Transcript for:
Understanding Neurotransmitters in Psychiatry

Hi, I'm Cathy with Level Up RN. In this video,  I will be discussing four key neurotransmitters   that are commonly affected by mental health  medications. I will also be talking about   important teaching that you need to provide  your patient who is prescribed psychiatric   medication. And at the end of the video, I'm  going to give you guys a little quiz to test   your knowledge of some of the key points I'll be  covering, so definitely stay tuned for that. And   if you have our Level Up RN psychiatric mental  health nursing flashcards, pull them out. I am   about a third of the way through our therapy  section. We just wrapped up coverage of our   non-pharmacological therapies, and now we will be  discussing pharmacological therapies. As a review,   a neurotransmitter is a chemical messenger that  allows neurons to communicate with one another.   So a neurotransmitter is released by one neuron  into the synapse where it binds to the receptors   of another neuron. After binding, some of these  neurotransmitters can be taken back up into the   first neuron and used again. This is referred  to as reuptake. So an important thing to note   is that the mode of action of many psychiatric  medications is to block this reuptake. And this,   in turn, increases the amount of  a neurotransmitter in the synapse.  Four key neurotransmitters that are commonly  affected by psychiatric medications include GABA,   serotonin, norepinephrine, and dopamine. GABA  is an inhibitory neurotransmitter that decreases   nerve excitability and has a calming effect. So  medications such as benzodiazepines and certain   mood stabilizers work by increasing levels of  GABA. Our cool chicken hint to help you remember   this neurotransmitter is Gabby gabs non-stop, and  it makes her friends very sleepy just like the   effects of the neurotransmitter GABA. Serotonin is  a neurotransmitter that regulates mood, attention,   and sleep. And several of the drug classes that we  will be talking about in this video playlist work   by blocking reuptake of serotonin, which increases  the amount of circulating serotonin in the brain.   Very common drug classes that have this mode  of action include SSRIs as well as SSNRIs.   Norepinephrine is a neurotransmitter  that affects stress, sleep, attention,   and focus, as well as autonomic nervous system  function. Several different antidepressants work   by increasing levels of norepinephrine, including  tricyclic antidepressants and SSNRIs. And finally,   dopamine is an important neurotransmitter that  regulates movement, attention, motivation,   and reward. And alterations in dopamine have been  linked to disorders such as schizophrenia and   ADHD. And several of the medication classes  that we will be talking about in this video   playlist altered levels of dopamine, including  antipsychotic agents, as well as buspirone.  Let's move on now to important teaching that  you'll want to provide your patient who is   prescribed a psychiatric medication. So each  medication, of course, has specific side effects   and specific considerations that you'll definitely  want to cover with your patient. However, there is   general teaching that is also important to convey  to your patient who is prescribed a mental health   medication. First of all, medications should be  taken exactly as prescribed. The patient should   not discontinue or change the dose without talking  with the provider first. And if they miss a dose,   they shouldn't just double up on their next  dose unless specifically instructed to do so   by their provider. The patient should notify  their provider of any herbal supplements,   over-the-counter medications, or prescription  medications they are taking because several   of the mental health medications we'll  be talking about interact with other   medications and supplements. And some of  these interactions can be life-threatening.   The patient should also be made aware that it  can take several weeks to feel the full effects   of a medication. So they should not expect  immediate results for most of the mental   health medications that we'll be talking about. Because many psychiatric medications increase   the risk for serotonin syndrome, it's important  to teach your patient to notify the provider for   any signs and symptoms of serotonin syndrome,  which include agitation, diaphoresis, fever,   nausea and vomiting, tachycardia, muscle rigidity,  and tremors. It's also important to tell your   patient that they should not take St. John's Wort,  which is a common herbal supplement, alongside   their psychiatric medication because this can  further increase the risk for serotonin syndrome.   All right, it's quiz time. Are you guys ready?  I have three questions for you. First question.   Blank is a neurotransmitter that decreases  nerve excitability and has a calming effect.   The answer is GABA. Question number two. Excess  levels of what neurotransmitter can cause symptoms   such as agitation, fever, diaphoresis, tremors,  and tachycardia? The answer is serotonin. So those   are the symptoms of serotonin syndrome. Question  number three. When taken with a psychiatric   medication, blank is a key herbal supplement that  increases a patient's risk for serotonin syndrome.   The answer is St. John's Wort. Okay.  I hope you did great with that quiz,   and I hope you enjoyed this video.  Take care and good luck with studying.