Nurses often have a role in administering psychiatric medications, but they need to understand the mechanism of action so they can provide the best care possible.

This NCLEX review will help nurses understand psychiatric pharmacology, including how drugs interact with the brain and central nervous system, how they’re prescribed, and how to monitor clients on these types of medications.

Psychiatric Pharmacology

The goal of psychiatric pharmacology is to treat mental disorders effectively with drugs that have the least amount of side effects on clients. Psychiatric disorders are categorized into three groups: mood disorders (affective disorders), psychotic disorders, and anxiety disorders.

Mood disorders include depression (major depressive disorder), bipolar disorder (manic-depressive illness), and seasonal affective disorder. Mood disorders are characterized by strong emotions such as sadness or anger that interfere with daily life.

However, mood disorders can also cause changes in thinking or behavior patterns. The most effective treatment for these disorders is medication combined with psychotherapy sessions that address the underlying causes of the disorder.

Psychotic disorders include schizophrenia and schizoaffective disorder. These are characterized by hallucinations (seeing or hearing things that are not actually present) or delusions (believing things that aren’t real). Antipsychotic medications help reduce symptoms such as delusions and hallucinations.

Anxiety disorders are characterized by excessive worry about everyday things or events. To treat anxiety disorders, psychiatrists often prescribe psychotropic drugs that alter serotonin or dopamine levels in the brain.

These neurotransmitters are known for regulating mood and controlling emotions, affecting behavior such as fearfulness or restlessness. There are several different types of anxiety disorders. Some include; generalized anxiety disorder; panic disorder; social anxiety disorder and separation anxiety disorder.

Bipolar Pharmacology

Bipolar disorder is a mood disorder that causes episodes of depression and mania. It is also a spectrum disorder – meaning that one person may experience only one type of episode, while another person may experience several different types in their lifetime.

There are three main types of episodes of bipolar disorder: mania, hypomania, and depression. It’s important to know what each type looks like so that accurate diagnosis can occur and appropriate medications can be prescribed.

Bipolar disorder can be treated with medications such as antidepressants and mood stabilizers. It’s important to understand the side effects of these drugs so that nurses can address them with clients if they arise.

Bipolar Medications

Antipsychotic Pharmacology

The main function of antipsychotic agents is to reduce the severity of psychotic behaviors, such as hallucinations, paranoia, and delusions. These medications do not cure schizophrenia, but help to manage symptoms. They may also be used for other conditions such as bipolar disorder and major depressive disorder.

Administering antipsychotics is a critical aspect of nursing care for people with schizophrenia and other psychotic disorders. Antipsychotic drugs are used to treat symptoms such as delusions, hallucinations, disorganized thinking, and catatonic behavior. They work by blocking dopamine receptors in the brain.

Antipsychotic Medications

Antipsychotic drugs can cause serious side effects when taken over long periods of time, which include:

• Movement disorders (tardive dyskinesia)
• Involuntary movements
• Dystonia (muscle spasms)
• Parkinsonism (slowed movement)
• Akathisia (restlessness)
• Orthostatic hypotension (low blood pressure on standing up suddenly)

Anxiety Pharmacology

Anxiety is a state of unease, and most clients with anxiety disorders experience symptoms such as excessive worry, tension, difficulty sleeping, and struggle with concentration.

According to research, an estimated 31.1% of U.S. adults experience any anxiety disorder at some time.

Many medications used to treat anxiety are also used to treat other conditions, but can interact with other medications. Nurses need to understand the mechanism of action and side effects/contraindications so these medications can be safely administered.

Anxiety Medications

Side effects clients may experience with anxiety medications include:

• Nausea
• Sexual dysfunction
• Difficulty sleeping
• Headaches
• Weight gain
• Blurry vision
• Fatigue

ADHD Pharmacology

Attention deficit hyperactivity disorder (ADHD) is a neurobiological disorder that affects the neurotransmitters dopamine, norepinephrine, and epinephrine. The neurotransmitters regulate attention, impulse control, motivation, and reward sensitivity.

There are many different medications used to treat ADHD, with stimulants being the most commonly prescribed class. Depending on the client’s needs, medications can either be given as an immediate-release or extended-release formulation.

These drugs block the reuptake of dopamine, norepinephrine, and epinephrine into the presynaptic neuron. When these neurotransmitters remain in the synapse longer than usual, they increase concentration and focus by increasing neuronal activity in the prefrontal cortex region of the brain.

ADHD Medications

Amphetamines like Methylphenidate (Ritalin) are the most common medications used to treat ADHD in children and adolescents. Non-stimulants such as Atomoxetine (Strattera) and Clonidine (Catapres) are also used to treat ADHD.

In adults, stimulants such as Dextroamphetamine-Amphetamine (Adderall), Methylphenidate HCI (Concerta), Lisdexamfetamine Dimesylate (Vyvanse), or Amphetamine Sulfate (Evekeo).

Side effects of ADHD medications include:

• Decreased appetite
• Headaches
• Abdominal pain
• Nausea
• Vomiting
• Dizziness
• Drowsiness
• Irritability

Conclusion

Psychiatric pharmacology (the study of drugs used to treat mental disorders) will most likely come up in NCLEX questions. So it’s crucial to know how drugs work in the brain and body and their side effects.

Many patients with mental illness require drug therapy to manage their symptoms. Some psychiatric medications are used for treating chronic conditions, while others are prescribed only for short-term use.

When you start practicing as a nurse, you must be familiar with these types of medication in order to make informed decisions when administering them to patients.

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3238080/
https://my.clevelandclinic.org/health/diseases/17843-mood-disorders
https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.16091016
https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder