© 2012 The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill/Irwin Drugs in American Society Prepared by James Roberts University of Scranton Erich Goode Eighth Edition

© 2012 The McGraw-Hill Companies, Inc. All rights reserved Chapter 11 The Pharmaceutical Neuroleptics: Sedatives, Hypnotics, Antipsychotics, and Antidepressants Outline The Top 200 Prescription Drugs Sedative-Hypnotics Antipsychotics Antidepressants

© 2012 The McGraw-Hill Companies, Inc. All rights reserved The Pharmaceutical Neuroleptics Pharmaceuticals are medical drugs Neuroleptics: from the Greek, means substances “seize hold” of the nerves, are drugs designed to reduce anxiety or depression by inducing a more “normal” state of mind. Include sedatives, tranquilizers, hypnotics, antipsychotics, and antidepressants

© 2012 The McGraw-Hill Companies, Inc. All rights reserved The Top 200 Prescription D r u g s In 2009, prescription drug sales totaled $303.3 billion In 2009, 3.9 billion prescriptions were dispensed Most pharmaceutical drugs (about 8 out of 10) have no psychoactive affect; are used to treat bodily ailments Revenues have slowed down in spite of increases in prescriptions, largely due to the increase in generic drugs Generics accounted for 75% of prescriptions dispensed

© 2012 The McGraw-Hill Companies, Inc. All rights reserved The Top 200 Prescription Drugs Some of the top 200 drugs are psychoactive but their effects are experienced as disagreeable by people who do not suffer from a psychological disorder Antipsychotics: most popular drug among pharmaceuticals Antidepressants: 4 th largest selling pharmaceutical drug

© 2012 The McGraw-Hill Companies, Inc. All rights reserved The Top 200 Prescription Drugs There are quite a few narcotics among the top 200 prescription drugs Prescription narcotics are more popular as recreational drugs than heroin Narcotics are the top drug type in causing overdose deaths

© 2012 The McGraw-Hill Companies, Inc. All rights reserved Sedative-Hypnotics Sedative/hypnotics Are downers, or general depressants They retard, dull, or obtund signals passing through the central nervous system They slow down a number of functions and actions of a wide range of organs of the body, as well as general activity, or “behavioral output” They reduce anxiety and at higher doses, induce sleep

© 2012 The McGraw-Hill Companies, Inc. All rights reserved Sedative-Hypnotics In terms of effects, barbiturates are remarkably like alcohol Due to harmful recreational use in the 1960s and 1970s, medical use of barbiturates has declined sharply In many ways, barbiturates are much more harmful drug than heroin – classic withdraw symptoms upon discontinuation; heavier the dependence, more extreme the reactions

© 2012 The McGraw-Hill Companies, Inc. All rights reserved Barbituates Defined as central nervous system depressants Derived from barbituric acid Classified according to their speed of action Ultra-short acting—administered by IV and produce unconsciousness and anesthesia within a minute Short-acting and intermediate-acting—used for sedation and as sleep aids Long-acting—used as anti-anxiety agents as well as anti-epileptic drugs, do not produce a high

© 2012 The McGraw-Hill Companies, Inc. All rights reserved Methaqualone A commonly prescribed sedative, classified as a Schedule I drug No longer prescribed in the U.S. Marked under a number of trade names: Quaalude, Sopor, Parest, and Optimil Capable of producing death by overdose, extreme mental clouding, drowsiness, discoordination, disorientation, and a true physical dependence

© 2012 The McGraw-Hill Companies, Inc. All rights reserved Benzodiazepines Valium is the trade name of diazepam, the earliest and most successful of the benzodiazepams In large doses: act as sedative-hypnotics and produce drowsiness In small doses: act as calming agents and are effective in combating anxiety and tension

© 2012 The McGraw-Hill Companies, Inc. All rights reserved Antipsychotics Used by psychiatrists in the treatment of psychosis Do not produce a high or intoxication Are virtually never used recreationally Not addictive and rarely result in lethal overdoses

© 2012 The McGraw-Hill Companies, Inc. All rights reserved Antidepressants Used for the treatment of depression Also called “mood elevators” Do not induce a euphoric state Have no recreational value