Nora Amammar 1ste Master Klinische Psychologie
Samenvatting Praktische
Psychopharmacologie
1 ste master Vrije Universiteit Brussel 2024-2025
1
,Nora Amammar 1ste Master Klinische Psychologie
Inhoud
Les 1: Anatomie v/d hersenen en Neurotransmissie ..................................................................9
1. Anatomie van de hersenen ...............................................................................................9
1.1 Anatomische terminologie ..........................................................................................9
1.2 Cerebrum ................................................................................................................. 10
1.3 Diencephalon ........................................................................................................... 16
1.4 Het limbisch systeem:............................................................................................... 17
1.5 De hersenstam ......................................................................................................... 17
1.6 Het cerebellum: ........................................................................................................ 18
1.7 Hersenbarriëres ........................................................................................................ 19
1.8 Cerebrale ventrikels .................................................................................................. 19
2. Neurotransmissie........................................................................................................... 20
2.1 Hersencellen ............................................................................................................ 20
2.2 Neuronen ................................................................................................................. 20
2.3 De celmembraan ...................................................................................................... 21
2.4 Synaptische transmissie ........................................................................................... 23
2.5 Chemische signaaloverdracht ................................................................................... 24
3. Aangrijpingspunten voor psychopharmaca ...................................................................... 26
3.1 Ionkanalen ............................................................................................................... 27
3.2 Enzymen .................................................................................................................. 28
3.3 Carriers of transporters ............................................................................................. 30
3.4 Receptoren............................................................................................................... 30
4. Mechanismen van neuromodulatie ................................................................................. 34
4.1 Desensitizatie, internalizatie, downregulatie .............................................................. 34
4.2 Upregulatie en supersensitiviteit ............................................................................... 35
4.3 Cotransmitters (niet relevant) .................................................................................... 35
4.4 Presynaptische autoreceptors ................................................................................... 35
4.5 Presynaptische heteroreceptoren .............................................................................. 35
4.6 Disinhibitie ............................................................................................................... 36
5. Neurotransmitter en neuromodulator systemen .............................................................. 36
5.1 Glutamaat ................................................................................................................ 36
5.2 GABA........................................................................................................................ 37
5.3 Glutamaat en GABA .................................................................................................. 37
5.4 Acetylcholine............................................................................................................ 39
2
,Nora Amammar 1ste Master Klinische Psychologie
5.5 Dopamine ................................................................................................................ 40
5.6 Noradrenaline........................................................................................................... 41
5.7 Serotonine ................................................................................................................ 41
5.8 Histamine................................................................................................................. 42
5.9 Is het mogelijk een rechtstreekse link te maken tussen activatie van neuromodulator
systemen en effecten op cognitie/emotie? ...................................................................... 43
Les 2: Aan middelen gebonden stoornissen en hun behandeling ............................................. 44
1. Aan middelen gebonden stoornissen (DSM criteria geen leerstof) .................................... 44
1.1 Het opponent process model .................................................................................... 45
1.2 Het Koob model voor verslaving ................................................................................. 46
1.3 Schade aan gebruikers en anderen ............................................................................ 50
1.4 Spoedopnames gerelateerd aan middelengebruik...................................................... 51
2. Centrale stimulantia ....................................................................................................... 51
2.1 Farmacologisch overzicht ......................................................................................... 51
2.2 Cocaïne.................................................................................................................... 53
2.3. Amfetamines ........................................................................................................... 56
2.4 MDMA ...................................................................................................................... 58
2.5 Synthetische cathinonen........................................................................................... 59
2.6 Behandeling van stimulantia gebruik stoornis?........................................................... 60
3. Nicotine ......................................................................................................................... 60
3.1 Verslavingspotentieel ................................................................................................ 61
3.2 Middelen bij tabaksgebruik (merknamen niet kennen) ................................................ 62
4. Opioïden ........................................................................................................................ 64
4.1 Morfine, heroine en synthetische opioiden ................................................................. 64
4.2 Endogene opoïden en opioïd receptoren .................................................................... 64
4.3 Opioïd tolerantie ....................................................................................................... 65
4.4 Famacologisch overzicht........................................................................................... 65
4.5 Verslavingspotentiëel ................................................................................................ 66
4.6 Behandeling opioid gebruik stoornis (dosis van medicatie geen leerstof) ..................... 66
5. Cannabinoiden .............................................................................................................. 69
5.1 Cannabis .................................................................................................................. 69
5.2 Farmacologisch overzicht ......................................................................................... 69
5.3 Therapeutische toepassingen.................................................................................... 70
5.4 Verslavingspotentieel ................................................................................................ 70
5.5 Behandeling cannabis gebruik stoornis...................................................................... 70
6. Alcohol .......................................................................................................................... 71
3
, Nora Amammar 1ste Master Klinische Psychologie
6.1 Ethanol..................................................................................................................... 71
6.2 Farmacologisch overzicht ......................................................................................... 71
6.3 Verslavingspotentieel ................................................................................................ 72
6.4 Neurotoxiciteit .......................................................................................................... 72
6.5 Behandeling ............................................................................................................. 73
6.6 Interacties ................................................................................................................ 75
7. GHB/GBL ....................................................................................................................... 75
7.1 Farmacologisch overzicht ......................................................................................... 75
7.2 Verslavingspotentieel ................................................................................................ 76
7.3 Absences, diepe slaap, coma (detail) ........................................................................ 76
8. Dissociatieve anaesthetica ............................................................................................. 76
8.1 Phencyclidine, ketamine, dextrometorphan ............................................................... 76
8.2 Dextrometorphan, phencyclidine, ketamine ............................................................... 77
8.3 Verslavingspotentieel ................................................................................................ 78
9. Klassieke psychedelica................................................................................................... 78
9.1 Farmacologisch overzicht ......................................................................................... 78
9.2 Verslavingspotentieel ................................................................................................ 79
9.3 Therapeutisch potentieel .......................................................................................... 79
10. Key Points ................................................................................................................. 79
Les 3: Behandeling van ADHD ................................................................................................ 80
1. Geneesmiddelen voor behandeling van ADHD ................................................................ 80
1.1 DSM-5: Attention deficit hyperactivity disorder ........................................................... 80
1.2 Het netwerk model ................................................................................................... 80
1.3 Het “catecholamine arousal” model .......................................................................... 82
1.4 Behandeling ............................................................................................................. 84
1.5 Verslavingspotentieel ................................................................................................ 91
Les 4: Hypnotica en sedativa ................................................................................................. 92
1. Insomnia en andere slaapstoornissen ............................................................................. 92
2. Slaap en alertheid .......................................................................................................... 92
2.1 SCN en circadiaan ritme (niet in detail kennen) .......................................................... 92
2.2 VLPO GABA projecties ............................................................................................... 93
2.3 LH orexine projecties ................................................................................................ 93
2.4 Ascenderend reticulair activerend systeem (ARAS) .................................................... 94
2.5 GABA en de thalamische filter ................................................................................... 95
2.6 GABA en angst/paniek ............................................................................................... 96
3. Hypnotica en sedativa .................................................................................................... 96
4
Samenvatting Praktische
Psychopharmacologie
1 ste master Vrije Universiteit Brussel 2024-2025
1
,Nora Amammar 1ste Master Klinische Psychologie
Inhoud
Les 1: Anatomie v/d hersenen en Neurotransmissie ..................................................................9
1. Anatomie van de hersenen ...............................................................................................9
1.1 Anatomische terminologie ..........................................................................................9
1.2 Cerebrum ................................................................................................................. 10
1.3 Diencephalon ........................................................................................................... 16
1.4 Het limbisch systeem:............................................................................................... 17
1.5 De hersenstam ......................................................................................................... 17
1.6 Het cerebellum: ........................................................................................................ 18
1.7 Hersenbarriëres ........................................................................................................ 19
1.8 Cerebrale ventrikels .................................................................................................. 19
2. Neurotransmissie........................................................................................................... 20
2.1 Hersencellen ............................................................................................................ 20
2.2 Neuronen ................................................................................................................. 20
2.3 De celmembraan ...................................................................................................... 21
2.4 Synaptische transmissie ........................................................................................... 23
2.5 Chemische signaaloverdracht ................................................................................... 24
3. Aangrijpingspunten voor psychopharmaca ...................................................................... 26
3.1 Ionkanalen ............................................................................................................... 27
3.2 Enzymen .................................................................................................................. 28
3.3 Carriers of transporters ............................................................................................. 30
3.4 Receptoren............................................................................................................... 30
4. Mechanismen van neuromodulatie ................................................................................. 34
4.1 Desensitizatie, internalizatie, downregulatie .............................................................. 34
4.2 Upregulatie en supersensitiviteit ............................................................................... 35
4.3 Cotransmitters (niet relevant) .................................................................................... 35
4.4 Presynaptische autoreceptors ................................................................................... 35
4.5 Presynaptische heteroreceptoren .............................................................................. 35
4.6 Disinhibitie ............................................................................................................... 36
5. Neurotransmitter en neuromodulator systemen .............................................................. 36
5.1 Glutamaat ................................................................................................................ 36
5.2 GABA........................................................................................................................ 37
5.3 Glutamaat en GABA .................................................................................................. 37
5.4 Acetylcholine............................................................................................................ 39
2
,Nora Amammar 1ste Master Klinische Psychologie
5.5 Dopamine ................................................................................................................ 40
5.6 Noradrenaline........................................................................................................... 41
5.7 Serotonine ................................................................................................................ 41
5.8 Histamine................................................................................................................. 42
5.9 Is het mogelijk een rechtstreekse link te maken tussen activatie van neuromodulator
systemen en effecten op cognitie/emotie? ...................................................................... 43
Les 2: Aan middelen gebonden stoornissen en hun behandeling ............................................. 44
1. Aan middelen gebonden stoornissen (DSM criteria geen leerstof) .................................... 44
1.1 Het opponent process model .................................................................................... 45
1.2 Het Koob model voor verslaving ................................................................................. 46
1.3 Schade aan gebruikers en anderen ............................................................................ 50
1.4 Spoedopnames gerelateerd aan middelengebruik...................................................... 51
2. Centrale stimulantia ....................................................................................................... 51
2.1 Farmacologisch overzicht ......................................................................................... 51
2.2 Cocaïne.................................................................................................................... 53
2.3. Amfetamines ........................................................................................................... 56
2.4 MDMA ...................................................................................................................... 58
2.5 Synthetische cathinonen........................................................................................... 59
2.6 Behandeling van stimulantia gebruik stoornis?........................................................... 60
3. Nicotine ......................................................................................................................... 60
3.1 Verslavingspotentieel ................................................................................................ 61
3.2 Middelen bij tabaksgebruik (merknamen niet kennen) ................................................ 62
4. Opioïden ........................................................................................................................ 64
4.1 Morfine, heroine en synthetische opioiden ................................................................. 64
4.2 Endogene opoïden en opioïd receptoren .................................................................... 64
4.3 Opioïd tolerantie ....................................................................................................... 65
4.4 Famacologisch overzicht........................................................................................... 65
4.5 Verslavingspotentiëel ................................................................................................ 66
4.6 Behandeling opioid gebruik stoornis (dosis van medicatie geen leerstof) ..................... 66
5. Cannabinoiden .............................................................................................................. 69
5.1 Cannabis .................................................................................................................. 69
5.2 Farmacologisch overzicht ......................................................................................... 69
5.3 Therapeutische toepassingen.................................................................................... 70
5.4 Verslavingspotentieel ................................................................................................ 70
5.5 Behandeling cannabis gebruik stoornis...................................................................... 70
6. Alcohol .......................................................................................................................... 71
3
, Nora Amammar 1ste Master Klinische Psychologie
6.1 Ethanol..................................................................................................................... 71
6.2 Farmacologisch overzicht ......................................................................................... 71
6.3 Verslavingspotentieel ................................................................................................ 72
6.4 Neurotoxiciteit .......................................................................................................... 72
6.5 Behandeling ............................................................................................................. 73
6.6 Interacties ................................................................................................................ 75
7. GHB/GBL ....................................................................................................................... 75
7.1 Farmacologisch overzicht ......................................................................................... 75
7.2 Verslavingspotentieel ................................................................................................ 76
7.3 Absences, diepe slaap, coma (detail) ........................................................................ 76
8. Dissociatieve anaesthetica ............................................................................................. 76
8.1 Phencyclidine, ketamine, dextrometorphan ............................................................... 76
8.2 Dextrometorphan, phencyclidine, ketamine ............................................................... 77
8.3 Verslavingspotentieel ................................................................................................ 78
9. Klassieke psychedelica................................................................................................... 78
9.1 Farmacologisch overzicht ......................................................................................... 78
9.2 Verslavingspotentieel ................................................................................................ 79
9.3 Therapeutisch potentieel .......................................................................................... 79
10. Key Points ................................................................................................................. 79
Les 3: Behandeling van ADHD ................................................................................................ 80
1. Geneesmiddelen voor behandeling van ADHD ................................................................ 80
1.1 DSM-5: Attention deficit hyperactivity disorder ........................................................... 80
1.2 Het netwerk model ................................................................................................... 80
1.3 Het “catecholamine arousal” model .......................................................................... 82
1.4 Behandeling ............................................................................................................. 84
1.5 Verslavingspotentieel ................................................................................................ 91
Les 4: Hypnotica en sedativa ................................................................................................. 92
1. Insomnia en andere slaapstoornissen ............................................................................. 92
2. Slaap en alertheid .......................................................................................................... 92
2.1 SCN en circadiaan ritme (niet in detail kennen) .......................................................... 92
2.2 VLPO GABA projecties ............................................................................................... 93
2.3 LH orexine projecties ................................................................................................ 93
2.4 Ascenderend reticulair activerend systeem (ARAS) .................................................... 94
2.5 GABA en de thalamische filter ................................................................................... 95
2.6 GABA en angst/paniek ............................................................................................... 96
3. Hypnotica en sedativa .................................................................................................... 96
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