Classes: Difference between revisions
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=== Monoamine Oxidase Inhibitors (MAOIs) === | === Monoamine Oxidase Inhibitors (MAOIs) === | ||
Inhibit MAO-A and/or MAO-B, increasing monoamine levels. Require strict dietary and med interaction precautions. Subclasses: | Inhibit MAO-A and/or MAO-B, increasing monoamine levels. Require strict dietary and med interaction precautions. Subclasses: | ||
* '''Irreversible non-selective MAOIs''' | * '''Irreversible non-selective MAOIs''', inhibit both MAO-A and MAO-B permanently | ||
* '''Reversible MAO-A inhibitors (RIMAs)''' | * '''Reversible MAO-A inhibitors (RIMAs)''', safer interaction profile; displaceable by tyramine | ||
* '''Selective MAO-B inhibitors''' | * '''Selective MAO-B inhibitors''', used primarily in Parkinson's disease; antidepressant at higher doses | ||
=== Noradrenergic and Specific Serotonergic Antidepressants (NaSSAs) === | === Noradrenergic and Specific Serotonergic Antidepressants (NaSSAs) === | ||
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=== First-Generation Antipsychotics (FGAs / Typicals) === | === First-Generation Antipsychotics (FGAs / Typicals) === | ||
Primarily D2 receptor antagonists. Effective for positive symptoms; high risk of extrapyramidal side effects and tardive dyskinesia. Subclasses by chemical structure: | Primarily D2 receptor antagonists. Effective for positive symptoms; high risk of extrapyramidal side effects and tardive dyskinesia. Subclasses by chemical structure: | ||
* '''Phenothiazines''' | * '''Phenothiazines''', chlorpromazine, fluphenazine, perphenazine, thioridazine, trifluoperazine, prochlorperazine | ||
* '''Butyrophenones''' | * '''Butyrophenones''', haloperidol, droperidol | ||
* '''Thioxanthenes''' | * '''Thioxanthenes''', thiothixene | ||
* '''Dibenzoxazepines''' | * '''Dibenzoxazepines''', loxapine | ||
* '''Dihydroindolones''' | * '''Dihydroindolones''', molindone | ||
* '''Diphenylbutylpiperidines''' | * '''Diphenylbutylpiperidines''', pimozide | ||
=== Second-Generation Antipsychotics (SGAs / Atypicals) === | === Second-Generation Antipsychotics (SGAs / Atypicals) === | ||
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=== Beta Blockers (peripheral somatic anxiolytic) === | === Beta Blockers (peripheral somatic anxiolytic) === | ||
β-adrenergic receptor antagonists. While primarily cardiovascular meds, they are widely used off-label as peripheral anxiolytics | β-adrenergic receptor antagonists. While primarily cardiovascular meds, they are widely used off-label as peripheral anxiolytics, blunting the somatic (tachycardia, tremor, sweating) manifestations of acute anxiety without sedation or dependence liability. Particularly useful for performance anxiety, akathisia, and essential tremor. [[Propranolol]] is the prototype. See [[:Category:Beta Blockers]]. | ||
== Stimulants & Wake-Promoting Agents == | == Stimulants & Wake-Promoting Agents == | ||
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=== Mu-Opioid Receptor Agonists === | === Mu-Opioid Receptor Agonists === | ||
Analgesia, euphoria, sedation, respiratory depression, and constipation via mu (μ) opioid receptors. The primary class for moderate-to-severe pain management. Subclasses: | Analgesia, euphoria, sedation, respiratory depression, and constipation via mu (μ) opioid receptors. The primary class for moderate-to-severe pain management. Subclasses: | ||
* '''Natural opioids''' | * '''Natural opioids''', derived directly from the opium poppy | ||
* '''Semisynthetic opioids''' | * '''Semisynthetic opioids''', modified natural opioids | ||
* '''Synthetic opioids''' | * '''Synthetic opioids''', fully synthetic; no plant-derived precursors | ||
=== Partial Mu-Opioid Agonists === | === Partial Mu-Opioid Agonists === | ||
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== Antihistamines == | == Antihistamines == | ||
H1 receptor antagonists. First-generation agents cross the blood-brain barrier and produce sedation, anticholinergic effects, and at high doses, delirium. Divided by generation: | H1 receptor antagonists. First-generation agents cross the blood-brain barrier and produce sedation, anticholinergic effects, and at high doses, delirium. Divided by generation: | ||
* '''First-generation''' | * '''First-generation''', lipophilic; CNS-penetrant; sedating; anticholinergic | ||
* '''Second-generation''' | * '''Second-generation''', less CNS penetration; non-sedating | ||
== Addiction Med == | == Addiction Med == | ||
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=== Classical Psychedelics (Serotonergic) === | === Classical Psychedelics (Serotonergic) === | ||
Primary mechanism is agonism at 5-HT2A receptors in the cortex, producing profound alterations in perception, cognition, and sense of self. Subclasses by chemical scaffold: | Primary mechanism is agonism at 5-HT2A receptors in the cortex, producing profound alterations in perception, cognition, and sense of self. Subclasses by chemical scaffold: | ||
* '''Tryptamines''' | * '''Tryptamines''', indole alkaloids structurally related to serotonin | ||
* '''Lysergamides''' | * '''Lysergamides''', ergoline derivatives of lysergic acid | ||
* '''Phenethylamines''' | * '''Phenethylamines''', related to the catecholamine scaffold (mescaline and analogues) | ||
* '''2C-x series''' | * '''2C-x series''', 2,5-dimethoxyphenethylamines | ||
* '''DOx series''' | * '''DOx series''', amphetamine-based phenethylamines; very long duration | ||
* '''NBOMe / NBOH series''' | * '''NBOMe / NBOH series''', N-benzyl derivatives; extremely potent; no oral activity | ||
=== Empathogens / Entactogens === | === Empathogens / Entactogens === | ||
Primarily monoamine-releasing agents (especially serotonin) with partial 5-HT2A agonism. Produce emotional openness and prosocial effects. Core subclasses: | Primarily monoamine-releasing agents (especially serotonin) with partial 5-HT2A agonism. Produce emotional openness and prosocial effects. Core subclasses: | ||
* '''MDxx''' | * '''MDxx''', methylenedioxy-substituted amphetamines and cathinones | ||
* '''Benzofurans''' | * '''Benzofurans''', related scaffold; primarily serotonergic | ||
=== Dissociatives === | === Dissociatives === | ||
NMDA receptor antagonists producing dose-dependent detachment from self and environment. At sub-anesthetic doses: analgesia, euphoria, perceptual distortion. Subclasses: | NMDA receptor antagonists producing dose-dependent detachment from self and environment. At sub-anesthetic doses: analgesia, euphoria, perceptual distortion. Subclasses: | ||
* '''Arylcyclohexylamines''' | * '''Arylcyclohexylamines''', ketamine, PCP, and analogues; σ1 and dopaminergic activity | ||
* '''Morphinans''' | * '''Morphinans''', dextromethorphan, dextrorphan; also sigma-1 and serotonergic | ||
* '''Diarylethylamines''' | * '''Diarylethylamines''', diphenidine and related | ||
* '''Adamantanes''' | * '''Adamantanes''', memantine | ||
* '''Other''' | * '''Other''', nitrous oxide, xenon | ||
=== Deliriants === | === Deliriants === | ||
Produce a state of true delirium | Produce a state of true delirium, confusion, disorientation, and realistic hallucinations indistinguishable from reality. Subclasses: | ||
* '''Anticholinergics (muscarinic antagonists)''' | * '''Anticholinergics (muscarinic antagonists)''', block muscarinic acetylcholine receptors; atropine, scopolamine, hyoscyamine, diphenhydramine | ||
* '''Kainate / AMPA agonists''' | * '''Kainate / AMPA agonists''', ibotenic acid | ||
* '''GABAA agonists (at sedating doses)''' | * '''GABAA agonists (at sedating doses)''', muscimol | ||
* '''Other''' | * '''Other''', benzydamine, myristicin | ||
=== κ-Opioid Agonists === | === κ-Opioid Agonists === | ||