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BNL home page Hartman Behavioral Neuroscience Lab User:Richard E. Hartman

LLU PSYC 555: Psychopharmacology

Fall 2010 - 2 credits

Thursday from 1:00-3:00 at the Behavioral Health Institute

Instructor

Rich Hartman, PhD (rhartman AT llu DOT edu)
- office hours Mon 10-12 and Thu from 11:30-12:30 in the Psychology (Central) Building office #119

Book

click on the title for a link to this title:

Robert M. Julien. A Primer of Drug Action. Worth Publishers. isbn:1429206799. [Julien]

Course description

This class provides a survey of psychopharmacology (the study of drugs that affect the brain), including pharmacokinetics (how drugs move through the body) and pharmacodynamics (how drugs work on the brain). Classes of drugs that will be covered include depressants, stimulants, antidepressants, mood stabilizers, antipsychotics, opiates, cannabis, and the psychedelics. Other topics will include pediatric / geriatric psychopharmacology, psychoactive herbs, and drug interactions. The primary objective of this course is to provide an understanding of drug mechanisms and effects (i.e., how drugs work). Specific clinical uses of psychoactive drugs (i.e., when / how to use a particular drug) will also be addressed.

Grading

Grading. There will be 2 exams (worth 100 points) with questions drawn from both the reading assignments and classroom discussions. Additionally, a written project worth 100 points will be turned in (details to be presented in class), and 20 points will be assigned reflecting classroom participation (attendance, discourse, not sleeping, etc.). Thus, there is a grand total of 320 points possible for this class.

Grading Scale:

90% A
80% B
70% C
60% D
ouch F

Tentative schedule (subject to change as needed)

Thu Sep 30 Ch 1-3, 21 Introduction to pharmacological principles (Hartman)
Thu Oct 7 Ch 4-6 Depressants / Stimulants (Hartman)
Thu Oct 14 Ch 7 Analgesics & opiates (Hartman)
Thu Oct 21 Drugs of Abuse / Marijuana / Psychedelics / Psychoactive Herbs (Hartman / Whyte?)
Thu Oct 28 Midterm
Thu Nov 4 Test review / Drug interactions (Gutierrez)
Thu Nov 11 Antidepressants / sedative-hypnotics (Hartman / Schaepper)
Thu Nov 18 Ch 8-9 Mood stabilizers / antipsychotics (Meyer)
Thu Nov 25 NO CLASS - Thanksgiving
Thu Dec 2 Ch 10-12, 19 Child / Adolescent & geriatric pharmacology (Hartman / Schaepper)
Thu Dec 9 Clinical Q&A / review (Hartman / Gutierrez)
Thu Dec 16 FINAL EXAM

Study guide ("stuff that may be on the test")

Intro

General overview of the nervous system with emphasis on areas as related to psychopharmacology
General overview of neurons with emphasis on structures and functions as related to psychopharmacology
General overview of the major neurotransmitter systems
Pharmacokinetics:
- Absorption:
  - Routes
- Distribution:
  - Routes
  - Barriers
- Metabolism
- Elimination:
  - Redistribution
  - Elimination / half-life
  - Steady-state
Pharmacodynamics:
- Types of receptors (fast vs. slow vs. reuptake)
- compound:receptor “specificity” and fit
- agonists vs. antagonists
- ways that neurotransmitter activity is neutralized
- Dose-response curves
- Side effects / safety
- Mechanisms of drug tolerance
- Concept of homeostasis
Toxicity
Placebo effect
Drug use versus abuse

Depressants

graded (dose-dependant) nature of effects
role of set & setting in effects
cross-tolerance
Ethanol:
- measuring dosage & blood alcohol content
- Effects and withdrawal effects
- Pharmacokinetics:
  - absorption / 1st pass metabolism
  - zero-order metabolism
  - individual differences
  - steps in ethanol metabolism
- Pharmacodynamics:
  - membrane
  - neurotransmitter systems
- Effects of over-use
- Dealing with addiction
Barbiturates:
- Pharmacokinetics
- Pharmacodynamics
  - Unique and dangerous
Benzodiazepines, GHB, Inhalants, & Misc depressants

Stimulants

Overall central and peripheral effects of stimulants
How route of administration affect subject effects
Effects of stimulant overdose
Effects of stimulant withdrawal
The neurotransmitter systems and brain areas involved in stimulants’ effects
Caffeine
- forms
- mechanisms of actions
- metabolism and metabolites
- potential therapeutic effects
Nicotine
- forms
- mechanisms of actions
- metabolism and metabolites
- potential therapeutic effects
Cocaine
- forms
- mechanisms of actions
- metabolism and metabolites
- potential therapeutic effects
Amphetamines
- forms
- mechanisms of actions
- potential therapeutic effects
Others

Pain/Analgesia/Opiates

Physiological basis of pain
- at the site of injury
  - cyclooxygenase enzymes and products
- neural mechanisms
  - nervous system regions
  - neurotransmitters / receptors involved
- strategies for blocking the subjective experience of pain
2 main classes of analgesic drugs:
- NSAIDs:
  - 2 main subtypes of NSAIDs
    - examples
  - general mechanisms
  - side effects
- opiates:
  - source
  - effects
  - pharmacokinetics
    - routes
    - absorption
    - metabolism
  - pharmacodynamics
    - endogenous neurotransmitters in the "opiate" system
    - receptor subtypes and distribution throughout the brain
    - general mechanisms of effects
  - "pure" agonists:
    - morphine
      - effects
      - tolerance
      - withdrawal
    - other examples
  - "partial" agonists
  - antagonists
  - mixed agonist / antagonist

Cannabis

major phytocannabinoids
- relative psychoactive effects
pharmacokinetics
- smoking
  - vaporizing
- oral ingestion
reverse tolerance
pharmacodynamics
- anandamide
- CB receptors
  - distribution and effects
  - mechanisms
medicinal use
- mechanisms
  - analgesia
  - muscle relaxant
  - oxidation
  - effects on A-beta aggregation
effects of overuse

Psychedelics

general effects
5 classes:
- serotoninergic
  - examples
  - pharmacodynamics
  - mechanisms
  - the "psychedelic trip"
  - pharmacokinetics
  - toxicity
  - tolerance / cross-tolerance
  - effects of overuse
- catecholaminergics
  - similarity to amphetamines
  - pharmacodynamics
    - relative contribution to effects
  - examples
  - effects of overuse
- glutamatergic
  - unique effects
    - analgesia
    - schizophrenia
      - Newcomer et al. (1999)
    - hippocampal dysfunction
    - reward
  - examples
  - pharmacokinetics
  - pharmacodynamics
- opioid
  - salvinorin a
    - pharmacodynamics
    - relative potency
    - medicinal use
- acetylcholinergic
psychedelics in a nut(meg)shell

Anti-depressants

Potential causes of depression
- stress hormones
- neurotransmitter deficiencies
- morphological changes
- loss of neuroplasticity
Animal tests of depression
- Basic mechanism of antidepressant drugs
- Other uses of antidepressant drugs
overview of 1st generation antidepressants (TCAs and MAOIs)
- common mechanisms
- relative efficacy and toxicity
TCAs:
- examples
- effects
- pharmacokinetics
- pharmacodynamics
  - synaptic effects on 5HT, NE, H, and ACh
Relative importance of 5HT vs. NE vs. DA in antidepressant effects
- behavioral effects of binding with various 5HT receptor subtypes
- problems
MAOIs:
- general mechanisms
- subtypes of MAO and effects of inhibiting each
- problems
  - used for a subset of patients
  - a strategy to make safer
2nd generation / Atypical antidepressants:
- relative efficacy and toxicity
- mostly just modified TCAs with more specific synaptic effects
  - block various receptors for 5HT, NE and DA (reuptake / postsynaptic)
SSRIs:
- examples
- uses besides "antidepressants"
- effects on synaptic availability of 5HT
- problems associated with overuse / withdrawal
Newer pharmacological strategies
- targeting multiple systems
- agonists / antagonists for 5HT receptor subtypes
- histamine, DA, NE, substance P, hormones, nutritional
drugs vs. talk therapy

Anti-psychotics

Mood stabilizers and Antipsychotics:
- ontology of schizophrenia symptoms
- Morphological / structural changes in the brain
- Neurotransmitter abnormalities
  - DA, 5-HT, glu, GABA
    - pure DA hypothesis
      - “Typical” antipsychotics block DA receptors
        DA receptor subtypes
        correlation between DA receptor binding and clinical efficacy
    - potential role of glu
    - positive vs. negative symptoms and neurotransmitter systems
    - potential role of 5-HT
- intro to bipolar disorder
- Antipsychotics overview
  - general effects / side effects
Typical antipsychotics - the phenothiazines
- antidote for serotoninergic psychedelics
- pharmacokinetics
- pharmacodynamics
  - effect on D2 receptors
    - % of bound receptors required to produce therapeutic effect
    - % of bound receptors required to produce "extrapyramidal" side effects
  - other blocked receptors and their behavioral effects
  - effects of binding D2 receptors in different brain areas
- Typical antipsychotics - the butyrophenones
  - comparison to the phenothiazines
- Typical antipsychotic overview
  - motor problems
  - effects on positive vs. negative symptoms
- Atypical antipsychotics
  - general definition based on activity at 5HT2 & D2 receptors
  - effects on positive vs. negative symptoms
  - side effects as compared to the typical antipsychotics
  - examples
- 3rd-generation antipsychotics
  - pharmacological differences from typical and atypical antipsychotics
- Mood stabilizers for bipolar disorder:
  - atypical antipsychotics
  - lithium
    - relationship with sodium
    - effect in patients with bipolar disorder vs. those without
    - negative aspects
    - pharmacokinetics
    - pharmacodynamics
  - anti-convulsants
    - pharmacodynamics / mechanisms
    - GABA, glu, Na channels, Ca channels
  - AChE inhibitors
  - nutrition
  - cannabinoids

Pediatrics

relative incidence of pediatric psychiatric disorders
ADHD
- effects of stimulants
  - effects on later drug abuse
  - methylphenidate
    - pharmacokinetics/dynamics
  - other drugs
conduct disorders
- pharmacological treatments
autism
depression / anxiety / ocd

Geriatrics

general principles
Parkinson's
- neurodegeneration
  - behavioral effects
  - relationship with antipsychotics
- pharmacological treatments
  - boost dopaminergic system
  - other strategies
Alzheimer's
- neurodegeneration
  - behavioral effects
- pharmacological treatments
- non-pharmacological treatments

Medicinal herbs

examples and potential mechanisms

Resources

Don't get caught at this party!
Erowid's vault contains a wealth of information, but much of it is user-generated content. Imbibe with an open mind and a fair amount of skepticism. Also, avert your eyes from any foul language as quickly as possible.
The DEA's scientific journal and monthly bulletins contain fascinating and up-to-date information on the full range of illicit drug use. The Obama administation has made this information classified, so anything after December 2009 is of little interest.
Message board for users of psychoactive medications.

Disability accommodation

If you are registered with the Dean's office for disability accommodation, please see me as soon as possible to discuss any course accommodations that may be necessary. If you have a disability and wish accommodation, please visit the Dean’s Office of your school.

Academic integrity policy

Don’t cheat.

@@ Line 79: / Line 79: @@
 *Placebo effect
 *Drug use versus abuse
 ===Depressants===
 *graded (dose-dependant) nature of effects
@@ Line 128: / Line 129: @@
 **potential therapeutic effects
 *Others
 ===Pain/Analgesia/Opiates===
 *Physiological basis of pain
@@ Line 162: / Line 164: @@
 ***antagonists
 ***mixed agonist / antagonist
+===Cannabis===
+*major phytocannabinoids
+**relative psychoactive effects
+*pharmacokinetics
+**smoking
+***vaporizing
+**oral ingestion
+*reverse tolerance
+*pharmacodynamics
+**anandamide
+**CB receptors
+***distribution and effects
+***mechanisms
+*medicinal use
+**mechanisms
+***analgesia
+***muscle relaxant
+***oxidation
+***effects on A-beta aggregation
+*effects of overuse
+===Psychedelics===
+*general effects
+*5 classes:
+**serotoninergic
+***examples
+***pharmacodynamics
+***mechanisms
+***the "psychedelic trip"
+***pharmacokinetics
+***toxicity
+***tolerance / cross-tolerance
+***effects of overuse
+**catecholaminergics
+***similarity to amphetamines
+***pharmacodynamics
+****relative contribution to effects
+***examples
+***effects of overuse
+**glutamatergic
+***unique effects
+****analgesia
+****schizophrenia
+*****[http://www.ncbi.nlm.nih.gov/pubmed/9885791?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum Newcomer et al. (1999)]
+****hippocampal dysfunction
+****reward
+***examples
+***pharmacokinetics
+***pharmacodynamics
+**opioid
+***salvinorin a
+****pharmacodynamics
+****relative potency
+****medicinal use
+**acetylcholinergic
+*psychedelics in a nut(meg)shell
 ===Anti-depressants===
 *Potential causes of depression
@@ Line 255: / Line 316: @@
 ***nutrition
 ***cannabinoids
-===Cannabis===
-*major phytocannabinoids
-**relative psychoactive effects
-*pharmacokinetics
-**smoking
-***vaporizing
-**oral ingestion
-*reverse tolerance
-*pharmacodynamics
-**anandamide
-**CB receptors
-***distribution and effects
-***mechanisms
-*medicinal use
-**mechanisms
-***analgesia
-***muscle relaxant
-***oxidation
-***effects on A-beta aggregation
-*effects of overuse
-===Psychedelics===
-*general effects
-*5 classes:
-**serotoninergic
-***examples
-***pharmacodynamics
-***mechanisms
-***the "psychedelic trip"
-***pharmacokinetics
-***toxicity
-***tolerance / cross-tolerance
-***effects of overuse
-**catecholaminergics
-***similarity to amphetamines
-***pharmacodynamics
-****relative contribution to effects
-***examples
-***effects of overuse
-**glutamatergic
-***unique effects
-****analgesia
-****schizophrenia
-*****[http://www.ncbi.nlm.nih.gov/pubmed/9885791?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum Newcomer et al. (1999)]
-****hippocampal dysfunction
-****reward
-***examples
-***pharmacokinetics
-***pharmacodynamics
-**opioid
-***salvinorin a
-****pharmacodynamics
-****relative potency
-****medicinal use
-**acetylcholinergic
-*psychedelics in a nut(meg)shell
 ===Pediatrics===

User:Richard E. Hartman:Courses:Psychopharmacology