• 3 Major Categories: tricyclics, monoamine Oxidase inhibitors, and selective serotonin
reuptake inhibitors (SSRIs)
• Tricyclics and monoamine Oxidase inhibitors (MAO) increase excitatory
neurotransmitters norepinephrine and serotonin activity, lowering activity in brain
regions involved in positive emotion and motivation which is related to depression.
• Tricyclics prevent reuptake of the excitatory transmitters into the presynaptic neurons,
allowing them to continue stimulating postsynaptic neurons.
• MAO inhibitors have more severe side effects. They can cause dangerous elevations in
blood pressure when taken with certain food
• SSRI are designed to decrease side effects by increasing activity of just one
• SSRIs gradually replace the tricyclics because they reduce depressive symptoms more
rapidly, reduce anxiety symptoms (panic disorders, obsessive-compulsive behaviours,
and social phobia)
• The combination of psychotherapy and drug treatment tends to yield the best
• Antipsychotic drug therapy began when it was accidentally discovered that reserpine, a
drug derived from the root of the snakeroot plant, calmed psychotic patients.
• This resulted in the development of synthetic antipsychotic drugs (major tranquilizers),
which are used today to treat schizophrenia
• They decrease the action of dopamine, whose overactivity is thought to be involved in
• They reduce positive symptoms such as hallucinations and delusions, but have little
effect on the negative symptoms, such as apathy and withdrawal.
• These drugs are suggested to be used on a continual basis due to the high likelihood of
• These drugs can produce a severe movement disorder called tardive dyskinesia –
uncontrollable and grotesque movements of the face and tongue and sometimes arms
and legs flail uncontrollably.
• Once this reaction develops it appears to be irreversible and they effects are sometimes
worse than the symptoms that diagnosed the patient with schizophrenia to begin with
• Other treatments with less severe side effects are in the process of being made
• A new drug called Clozaril reduces positive and negative symptoms and does not
appear to produce tardive dyskinesia. But, it produces a fatal blood disease in 1-2% of
people who take it, requiring extensive weekly blood tests for patients who use it
• Antipsychotic drugs work best in conjunction with psychotherapy