intense fear and discomfort peaking in 10 minutes with at least 4 of the following:
3. Abdominal distress
Intense fear of dying or losing control, light-headedness, chest pain, chills, choking, disconnectedness, sweating,
shaking, shortness of breath.
Described in context of occurrence (e.g., panic
disorder with agoraphobia). Associated with persistent fear of having another attack.
Strong genetic component.
Treatment: cognitive behavioral therapy (CBT), venlafaxine, SSRIs, TCAs, benzodiazepines (risk of tolerence and physical dependence)
Persistent reexperiencing of a previous traumatic event (e.g., war, rape, robbery, serious accident, fire). May involve nightmares or flashbacks, intense fear, helplessness, or horror. Leads to avoidance of stimuli associated with the trauma and persistently increased arousal.
Disturbance lasts > 1 month, with onset of symptoms beginning anytime after event, and causes significant distress and/or impaired functioning.
Treatment: psychotherapy, SSRIs.
Acute stress disorder-lasts between 3 days and 1 month.
Cluster A = paranoid, schizoid, schizotypal
Odd or eccentric; inability to develop meaningful social relationships. No psychosis; genetic association with schizophrenia. "Weird" (Accusatory, Aloof, Awkward),
Cluster B = Antisocial, borderline, histrionic, narcissistic
Dramatic, emotional, or erratic; genetic association with mood disorders and substance abuse.
"Wild" ( Bad to the Bone).
Cluster C = Avoidant, obsessive-compulsive, dependent
Anxious or fearful; genetic association with anxiety disorders. "Worried" (Cowardly, Compulsive, Clingy) .
l. Highly lipid soluble and stored in body fat; thus, very slow to be removed from body
2. Extrapyramidal system (EPS) side effects
3. Endocrine side effects (e.g., dopamine receptor antagonism => hyperprolactinemia
4. Side effects arising from blocking muscarinic
(dry mouth, constipation), a (hypotension),
and histamine (sedation) receptors (anti-HAM)
5. Neuroleptic malignant syndrome (NMS) -rigidity, myoglobinuria, autonomic instability, hyperpyrexia.
Treatment: dantrolene, 02 agonists (e.g.,
Tardive dyskinesia - stereotypic oral-facial
movements due to long-term antipsychotic
use. Often irreversible.
MOA = 5-HT specific reuptake inhibitors
Used for: depression, GAD, panic disorder, OCD, bulemia, social phobias, PTSD
Tox: (Fewer than TCAs)
- GI distress
- Sexual dysfunction (anorgasmia and decreased libido)
Serotonin Syndrome - with any drug that increases 5-HT (MAO inhibitors, SNRIs, TCAs) = hyperthermia, confusion, myoclonus, CV collapse, flushing, diarrhea, seizures. Treatment = cyproheptadine (5-HT2 receptor antagonist)
Takes 4-8 weeks to have an effect