Psychopharmacology Summary & Practice questions

* - topics that were shown on the 2025 exam

Lecture 1:

Definitions:

Pharmacology: knowledge about drugs or medicines; the art of preparing medication

1. The science that deals with studying the reciprocal actions, or interactions,
between pharmacological substances and physiological processes

Pharmacon: medicine/pharmaceutical product

Drug: pharmacologically active substance (English)

2. Medication or other substance with a physiological effect
3. Psychoactive substance for abuse, narcotic or stimulating
4. Dutch: psychoactive substance for abuse (negative connotation)
 Drug/stimulant with a more or less ‘drugging’ effect, which can lead to
dependence (addiction)

Classification

 Possible grounds include:
1. Chemical structure
 Interesting, but the same structure can have different effects
2. Working mechanism
 Ideal, but working mechanism not always known
3. Behavioral effects
 Easiest and most used, linked to the disorder being treated
 Recently: Behavioral (ATC) -> working (NbN)

1. ATC
 The classic system groups drugs based on their purpose (e.g., what they treat), and
their chemical effects.
 Anatomical Therapeutic Chemical
 Behavioral effects
 Indication based
 Older (1976)
 Gold standard (WHO)
 Cons
 Use for other than primary disorder
 Stigma (i.e., anxiety patient gets prescribed depression drug,
doesn’t want to) -> less patient adherence
2. NbN
 A newer system that groups drugs based on how they work in the brain, not just
what they treat.


1

,  Neuroscience-based Nomenclature
 Working mechanism
 Pharmacologically driven
 Newer (2018)
 Taskforce 5 organizations
 The names are based on the primary disorder for which it is prescribed
 Cons
 New, not acknowledged by WHO/scientific community
 Lack of sufficient evidence

 Difference in nomenclature ATC vs NbN
1. ATC: anti-psychotics
2. NbN: serotonin/dopamine antagonists with antipsychotic actions

3. ATC: anti-depressants
4. NbN: monoamine reuptake inhibitors with antidepressant action

 Classes ATC
1. Psychotropic drug main classes:
 Antipsychotics
 Conventional (meaning earlier discovered) antipsychotic, e.g.,
Haloperidol
 Atypical, e.g., Risperidone
 Antidepressants
 Tricyclic, e.g., Imipramine
 Selective serotonin reuptake inhibitors (SRRI), e.g., Prozac
 Monoamine Oxidase Inhibitors (MAOI), e.g., Nardil
 Anxiolytics (anti-anxiety medication)
 Benzodiazepines, e.g., Valium
 Non-benzodiazepines, e.g., Buspirone
 Mood stabilizers
 Lithium
 Hypnotics

2. Other relevant drug classes
 Anti-epileptics
 Benzodiazepines, Clonazepam, Clorazepate
 Stimulants
 Cocaine, Amphetamine (speed), Methylphenidate, Ritalin,
Caffeine, Nicotine
 Narcotic painkillers
 Opioids, Morphine, Codeine, Heroin
 Central nervous system (CNS) suppressors (alcohol)

2

,  Psychedelics & hallucinogens
 LSD, Marijuana, Hashish, Mescaline, Psilocybin (mushroom)
 Mescaline -> LSD
o Peyote & San Pedro cactus, really gross (first two hours
of sickness and diarrhea, then 8-10 hours peak)

Administration

 Includes 4 important stages
1. Absorption: from the site of administration -> blood
 Oral: easy, but stomach acid eats away 2/3 of meds, better safe way if
you expect side effects
 Rectal: lose 1/3 of activity
 Topical
 Skin, e.g., nicotine patches
 Oral mucosa
o Sublingual: medicine under your tongue
o Buccal: side between teeth and cheek
 Parenteral (injection) works very quickly
 Intravenous (in the veins, quick effect because there is no first-
pass metabolism, but difficult to reverse action in case of
allergic reaction)
 Intramuscular (in muscle)
 Subcutaneously (under the skin, slower)
 Inhalation

2. Distribution: throughout the body
 In blood (albumin)
 Distribution
 Extracellular (blood plasma)
 Intracellular (water in body cells) important for the medication
to work, easier goes through the membrane, faster and more
effective
 Speed depends on lipid solubility
 Through membranes: passive diffusion following
concentration gradient
 Higher lipid solubility  faster distribution

3. Metabolism: conversion by body  effect
4. Excretion: elimination from body


Pharmacokinetics: process



3

, Change over time in terms of serum concentration of medication and metabolites. How
does the body process the medication? what happens to a drug in the body after it’s taken

 Distribution half-live
 Alpha phase: to -> 50%
 First half-life = important -> onset action
 How fast is it absorbed?
 Affects: (ADIME)
 Absorption (gets into the bloodstream) except for intravenous
 Distribution (gets into tissue from the bloodstream)
 Interaction with receptor
 Metabolism
 Elimination
 Blood circulation: most important in pharmacokinetics
 Entire blood circulation takes +/- 1 minute
 Capillaries
 10 billion
 200 m2
 Every cell gets reached



Pharmacodynamics:

How does the body respond to medication?

 Graph: toxic range, therapeutic range, subtherapeutic range
 Half-lives: time for the medication to halve in concentration
 Distribution half-live
 Alpha phase
 To -> 50%
 Elimination half-live *
 Beta phase: degradation (liver) and 50% excretion (kidneys)
 Time it takes to eliminate half of the concentration
 Sixth half-live = important -> stop action/eliminated




Neurons

4