Reviewing a list of the medications and social drugs your client is currently taking is essential. They can individually and synergistically affect time-domain, frequency-domain, and nonlinear measurements. In some cases, different members of a drug class can produce different effects, like clozapine among antipsychotics. Individual responses to medications can vary widely and may depend on factors like dosage, individual physiology, and the presence of other medical conditions.
Glossary
Alcohol: Ethanol, a psychoactive substance characterized as a central nervous system depressant with the potential for addiction and physical dependence.
Alpha-1 blockers: Drugs that inhibit alpha-1 adrenergic receptors, resulting in vasodilation and reduced systemic vascular resistance and blood pressure; primarily used in managing hypertension and benign prostatic hyperplasia.
Amphetamine: Central nervous system stimulant that promotes neurotransmitter release, specifically dopamine, norepinephrine, and serotonin; used therapeutically to manage attention deficit hyperactivity disorder (ADHD) and narcolepsy.
Antidepressants: A broad class of medications designed to treat depressive disorders; function by altering neurotransmitter activity within the brain; types include SSRIs, SNRIs, tricyclics, and MAOIs.
Antiepileptics: Anticonvulsants are a diverse group of pharmacological agents used to prevent epileptic seizures.
Antipsychotics: Medications primarily used to manage psychosis, including delusions, hallucinations, paranoia, or disordered thought, principally in schizophrenia and bipolar disorder; work by modulating neurotransmitter activity.
Appetite suppressants: Pharmacologic agents that inhibit appetite, potentially leading to weight loss; commonly used in managing obesity.
Asthma drugs: A range of medications, including bronchodilators, corticosteroids, and leukotriene modifiers, used to control the symptoms of asthma by reducing inflammation and constriction in the lungs.
Benzodiazepines: Psychoactive drugs that enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABA-A receptor, producing sedative, hypnotic, anxiolytic, anticonvulsant, and muscle relaxant effects.
Beta-blockers: A class of medications predominantly used to manage abnormal heart rhythms and protect the heart from a second heart attack (myocardial infarction) after a first heart attack (secondary prevention). They work by blocking the effects of adrenaline on beta receptors, reducing heart rate and blood pressure.
Bupropion: A norepinephrine-dopamine reuptake inhibitor (NDRI) used for the management of major depressive disorder (MDD) and as an aid to smoking cessation.
Caffeine: A methylxanthine naturally occurring in some plants, with CNS-stimulating activity.
Calcium channel blockers: Drugs that disrupt the movement of calcium through calcium channels used in managing hypertension, angina pectoris, and some types of arrhythmia.
Cannabis: Marijuana is a plant that contains over 100 different chemical compounds called cannabinoids. The two most well-known cannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the primary psychoactive compound that gives cannabis its mind-altering effects. In contrast, CBD is non-psychoactive and has been researched for its potential therapeutic effects on conditions like epilepsy, anxiety, and chronic pain.
CGRP blockers: Monoclonal antibodies targeting the calcitonin gene-related peptide or its receptor, used in the prophylaxis of migraine.
Cocaine: A powerful central nervous system stimulant and local anesthetic, specifically a dopamine reuptake inhibitor, leading to an accumulation of dopamine in the synapse and heightened neuronal activity.
Decongestants: Medications that relieve nasal congestion, primarily by constricting blood vessels in the nasal mucosa, reducing blood flow and subsequently decreasing swelling and inflammation.
Diuretics: Drugs that promote diuresis, the increased urine production, used in managing conditions such as hypertension, heart failure, and edema.
Flecainide: A class 1C antiarrhythmic drug that inhibits the rapid influx of sodium ions into cardiac muscle cells, slowing conduction velocity and stabilizing the heart rhythm.
Levothyroxine: A synthetic form of thyroxine (T4) used as a replacement therapy for hypothyroidism and a suppressive therapy in certain thyroid cancers.
Lithium: A mood stabilizer primarily used to manage bipolar disorder; it modulates neurotransmission pathways and alters intracellular signaling.
MAOI antidepressants: Monoamine oxidase inhibitors, a class of antidepressants that work by inhibiting the activity of one or both monoamine oxidase enzymes, leading to an increase in monoamine neurotransmitters (serotonin, norepinephrine, and dopamine).
Melatonin: A hormone produced by the pineal gland that regulates sleep-wake cycles; used therapeutically to treat insomnia and other sleep disorders.
Methamphetamine: A potent central nervous system stimulant that affects the release, reuptake, and metabolism of monoamine neurotransmitters, particularly dopamine; used clinically in treating ADHD and obesity, but also associated with illicit use and addiction.
Narcotics: A broad term often used to refer to opioids, a class of drugs that interact with opioid receptors in the brain to produce analgesic effects; used for pain management but also associated with high risk of addiction and overdose.
Nicotine: An alkaloid found in the nightshade family of plants that acts as a nicotinic acetylcholine receptor agonist, leading to both stimulant and relaxant effects, most commonly consumed via smoking tobacco.
NSAIDs: Nonsteroidal anti-inflammatory drugs, a class of medication that provides analgesic and antipyretic effects, and, in higher doses, anti-inflammatory effects; works by inhibiting the enzyme cyclooxygenase (COX), which plays a key role in the biosynthesis of prostaglandins.
Omega-3 fatty acids: Polyunsaturated fatty acids that play important roles in various metabolic functions; often used as a dietary supplement to reduce inflammation and promote heart health.
Ritalin: A brand name for Methylphenidate, a central nervous system stimulant used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy.
Scopolamine: A tropane alkaloid drug with muscarinic antagonist effects used to treat motion sickness and postoperative nausea and vomiting.
Sleep medications: A broad category of drugs, including benzodiazepines and non-benzodiazepines ("Z-drugs"), used to induce or maintain sleep in treating insomnia and other sleep disorders.
SNRI antidepressants: Serotonin and norepinephrine reuptake inhibitors, a class of antidepressant drugs that inhibit the reuptake of serotonin and norepinephrine, increasing their levels in the brain.
SSRI antidepressants: Selective serotonin reuptake inhibitors, a class of drugs that inhibit the reuptake of serotonin into presynaptic cells, increasing the level of serotonin available to bind to the postsynaptic receptor.
Tricyclic antidepressants: A class of antidepressants named after their chemical structure, which contains three rings of atoms, work by inhibiting the reuptake of certain neurotransmitters, including norepinephrine and serotonin.
Quiz
Take a five-question exam on Quiz Maker to test your mastery.
References
Barton, D., Sprau, D. J., Turner, J. N., & Hobbs, K. (2010). Antidepressant medication use and breast cancer risk: A case-control study. Pharmacoepidemiology and Drug Safety, 19(2), 118-126. https://doi.org/10.1002/pds.1880
Billman, G. E. (2002). The effects of omega-3 polyunsaturated fatty acids on cardiac rhythm: A critical reassessment. Pharmacology & Therapeutics, 94(1), 71-88. https://doi.org/10.1016/S0163-7258(02)00187-2
Curigliano, G., Cardinale, D., Suter, T., Plataniotis, G., de Azambuja, E., Sandri, M. T., ... & Stragliotto, S. (2016). Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO Clinical Practice Guidelines. Annals of Oncology, 27(suppl_5), v166-v181. https://doi.org/10.1093/annonc/mdw235
DeVon, H. A., Piano, M. R., Rosenfeld, A. G., & Hoppensteadt, D. A. (2008). The association of pain with protein inflammatory biomarkers: A review of the literature. Nursing Research, 57(5), 301-319. https://doi.org/10.1097/01.NNR.0000313495.53514.74
Goadsby, P. J., Reuter, U., Hallström, Y., Broessner, G., Bonner, J. H., Zhang, F., ... & Picard, H. (2017). A controlled trial of erenumab for episodic migraine. New England Journal of Medicine, 377(22), 2123-2132. https://doi.org/10.1056/NEJMoa1705848
Gorman, J. M., Korotzer, A., & Su, G. (2000). Efficacy comparison of escitalopram and citalopram in the treatment of major depressive disorder: Pooled analysis of placebo-controlled trials. CNS Spectrums, 5(2), 40-44. https://doi.org/10.1017/S1092852900008044
Hammerness, P., McCarthy, K., Mancuso, E., Gendron, C., & Geller, D. (2003). Psychopharmacological treatment of ADHD and comorbid anxiety: A retrospective chart review of 191 preadolescents and adolescents. CNS Spectrums, 8(10), 727-733. https://doi.org/10.1017/S1092852900019260
Haverkamp, W., & Breithardt, G. (1984). The effects of flecainide on electrophysiological properties of the heart: Experimental data and clinical implications. European Heart Journal, 5(Supplement A), 35-43. https://doi.org/10.1093/eurheartj/5.suppl_A.35
Jones, R. T. (2002). Cardiovascular system effects of marijuana. Journal of Clinical Pharmacology, 42(S1). https://doi.org/10.1002/j.1552-4604.2002.tb06004.x
Lago, J. A., Kosten, T. R., Nestler, E. J., Goldberg, S. R., & Stine, S. M. (2008). Bupropion treatment in veterans with posttraumatic stress disorder: An open study. Journal of Clinical Psychopharmacology, 28(5), 518-519. https://doi.org/10.1097/JCP.0b013e318184a9ac
Lyon, A. R., Yousaf, N., Battisti, N. M. L., Moslehi, J., & Larkin, J. (2018). Immune checkpoint inhibitors and cardiovascular toxicity. The Lancet Oncology, 19(9), e447-e458. https://doi.org/10.1016/S1470-2045(18)30457-1
Mohanraj, R., & Brodie, M. J. (2006). Diagnosing refractory epilepsy: Response to sequential treatment schedules. European Journal of Neurology, 13(3), 277-282. https://doi.org/10.1111/j.1468-1331.2006.01197.x
Mozaffarian, D., Longstreth, W. T., Lemaitre, R. N., Manolio, T. A., Kuller, L. H., Burke, G. L., ... & Siscovick, D. S. (2005). Fish consumption and stroke risk in elderly individuals: The cardiovascular health study. Archives of Internal Medicine, 165(2), 200-206. https://doi.org/10.1001/archinte.165.2.200
Mukherjee, D., Nissen, S. E., & Topol, E. J. (2001). Risk of cardiovascular events associated with selective COX-2 inhibitors. JAMA, 286(8), 954-959. https://doi.org/10.1001/jama.286.8.954
Niederhoffer, N., & Szabo, B. (1999). Effect of the cannabinoid receptor agonist WIN55212-2 on sympathetic cardiovascular regulation. British Journal of Pharmacology, 126(2). https://doi.org/10.1038/sj.bjp.0702337
Ozdemir, V., Naranjo, C. A., Herrmann, N., Reed, K., Sellers, E. M., & Kalow, W. (2006). Paroxetine potentiates the central nervous system side effects of perphenazine: Contribution of cytochrome P4502D6 inhibition in vivo. Clinical Pharmacology & Therapeutics, 60(6), 571-579. https://doi.org/10.1016/S0009-9236(96)90217-3
Piano, M. R. (2017). Alcohol’s effects on the cardiovascular system. Alcohol Research: Current Reviews, 38(2), 219-241. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513687/
Rauh, V. A., Garfinkel, R., Perera, F. P., Andrews, H. F., Hoepner, L., Barr, D. B., ... & Whyatt, R. M. (2006). Impact of prenatal chlorpyrifos exposure on neurodevelopment in the first 3 years of life among inner-city children. Pediatrics, 118(6), e1845-e1859. https://doi.org/10.1542/peds.2006-0338
Reiter, R. J., Tan, D. X., & Galano, A. (2017). Melatonin reduces lipid peroxidation and membrane viscosity. Frontiers in Physiology, 5, 377. https://doi.org/10.3389/fphys.2014.00377
Roehrborn, C. G. (2006). Alfuzosin 10 mg once daily prevents overall clinical progression of benign prostatic hyperplasia but not acute urinary retention: Results of a 2-year placebo-controlled study. BJU International, 97(4), 734-741. https://doi.org/10.1111/j.1464-410X.2006.06036.x
Salo, R., Nordahl, T. E., Buonocore, M. H., Natsuaki, Y., Waters, C., Moore, C. D., ... & Leamon, M. H. (2011). Cognitive control and white matter callosal microstructure in methamphetamine-dependent subjects: A diffusion tensor imaging study. Biological Psychiatry, 69(1), 59-66. https://doi.org/10.1016/j.biopsych.2010.08.023
Salpeter, S. R., Ormiston, T. M., & Salpeter, E. E. (2004). Meta-analysis: Respiratory tolerance to regular beta2-agonist use in patients with asthma. Annals of Internal Medicine, 140(10), 802-813. https://doi.org/10.7326/0003-4819-140-10-200405180-00012 Vongpatanasin, W., Taylor, J. A., Victor, R. G., & Toto, R. D. (1999). Effects of cocaine on heart rate variability in healthy subjects. The American Journal of Cardiology, 83(8), 1262-1264. https://doi.org/10.1016/S0002-9149(99)00057-2 Vybiral, T., Bryg, R. J., Maddens, M. E., Bhasin, S. S., Cronin, S., Boden, W. E., & Lehmann, M. H. (1990). Effects of transdermal scopolamine on heart rate variability in normal subjects. The American Journal of Cardiology, 65(9), 604–608. https://doi.org/10.1016/0002-9149(90)91038-8
Wang, C., Zhang, M., Sun, S., Li, Z., Han, Y., & Zhang, J. (2017). Long-term effects of clozapine on sleep in patients with schizophrenia: A 4-week polysomnography study. Psychiatry Research, 256, 281-286. https://doi.org/10.1016/j.psychres.2017.06.068