Another approach to dividing the various psychotropic drugs categories is the ATC system of classification based on the anatomical site, therapeutic action, and chemical structure. For the psychotropic agents, the ATC system classifies the agents in the following categories of three levels:
Level 1: CNS drugs
Level 2: Antidepressants
Level 3: Monoamine oxidase inhibitors, noradrenaline reuptake inhibitors, Tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors (SNRIs), noradrenergic and selective serotonergic antidepressants
However, the ATC classification of psychotropic drugs holds several drawbacks in terms of systematically classifying drugs. This lack of organization in the classification of drugs in the ATC system withholds the agents to be used in a wide range of prevailing circumstances.
Mechanism of Action of Medication Used for Mental Disorders
Most of the drugs aimed at mental disorders have been known to block the dopamine D2 receptors primarily. The pharmacological activity of these agents directly relates to the ability to bind with the D2 receptors. The pharmacological actions are assumed to be a direct consequence of the blockage of dopaminergic projections in the temporal and prefrontal areas of the limbic system along with mesocortical areas. Another mode of action believed in the blocking theory of the dopaminergic pathway is the agents that increase the dopamine activity in the brain, which triggers or aggravates schizophrenia. This condition leads to the observation that the overactivity of dopamine in the brain’s limbic area is responsible for the condition of mental illness. However, it is noteworthy that the dopamine theory of the mechanism of action fails to explain the nature of drugs with relatively weak D2 blocking ability. Thus, it is important to profile the medicinal agents based on the targeted neurotransmitter receptors. The involvement of the neurotransmitter pathway followed by the drugs for mental disorders is not limited to the dopaminergic system. Recent shreds of evidence have reported the involvement of monoamine transmitters, GAB Aergic, Serotoninergic, and catecholaminergic pathways for various classes of drugs to provide the antipsychotic activity.
Adverse Reaction Profile of Medications Used for Mental Disorders
With the long-term use of drugs aimed at treating mental disorders, the most common adverse effect is the occurrence of weight gain in the patient and a concomitant rise of sugar and lipid levels. Extrapyramidal disturbances are the major adverse reactions associated with the use of pharmacological agents. These include Parkinsonism which manifests itself in the form of tremor, mask-like facies, and hypokinesia. Acute muscular dystonia is evident in the form of muscle spasms, locking of jaws, thrusting of the tongue. Akathisia is followed by restlessness and a feeling of discomfort. The malignant neuroleptic syndrome occurs post-high doses of potent agents used for mental disorders. Its physical manifestation is marked by rigidity, fever, fluctuating blood pressure, and heart rate. Tardive dyskinesia manifests itself as involuntary facial and limbs movements, postural hypotension, palpitations, drowsiness, mental confusion, aggravation of seizures in patients with a history of epilepsy.
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