PSY 320 - Ch 7 - Depressants
PSY 320 - Ch 7 - Depressants PSY 320
Popular in Drugs & Behavior
Popular in Psychlogy
This 9 page Class Notes was uploaded by Elliana on Wednesday March 16, 2016. The Class Notes belongs to PSY 320 at University of Miami taught by Dr. Marc Gellman in Spring 2015. Since its upload, it has received 53 views. For similar materials see Drugs & Behavior in Psychlogy at University of Miami.
Reviews for PSY 320 - Ch 7 - Depressants
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 03/16/16
PSY 320 Drugs amp Behavior Chapter 7 Inhalants Depressants 0 Class of drugs that decreaseslow CNS activity amp have widespread effects on the brain 0 Group name SedativeHypnotics 0 Include prescription drugs treating anxiety sedatives amp insomnia hypnotics O Sedatives calming Hypnotics sleep inducing Alcohol most widely used depressant Benzodiazepines most widely prescribed depressants 0 Grouped on the basis of 0 Time of onset amp duration of activity 0 Shortacting amp rapid onset Used to induce sleep amp often prescribed in high doses hypnotic drug 0 Shortacting pentobarbital secobarbital 15 min onset time o 23 hrs duration of action 0 100200 mg 0 Intermediateacting amobarbital butabarbital 0 30 min onset time 0 56 hrs duration of action 0 Longacting amp delayed onset Used to reduce anxiety amp often prescribed in low doses sedative drug 0 1 hr onset time 0 610 hrs duration of action 0 3050 mg History Choral Hydrate O quotKnockout drops quotMickey Finn Mickey Finn Famous Chicago bartender who39d slip CH into customers39 drinks before accomplices robbed them 0 Synthesized in 1832 used clinically in 1870 O Induces sleep in less than an hr 0 Rapidly metabolized to trichoroethanol 0 Abuse leads to gastric irritation O Ppl often slipped them into drinks like roofies to make individuals pass out Paraldehyde O Synthesized in 1829 used clinically in 1882 0 Effective CNS depressant w a wide safety margin 0 Noxious taste amp odor causes bad breath O Widespread use in mental hospitals before 19505 Bromides O Widely used as sleep agent in patent medicines O Appeared in OTC drugs thru the 1960s PSY 320 Drugs amp Behavior 0 Can accumulate in the body amp cause toxic effects over several days of regular use 0 Any of these drugs in combination w alcohol induced comas or death 0 Pulled off the market 0 Late 18005 search for new drug replacement 0 Discovery of Barbiturates Chemical group of sedativehypnotics 0 First CNS depressant prescription medications to be widely used amp abused O Grouped according to duration of action 0 1903 Barbital Veronal first barbiturate to be used clinically 0 Used for calming overactivity in the brain 0 1912 Phenobarbital Luminal introduced still used today 0 Harms O Overdose deaths 0 Both intentional amp accidental 0 Caused by respiratory depression 0 Abuse amp dependence Reinforcing effects related to rapidity of drug39s onset of effects 0 Shortacting drugs more likely to lead to psychological dependence 0 Concerns led to search for safer medications 19505 0 End of WW2 0 Research turned to identifying less addicting drugs Meprobamate O Introduced in the 19505 0 First modern antianxiety anxiolytic agent 0 Produce psychologicalphysical dependence like barbiturates 0 Made a Schedule 4 drug in 1970 0 Still available as prescription drug tho largely replaced by benzodiazepines Methadualone 39ludes Quaalude Sopor O Primarily a CNS depressant effects include sexual arousal amp paresthesias numbing of fingers light tingling O Introduced to the USA in 1965 No initial monitoring no perceived abuse potential 0 Package insert read quotAddiction potential not established 0 Overprescribed thinking drug was a safe alternative to previous barbiturates 0 Prescribed to reduce stress 0 quotStress clinics opened up for ppl to visit amp get prescription drugs 0 Quickly became widely misused amp abused 0 19605 Germany amp Japan both experienced high rates of abuse amp suicide due to methaqualone 0 Placed tight restrictions on prescriptions to reduce overdoses 0 One of the top selling drugs 19605705 Major party drug of 705 disco era quotDisco biscuits 0 Many ppl overdosed amp abused combined w alcohol DUI incidences overdoses date rape etc 0 1973 made a Schedule 2 drug PSY 320 Drugs amp Behavior Movement to withdraw from the market for safer alternative drugs Pharmaceutical companies agreed to stop manufacturing around 19805 1985 no longer made available as prescription drug listed as Schedule 1 drug Large demand remained Illicit manufacturing of bootleg Qualudes 0 Became more difficult as manufacturers stopped producing active ingredients Pills w other ingredients still circulating Diazepam Valium contained huge doses Ppl overdosed not by dying but for sleeping 3 days amp then waking up 0000 Benzodiazepines 0 1960 introduction of chlordiazepoxide Librium First commercially marketed benzodiazepine in 19605 O Reduces anxiety wo inducing sleep 0 Much larger safety margin than barbiturates Much more rare cases of OD usually just when combined w other depressants 0 Physical dependence rare 19705 Diazepam Valium O Lowdose benzodiazepine O Became best seller among prescription drugs for a time 0 One of the most frequently mentioned drugs in DAWN reports almost always in combination w other depressants O Alprazolam now currently most widely prescribed from this drug class Benzodiazepines many end in quotpamquot or quotlamquot O Clonazepam Klonopin Lorazepam Ativan Diazepam Valium Alprazolam Xanax OOOO Temazepam Restoril O Triazolam Halcion Rohypnol unitrazepam O Daterape drug 0 Hypno c 0 19905 version of quotMickey Finn 0 Produce profound intoxication in combination w alcohol 0 Changes in laws amp formulation of pills have reduced abuse 0 1997 manufacturers changed formulation to produce characteristic color when dissolved in drinks Benzodiazepine Hypnotics 0 Temazepam Restoril O For patients initially seeking treatment for short term insomnia amp naive to prescription sleep aids Nonbenzodiazepine hypnotics O Concerns about use as sleeping agents 0 Hypnotics may induce tolerance dependence rebound insomnia quothangoverquot effects PSY 320 Drugs amp Behavior 0 After 1976 benzodiazepines displaced barbiturates in the sleepingpill market Nonbenzodiazepine Hypnotics Different chemical structure than 825 same effects 0 1993 Zolpidem Ambien introduced 0 One of the most widely prescribed hypnotics for a time 0 Rapid onset short duration of acton Followed by Zaleplon Sonata amp Eszoplicone Lunesta Reports of withdrawal symptoms amp complications 0 Listed as Schedule 4 drugs Table 71 Some Popular SedativeHypnotics Type HalfLife hours Anxloly cs Alprazolam Xanax 6 to 20 Chlordiazepoxide Librium 5 to 30 Clonazepam Klonopin 30 to 40 Diazepam Valium 20 to 100 Lorazepam Ativan 10 to 20 Hypno cs Temazepam Resioril 5 lo 25 Zolpidem Ambien 1 Eszopiclone Lunesta 6 lnhalants Volatile solvents inhaled for intoxicating purposes 0 Gasoline glue paint lighter uid nail polish etc 0 High dose exposure 0 Intoxication slurred speech trouble walking similar to drunkenness 0 Gaseous Anesthetics 0 Used for medicine amp surgery 0 Abused by physicians amp individuals w access 0 18005 Nitrous Oxide laughing gas rst used 0 Pure inhalation may result in suffocation from lack of oxygen 0 Used in whipcream bottles whippets Nitrites 0 Mid 18005 Amyl Nitrite introduced as treatment for chest pain 0 Relaxes blood vessels increases blood flow reduces blood pressure PSY 320 Drugs amp Behavior 0 19605 recreational use of quotpoppersquot small glass vials crushed amp vapors inhaled Increased warmth amp blood flow links use to aphrodisiac Late 19705 linked to men getting high before sex 19805 statistical correlation w HIV infection 1988 AntiDrug Abuse Act listed nitrites as controlled substances amp limited manufacturer production Volatile Solvents 0 1959 reports of glue inhaled to induce similar intoxication effects to alcohol 0 Reports describing methods led to increased rates around Colorado Inhalant use more common among lowincome populations wo access to alcohol 0 Harms O Kidney damage brain damage peripheral nerve damage 0 Irritation of respiratory tract amp headaches O Suffocation GHB Gamma Hydroxybutyric Acid 0 Occurs naturally in the brain amp body 0 Similar structure to GABA 0 Sold for a while as a dietary supplement for athletes amp bodybuilders 0 Combination w alcohol yields similar effects as other depressants 0 Behavioral effects similar to alcohol 0 1990 banned inclusion from dietary supplements 0 2000 listed as Schedule 1 substance 0 2002 oral solution of GHB known as Xyrem approved for treatment of narcolepsy O Reduces cataplexy muscular weakness or paralysis resulting from episodes of narcolepsy 0 Available by prescription as Schedule 2 drug Anxiolytics Benefits of anxiolytics 0 Anxiety reducers O Sedatives often prescribed to reduce anxiety 0 4 benzodiazepines among top 100 most commonly prescribed meds in the US 0 Alprazolam Xanax 0 Lorazepam Ativan 0 Clonazepam Klonopin 0 Diazepam Valium Anxiolytic Drugs 0 Most commonly prescribed psychotropic drugs 0 Psychiatrists write less than 20 of US prescriptions O Prescribed most commonly by general practitioners family physicians internal medicine MDs 0 Work very quickly 0 Elderly often abuse have reduced ability to metabolize long acting 82 0 Concerns 0 Some anxiety disorders respond to anxiolytics while others seem treated more effectively by antidepressants or behavior therapy PSY 320 Drugs amp Behavior 0 Patients may take drugs for long periods May be overprescribed Is patient taking the drug to treat a disorder or to feel better in a general way Anxiolytics as anticonvulsants O Barbiturates amp benzodiazepines in low doses or combined w other anticonvulsants may be prescribed for seizure disorders epilepsies Potential problems 0 Tolerance amp nding a dose that is effective but doesn39t cause excessive drowsiness Abrupt withdrawal likely to cause seizures As sleeping pillshypnotics O O 0 Taking a large enough dose of a hypnotic drug helps individuals sleep quickly 0 Insomnia a common complaint although ppl sometimes overestimate severity 0 Today fewer hypnotics are prescribed than in the past amp taken only for a few nights at a time Insomnia 0 Persistent difficulty initiatingmaintaining sleep 0 Do not wake feeling refreshed O Decline in social or occupational functioning Insomnia39s effects 0 Daytime sleepiness Fatigue 0 Cognitive impairment 0 Decline in work performance 0 Work days missed 0 Depressionanxiety Insomnia therapies O Pharmacologic Melatonin Antidepressants Antihistamines Benzodiazepines Nonbenzodiazepine hypnotics Anti psychotics O Nonpharmacologic CBTi cognitive behavioral therapy for insomnia Stimulus control therapy Sleep restriction therapy Relaxation training Cognitive therapy Sleep hygiene education Benefits are longlasting even after therapy ends Relatively free of medical risks No significant interactions w other medical treatments Monetary costs repeated visits to providers Improvement may not occur for several weeks Requires time amp motivation PSY 320 Drugs amp Behavior 0 Daytime sleepiness during sleep restriction 0 Lack of access to a trained therapist Lack of therapist expertise 0 Both have strong evidence to support their use Mechanism of Action Benzodiazepine amp Barbiturates 0 Bond w brain receptors 0 Enhance inhibitory effects of GABA 0 Attach to receptors Nonbenzodiazepine hypnotics Selectively target GABAA receptor Bind to subtypes of GABA receptors speci cally modulating sleep Thought to have less unwanted side effects Tolerance amp abuse not a major concern Shorter duration of action than most benzos less likely to cause next day sedation Seem to work better as sleeping pills than as antianxiety drugs Drowsiness dizziness unsteadiness of gait rebound insomnia memory impairment OOOOOO Include zolpidem Ambien zaleplon Sonata eszopiclone Lunesta Bene ts vs Harms of 325 0 Bene ts 0 Good medicinal uses 0 Enhance sleep hypnotic O Decrease anxiety anxiolytic 0 Muscle relaxant O Anticonvulsant Harms 0 Daytime sedation slows you down Decreased reaction time Unsteadiness of gait may cause falls esp in elderly Cognitive impairments amp memory problems Risk of tolerance Risk of withdrawal amp rebound insomnia Risk of abuse 00000 O Shortacting drugs more likely to produce withdrawal symptoms 0 Dependence amp overdose can occur 0 Dosage amp time course are critical factors 0 Overdose deaths more likely for drugs sold in higher doses 0 Psychological dependence more likely w drugs that have rapid onset of effects 0 Physical dependence more likely w drugs having a shorter duration of action 0 More differences among barbiturates amp among benzodiazepines than there are btwn the 2 classes of drugs Depressants amp concerns PSY 320 Drugs amp Behavior 0 Dependence O Psychologicaldependence 0 Esp associated w shortacting barbiturates 0 Physical dependence Potentially lifethreatening withdrawal syndrome linked to large doses of sedativehypnotics 0 Withdrawal symptoms similar to amp longer lasting than alcohol withdrawal 0 Barbituratewithdrawal Anxiety insomnia weakness nausea vomiting seizures disorientation agitation delusions visual amp auditory hallucinations O Benzodiazepine withdrawal 0 Less severe anxiety irritability insomnia O Crossdependence 0 Occurs among barbiturates benzodiazepines alcohol 0 Toxicity O Behavioral Alcohollike intoxication w impaired judgment amp coordination 0 Increased risk of injury while driving or engaging in activities 0 Additive effects if combined w alcohol 0 Physiological 0 Respiratory depression death 0 Esp dangerous if combined w alcohol 0 Patterns of abuse 0 Most abuse associated w oral use of legally manufactured products 0 Two types of typical abusers 0 Older adults using prescription drug tolerance develops dose increases 0 Younger ppl who obtain drugs to get high may take high dosesmix w alcohol Benzodiazepines during pregnancy 0 Association remains unclear btwn BZDs amp cleft palate birth defects 0 No conclusive data regarding possible behavioral teratogenicity Exposure late in pregnancy 0 Delivery complications withdrawal symptoms in baby convulsions Article Increasing Benzodiazepine Prescriptions amp Overdose Mortality in the US 19962013 Describes trends in benzodiazepine prescriptions amp OD mortality among US adults 0 Data examined from Medical Expenditure Panel Survey amp caueof death data from Centers for Disease Control amp Prevention 0 From 1996 2013 0 Adults ling for benzodiazepine prescriptions increased from 41 to 56 0 Quantity of 825 lled increased from 11 to 36 0 OD death rate increased from 058 to 307 0 Rate continued to increase for 0 Adults 65 0 Black amp Hispanic participants 0 Prevalence of longterm use increased w age PSY 320 Drugs amp Behavior 0 Rate of OD deaths involved 825 have stabilized O Remains over 5x the rate from the beginning of the study
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'