Psychopharmacology

PRESENTED BY:
SANYA KAPUR
(M.PHIL PART 1)

CHAIRPERSON:
MS. SHIVANGI AGRAWAL
 Contents
Introduction of Classification of
Psychopharmacology Psychotropic Medication

Role of Clinical Side Effects and

Psychologists Adverse Reactions

Basic principles Advances in the field of

and Concepts psychopharmacology

Functioning of the Guidelines and Special

psychotropic medicines Population
Introduction
Pharmacology
The broad study of drugs and their effects on the entire body,
including cardiovascular, digestive, and immune systems.

Psychopharmacology
It is a professionally recognized specialty field dedicated to the
study and therapeutic use of psychotropic medication, in
addition to traditional psychological interventions, for the
treatment of mental disorders and the promotion of overall
patient health and well-being.

Key Focus:
Unlike general pharmacology, which studies effects across the
body, psychopharmacology focuses on how medications target
specific neurotransmitters and neural circuits in the brain and
how they further influence mental health and behavior.
 Psychotropic
Medication
“Psycho” relates to the mind or brain

“Tropic” means to be attracted to or turn toward

Psychotropics are defined as a chemical substance

that crosses the blood-brain barrier, acts on the central
nervous system, and affects consciousness, cognition,
mood, and behavior. (Thomas A. Ban)
 Characteristics of an Ideal
Psychotropic Drug
An ideal psychotropic drug should have the following characteristics
(Hollister, 1983):

1. It should cure the underlying pathology causing the disorder or

symptom(s) under focus, so that the drug can be stopped after sometime.
2. It should benefit all the patients suffering from that disorder.
3. It should have no side-effects or toxicity in the therapeutic range.
4. It should have rapid onset of action.
5. There should be no dependence on the drug and no withdrawal
symptoms on stopping the drug.
6. There should be no tolerance to the drug so that same dose is effective
for long duration of time.
7. It should not be lethal in overdoses.
8. It can be given in both inpatient and out patient settings.
 "Psychiatrists prescribe
psychotropic medications,
so why should clinical
psychologists study about
them?"
 COMPREHENSIVE ENHANCED INFORMED PATIENT HOLISTIC PATIENT
UNDERSTANDING OF COLLABORATION EDUCATION AND ASSESSMENT AND
TREATMENT OPTIONS WITH PSYCHIATRISTS SUPPORT SYMPTOM MONITORING

Equips clinical psychologists with Allows clinical psychologists Help provide accurate Enables clinical psychologists to
knowledge about medication to collaborate more information to patients about distinguish between
options, allowing them to effectively in medication effects, side effects, medication side effects and
understand the full spectrum multidisciplinary teams, and the role of medication symptoms of a mental health
of treatment possibilities for contributing valuable alongside therapy, improving disorder, leading to more
mental health conditions. insights on treatment plans treatment adherence and accurate assessments and timely
and patient progress. patient empowerment. interventions.

https://www.apa.org/ed/graduate/specialize/clinical-psychopharmacology
Understanding how the drugs function:
To understand how the drug effects our body, it is important to know the
functions of the various neurotransmitters (chemical messengers that carry
signals between neurons, muscles, and glands) in our body:
Before understanding drug function:

Receptors: protein molecules including enzymes, transporters and ion

channels where a,
Ligand: (specific endogenous neurotransmitter/hormone or an external
pharmacological agent (drug)) binds to, resulting in a cellular response
Understanding the effect of drug:
There are two major interactions that occur when a drug
(ligand) exerts its effects onto a receptor:

Agonist (enhance)
Antagonists (block)

Agonists: Drugs that bind to and activate receptors, mimicking

the action of natural neurotransmitters.
They are classified into:
Full Agonists: Produce a maximal biological response.
Partial Agonists: Bind to the same receptor but elicit a
weaker response.
Inverse Agonists: Bind to the receptor and produce the
opposite effect, reducing baseline receptor activity.

Antagonists: Drugs that bind to receptors without activating

them, blocking the action of agonists or natural
neurotransmitters, thereby inhibiting their effects.
PRINCIPLES OF PSYCHOPHARMACOLOGY

It is the study of how the body It is the study of how the drug
interacts with the drug. effects on our body.
 Concept:
Pharmacokinetics
 Pharmacokinetics

*Cytochrome P450
(CYP450) enzymes
Pharmacokinetics
 Concept:
Pharmacodynamics
Effects of these drugs on the body:
Dose-Response Curve: The dose – response curve plots the effects of a drug against its plasma
concentration.

Potency: Potency refers to the ratio of drug dosage to clinical effect.

Efficacies: capability of the drug to elicit maximal beneficial response at their respective optimal dosages.
Key Elements of Pharmacodynamics
Therapeutic index: A ratio that compares the blood concentration at which a drug becomes toxic
and the concentration at which the drug is effective.
The larger the therapeutic index (TI), the safer the drug is. If the TI is small (the difference between the
two concentrations is very small), the drug must be dosed carefully and the person receiving the drug
should be monitored closely for any signs of drug toxicity.
Key Elements of Pharmacodynamics
Tolerance and Dependance: When a person becomes less responsive to a particular drug with time,
tolerance to the effects of the drug has developed. The development of tolerance can be associated
with the appearance of physical dependence, which is the need to continue taking a drug to prevent
the appearance of withdrawal symptoms.
 CLASSIFICATION OF
PSYCHOTROPIC DRUGS
MISCELLANEOUS
ANTIPSYCHOTICS ANTIDEPRESSANTS
DRUGS

1 2 3 4 5

ANXIOLYTICS MOOD STABILISERS

 IMPORTANT TERMS
Indications: Indications refer to the specific medical conditions or
symptoms for which a drug is prescribed.

Contradictions: Contraindications are specific situations or conditions

where a drug should not be used because it may be harmful.

Side effects: These are expected and often mild effects that occur at
therapeutic doses. Side effects may not always require stopping the
medication and are often manageable (e.g., dry mouth, sedation).

Adverse Effects: These are unexpected, harmful effects that may occur
even at therapeutic doses. Adverse effects are more serious and can lead
to complications, requiring drug discontinuation or alternative therapies
 IMPORTANT TERMS
PLACEBO-NOCEBO EFFECT:
Placebo is defined as an inert substance that provokes perceived benefits,
whereas,
Nacebo is used when an inert substance causes perceived harm.

The placebo effect occurs when a placebo makes the patient feel better or
improves symptoms. Examples: sugar pills, vitamin capsules, saline injections
etc.
Use of placebo is restricted majorly to clinical trials for conditions such as
depression, somatoform disorders, pain conditions, psychosis, sleep disorders,
asthma, irritable bowel disease.

Though active drugs have significantly better evidence in symptom reduction,

the placebo rates are promising. 30-50% response rates in depression and
anxiety; 7-10% in psychosis.
ANTIPSYCHOTICS
 ANTIPSYCHOTICS
Antipsychotics, also known as neuroleptics or major
tranquilizers, are medications primarily used to treat
psychotic disorders such as schizophrenia, bipolar CLASSIFICATION
disorder, and other mental health conditions.

Classification: Potency of Based on year of

causing Extra manufacturing and
Classical (Typical/1st Generation) Antipsychotics: receptor occupancy
Pyramidal Side
Primarily dopamine antagonists that are effective in managing Effects First generation (more
positive symptoms of psychosis (hallucinations, delusions) but Typical (more) vs action on D2 receptors
have a high risk of extrapyramidal side effects. Atypical blockade) vs Second
generation (more action
on 5HT receptors and
Atypical (Second-Generation) Antipsychotics: Target
dopamine receptor partial
both dopamine and serotonin receptors. Known for a broader agonism)
spectrum of action, fewer motor side effects, and additional
effects on negative symptoms of schizophrenia.
ANTIPSYCHOTICS
Mechanism of Action
Dopamine Pathway:
Both classical and atypical antipsychotics primarily act by blocking dopamine
D2 receptors, which helps reduce psychotic symptoms.

Serotonin Receptor Activity:

Atypical antipsychotics also affect serotonin receptors (specifically 5-HT2A
receptors), which helps alleviate negative symptoms of schizophrenia and
reduces the likelihood of extrapyramidal side effects.

Additional Effects:
Some antipsychotics also have anticholinergic, anti-alpha adrenergic, and
antihistaminic actions, which contribute to their therapeutic and side effect
profiles.
 ANTIPSYCHOTICS
Indications and Contraindications
Indications for Antipsychotics: Contraindications for Antipsychotics:
Schizophrenia (acute and long-term Parkinson’s disease and epilepsy (due to
treatment) exacerbation of motor and seizure
Bipolar disorder (manic episodes and symptoms)
maintenance) Liver disease (risk of hepatotoxicity)
Severe anxiety and acute agitation Cardiovascular disorders
Psychotic depression (in combination Pregnancy and breastfeeding: Some
with antidepressants) antipsychotics may pose risks to fetal
Tourette syndrome and drug-induced development or lactation.
psychoses
ANTIPSYCHOTICS
Types of Different Drugs
Classical (Typical) Antipsychotics:
• Chlorpromazine: Known for strong sedation and anticholinergic effects.
• Haloperidol: High potency, used frequently for acute psychotic agitation.
• Trifluoperazine: Effective but has a high risk of extrapyramidal effects.

Atypical (Second-Generation) Antipsychotics:

Clozapine: Used for treatment-resistant schizophrenia but requires blood monitoring
for agranulocytosis.
Risperidone: Effective for both positive and negative symptoms; lower EPS risk.
Olanzapine and Quetiapine: Known for their sedative and weight gain effects.
Aripiprazole: Partial dopamine agonist with a favorable side effect profile.
 ANTIPSYCHOTICS
Side Effects and Adverse Effects
Side Effects for Antipsychotics: Adverse Effects for Antipsychotics:
Sedation: Due to antihistaminic action, common with Extrapyramidal Symptoms (EPS): Motor side
drugs like chlorpromazine. effects like
Weight gain: Particularly with atypical antipsychotics. Acute Dystonia: Sudden, involuntary muscle
Anticholinergic effects: Dry mouth, blurred vision, contractions, often in the face, neck, or back, causing
urinary retention painful twisting movements or abnormal postures.
Akathisia: A feeling of inner restlessness and an
Adverse Effects for Antipsychotics: uncontrollable need to move, making it difficult for
Neuroleptic Malignant Syndrome (NMS): Rare but patients to sit still.
life-threatening, involves high fever, muscle rigidity, and Parkinsonism: Symptoms resemble Parkinson’s
autonomic instability. disease, including tremors, rigidity, and bradykinesia
Metabolic Syndrome: Atypical antipsychotics may (slowness of movement).
increase the risk of diabetes, hypertension, and Tardive Dyskinesia: A late-onset, often irreversible
dyslipidemia. condition characterized by repetitive, involuntary
Prolonged QT Interval: Increased risk of heart movements, particularly around the mouth and face,
arrhythmias with certain antipsychotics. such as lip-smacking or tongue movements.
ANTIDEPRESSANTS
ANTIDEPRESSANTS
Antidepressants are medications used to alleviate symptoms of depressive disorders and other
conditions such as anxiety and chronic pain.

Classification: (Based on mechanism of action)

Tricyclic Antidepressants (TCAs): Older antidepressants that block the reuptake of norepinephrine
and serotonin. -> Tetracyclic antidepressants have a slightly different structure and mechanism, are often
considered a tricyclic variant and have fewer side effects.

Selective Serotonin Reuptake Inhibitors (SSRIs): Specifically inhibit serotonin reuptake, widely
prescribed due to fewer side effects.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Block reuptake of both serotonin and

norepinephrine, useful in both depression and chronic pain.

Monoamine Oxidase Inhibitors (MAOIs):Inhibit the enzyme monoamine oxidase, which breaks
down neurotransmitters; effective but require dietary restrictions.

Atypical Antidepressants: These include drugs with unique mechanisms, like mirtazapine and bupropion.
 ANTIDEPRESSANTS
Indications and Contraindications
Indications for Antidepressants: Contraindications for Antidepressants:
Major Depressive Disorder (MDD): Primary MAOIs: Contraindicated with foods high in
indication for all types of antidepressants. tyramine (e.g., aged cheese, red wine) and certain
Anxiety Disorders: SSRIs and SNRIs are often medications (risk of hypertensive crisis).
prescribed for generalized anxiety, panic disorder, SSRIs and Pregnancy: Use with caution due to
and OCD. potential risk to fetal development.
Chronic Pain: TCAs and SNRIs can alleviate Bipolar Disorder: Antidepressants can trigger
neuropathic pain. manic episodes in patients with bipolar disorder,
Obsessive-Compulsive Disorder (OCD): especially without a mood stabilizer.
Especially SSRIs, which help in managing intrusive Cardiac Disorders: TCAs are contraindicated in
thoughts and repetitive behaviors. patients with heart disease due to their cardiotoxic
PTSD and Eating Disorders: SSRIs are effects.
sometimes used for symptoms of post-traumatic Liver Disease: Some antidepressants require
stress disorder and certain eating disorders. caution as they are metabolized in the liver.
ANTIDEPRESSANTS
Types of Different Drugs
TCAs: Amitriptyline, Nortriptyline, Imipramine
Effective for depression and chronic pain, but with strong anticholinergic effects.
SSRIs: Fluoxetine, Sertraline, Paroxetine
Widely used for depression and anxiety disorders with a favorable side effect
profile.
SNRIs: Venlafaxine, Duloxetine
Effective for depression, anxiety, and pain syndromes.
MAOIs: Phenelzine, Tranylcypromine
Effective in treatment-resistant depression but requires dietary restrictions.
Atypical Antidepressants:
Bupropion: Useful in depression, with low sexual side effects, also aids in
smoking cessation.
Mirtazapine: Sedative and appetite-stimulating, often used in depression with
insomnia or weight loss.
 ANTIDEPRESSANTS
Side Effects and Adverse Effects
Side Effects for Antidepressants: Adverse Effects for Antidepressants:
SSRIs: Nausea, headache, insomnia, sexual Serotonin Syndrome: A rare but potentially life-
dysfunction. threatening condition caused by an excess of
TCAs: Sedation, dry mouth, blurred vision, serotonin in the brain, often from combining
constipation (anticholinergic effects). serotonergic drugs.
SNRIs: Similar to SSRIs, with additional sweating and Symptoms: Agitation, confusion, muscle rigidity, high
blood pressure increases. fever, sweating, and tremors.
Hypertensive Crisis (MAOIs): dangerous
Adverse Effects for Antidepressants: increase in blood pressure in patients taking
Withdrawal Symptoms (Antidepressant monoamine oxidase inhibitors (MAOIs) if they
Discontinuation Syndrome): occur if consume foods high in tyramine.
antidepressants, especially SSRIs and SNRIs, are Symptoms: Severe headache, nausea, rapid heartbeat,
stopped suddenly. and dangerously high blood pressure.
Symptoms: Dizziness, nausea, fatigue, headache, Cardiotoxicity: TCAs can be toxic to the heart,
irritability, and "brain zaps" (sensory disturbances). especially at high doses, causing heart arrhythmias.
Symptoms: Irregular heartbeats, which can be severe
and life-threatening.
ANXIOLYTICS
 ANXIOLYTICS
Anxiolytics (anti-anxiety) are medications designed to reduce symptoms of anxiety,
commonly used to treat generalized anxiety disorder, panic disorder, and other anxiety-
related conditions.

Classification: (Based on mechanism of action)

Benzodiazepines: The most commonly used class of anxiolytics. *Barbiturates are no longer used or
Selective Serotonin Reuptake Inhibitors (SSRIs) and recommended as anti-anxiety agents.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): They produce multiple side effects
Azapirones (e.g., Buspirone): A unique class with partial such as excessive sedation, respiratory
serotonin agonist effects, used specifically for generalized anxiety and circulatory depression, hepa tic
enzyme induction, dependence, with
disorder.
drawal symptoms, rebound increase in
Beta-Blockers
REM- sleep on withdrawal, and potential
Other Classes: Including tricyclic antidepressants and
for use in suicide.
monoamine oxidase inhibitors (MAOIs) for treatment-resistant
cases.
ANXIOLYTICS
Mechanism of Action
Benzodiazepines:
Enhance the effect of GABA (gamma-aminobutyric acid), the brain’s primary
inhibitory neurotransmitter, leading to reduced neuronal excitability and a calming effect.
SSRIs and SNRIs:
Increase serotonin and norepinephrine levels by inhibiting their reuptake, which
helps alleviate both anxiety and depression over time.
Azapirones (e.g., Buspirone):
Act as a partial agonist at the serotonin (5-HT1A) receptor, providing anxiolytic
effects without sedation or potential for dependence.
Beta-Blockers:
Block the effects of adrenaline on the body, reducing physical symptoms of anxiety like
rapid heart rate and tremors.
 ANXIOLYTICS
Indications and Contraindications
Indications for Anxiolytics: Contraindications for Anxiolytics:
Generalized Anxiety Disorder (GAD): SSRIs, Benzodiazepines: Avoid in patients with a history
SNRIs, and buspirone are commonly prescribed for of substance abuse or severe respiratory conditions
sustained symptom relief. (risk of respiratory depression).
Panic Disorder: Benzodiazepines may be used for SSRIs: Caution in patients with bipolar disorder
short-term relief; SSRIs are preferred for long-term (risk of manic episodes).
treatment. Pregnancy: Many anxiolytics, especially
Social Anxiety Disorder: SSRIs and sometimes benzodiazepines, should be used cautiously due to
beta-blockers for performance-related anxiety. potential risks to fetal development.
Insomnia and Acute Stress Reactions: Short- Severe Liver Disease: Benzodiazepines and certain
term benzodiazepine use can be effective. antidepressants are metabolized in the liver and
Obsessive-Compulsive Disorder (OCD): SSRIs require caution in liver impairment.
are often first-line treatment.
ANXIOLYTICS
Types of Different Drugs
Benzodiazepines: Lorazepam (Ativan), Diazepam (Valium), Alprazolam
(Xanax): Fast-acting relief of acute anxiety but potential for dependence with
long-term use.
Selective Serotonin Reuptake Inhibitors (SSRIs): Sertraline (Zoloft),
Paroxetine (Paxil): First-line for generalized anxiety disorder and social anxiety
due to safety in long-term use.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Venlafaxine
(Effexor), Duloxetine (Cymbalta): Effective for both anxiety and depression.
Azapirones: Buspirone (BuSpar): Effective for generalized anxiety disorder,
with minimal sedation and low risk of dependence.
Beta-Blockers: Propranolol: Often used off-label for performance anxiety to
reduce physical symptoms like trembling and heart palpitations.
ANXIOLYTICS
Side Effects and Adverse Effects

Side Effects for Anxiolytics: Adverse Effects for Anxiolytics:

Benzodiazepines: Sedation, dizziness, cognitive Dependence and Withdrawal: Benzodiazepines
slowing, and coordination issues. can lead to physical dependence and withdrawal
SSRIs and SNRIs: Initial anxiety, nausea, headache, symptoms upon discontinuation.
sexual dysfunction. Serotonin Syndrome: Rare but serious with
Buspirone: Dizziness, headache, and nausea SSRIs; symptoms include confusion, agitation, and
(generally mild and short-term). muscle rigidity.
Beta-Blockers: Fatigue, cold extremities, and
Rebound Anxiety: With benzodiazepines, anxiety
potential for low blood pressure.
may worsen when stopping the drug suddenly.
MOOD STABILIZERS
MOOD STABILIZERS
Mood stabilizers are medications primarily used to stabilize mood swings,
particularly in bipolar disorder, and to prevent both manic and depressive episodes

Classification and Mechanism

Lithium:
The first mood stabilizer and a highly effective treatment for mania and bipolar disorder.
Although the exact mechanism is unclear, lithium is thought to affect neurotransmitter balance
and intracellular signaling, influencing mood regulation. It may inhibit inositol
monophosphatase and modulate serotonin and dopamine levels.

Atypical Antipsychotics:
Certain atypical antipsychotics (e.g., quetiapine, aripiprazole) have mood-stabilizing effects and
are used in bipolar disorder.
Affect both dopamine and serotonin receptors, which helps balance mood and manage manic
symptoms.
MOOD STABILIZERS
Mood stabilizers are medications primarily used to stabilize mood swings,
particularly in bipolar disorder, and to prevent both manic and depressive episodes

• Anticonvulsants: Originally developed for epilepsy, these drugs

stabilize mood in bipolar disorder.

Examples include:

Valproate: Increases GABA (an inhibitory neurotransmitter), which

has calming effects on the brain and helps control manic episodes.
Carbamazepine: Stabilizes mood by blocking sodium channels,
reducing excessive neuronal firing.
Lamotrigine: Acts on sodium channels and modulates glutamate
release, which is particularly helpful in bipolar depression.
 MOOD STABILIZERS
Indications and Contraindications
Indications for Mood Stabilizers: Contraindications for Mood Stabilizers:
Generalized Anxiety Disorder (GAD): SSRIs, Lithium: Contraindicated in severe renal disease
SNRIs, and buspirone are commonly prescribed for (lithium is excreted by the kidneys), cardiovascular
sustained symptom relief. disease, and in cases where close monitoring is
Panic Disorder: Benzodiazepines may be used for difficult.
short-term relief; SSRIs are preferred for long-term Valproate: Should be avoided in pregnancy due to
treatment. teratogenic risks; also requires caution in liver
Social Anxiety Disorder: SSRIs and sometimes disease.
beta-blockers for performance-related anxiety. Carbamazepine: Avoid in patients with bone
Insomnia and Acute Stress Reactions: Short- marrow suppression or certain types of liver
term benzodiazepine use can be effective. disease.
Obsessive-Compulsive Disorder (OCD): SSRIs Atypical Antipsychotics: Contraindicated or used
are often first-line treatment. with caution in patients with severe metabolic or
cardiovascular issues.
MOOD STABILIZERS
Side Effects and Adverse Effects

Side Effects for Anxiolytics: Adverse Effects for Anxiolytics:

Lithium: Increased thirst, weight gain, mild Dependence and Withdrawal:
tremor, nausea, hypothyroidism, and increased Benzodiazepines can lead to physical dependence
urination. and withdrawal symptoms upon discontinuation.
Valproate: Weight gain, gastrointestinal Serotonin Syndrome: Rare but serious with
discomfort, and hair thinning. SSRIs; symptoms include confusion, agitation,
Carbamazepine: Drowsiness, dizziness, and and muscle rigidity.
mild cognitive effects. Rebound Anxiety: With benzodiazepines,
Lamotrigine: Skin rash, drowsiness, and anxiety may worsen when stopping the drug
dizziness. suddenly.
 MISCELLANEOUS
DRUGS
Miscellaneous psychiatric drugs refer to medications that don’t
fit neatly into the main categories (antipsychotics,
antidepressants, anxiolytics, mood stabilizers) but are still used
to treat specific psychiatric symptoms.

•Examples:
• Stimulants: (e.g., Methylphenidate, Amphetamines)
Primarily used for attention-deficit/hyperactivity disorder (ADHD).
• Alpha-2 Adrenergic Agonists: (e.g., Clonidine,
Guanfacine)
Used for ADHD and managing symptoms of PTSD.
• Cognitive Enhancers: (e.g., Donepezil, Rivastigmine)
Primarily prescribed for dementia-related cognitive impairment.
• Others:
Includes drugs with specific or off-label uses, like prazosin for PTSD
nightmares.
 ADVANCES IN
PSYCHOPHARMACOLOGY
• Third-Generation Antipsychotics: Medications like cariprazine and
brexpiprazole represent newer antipsychotics that act as partial dopamine agonists,
providing effective symptom control with potentially fewer side effects than previous
generations.
• Ketamine for Depression: Traditionally an anesthetic, ketamine and its
derivative esketamine have shown rapid-acting effects in treatment-resistant
depression, working within hours compared to traditional antidepressants that take
weeks.

Why It Matters:
These innovations address treatment-resistant cases and symptom profiles that
previous drugs have not managed well, providing more options for complex or
refractory cases. The development of these therapies underscores the need for mental
health professionals to stay informed about research advances to offer the best, most
current treatments to patients.
 CLINICAL GUIDELINES: THE
SIX D’S

Diagnosis Drug selection Dosage

Factors that determine drug The two most common causes of
A careful diagnostic investigation
selection include diagnosis, past failure of psychotropic drug
should identify specific target
personal and family history of treatment are inadequate dosing
symptoms with which the drug
response to a particular agent, and and an incomplete therapeutic trial
response can be objectively
the overall medical status of the of a drug.
assessed.
patient.

Duration Dialogue
In the treatment of these Discontinuation
Informing patients about likely side
conditions, drug efficacy tends to
Many psychotropic agents are effects at the outset of treatment,
improve with time, whereas drug
associated with a discontinuation as well as the reasons they are
discontinuation is frequently
syndrome when they are stopped. taking a specific drug, serves to
associated with relapses.
improve treatment compliance.
 TREATING SPECIAL POPULATIONS
PREGNANT AND
CHILDREN ELDERLY MEDICALLY-ILL PEOPLE
NURSING WOMEN

Begin with a small dosage and Begin treating elderly patients avoid administering any drug be treated conservatively, which
increase until clinical effects are with a small dosage, usually to a woman who is pregnant means beginning with a small
observed. Do not hesitate to use approximately one-half the (particularly during the first dosage, increasing it slowly,
adult dosages in children if the usual dosage. The dosage trimester) or nursing a child. and watching for both clinical
dosage is effective and no adverse should be increased in small This rule, however, occasionally and adverse effects.
effects develop. Some children amounts, until either a needs to be broken when the
need higher doses because their clinical benefit is achieved or mother’s psychiatric disorder
livers metabolize drugs more unacceptable adverse effects is severe.
quickly than adults. appear.
Thank You
PRESENTED BY
SANYA KAPUR