ANCC PMHNP key terms

A chemical messenger released from a neuron's presynaptic terminal that crosses a synapse and binds to receptors on a postsynaptic cell, altering its electrical or metabolic activity. Psychiatric drugs commonly target neurotransmitter synthesis, release, reuptake, or receptor binding.

The theory that depression arises from deficient monoamine signaling, especially serotonin, norepinephrine, and dopamine. It explains why reuptake-blocking drugs relieve depression but does not fully account for the delayed therapeutic response or treatment resistance.

Blockade of the transporter protein that normally returns a neurotransmitter from the synapse into the presynaptic neuron. This leaves more transmitter in the synaptic cleft. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors work this way.

Binding to a receptor without activating it, thereby blocking endogenous neurotransmitters or agonist drugs from producing their usual effect. Second-generation antipsychotics, for example, antagonize dopamine D2 and serotonin 5-HT2A receptors.

The study of how inherited genetic variation, such as cytochrome P450 enzyme polymorphisms, affects drug metabolism, response, and adverse effects. Testing may help guide antidepressant or antipsychotic selection when standard trials have failed.

A family of liver enzymes, notably CYP2D6 and CYP2C19, that metabolize many psychotropic medications. Genetic variants and interacting drugs can raise or lower blood levels, producing toxicity or loss of efficacy.

The time required for the plasma concentration of a drug to fall by half. It determines how long a medication persists after a dose change or discontinuation and how long washout must last before starting an interacting drug.

The condition in which drug intake equals elimination, so plasma levels remain stable. It is generally reached after about four to five half-lives, which is why many psychotropics take weeks to reach full effect.

Measuring plasma drug concentrations to guide dosing, confirm adherence, or assess toxicity. It is most useful for medications with narrow therapeutic ranges, such as lithium, clozapine, and some tricyclic antidepressants.

A potentially life-threatening toxidrome from excess serotonergic activity, marked by agitation, clonus, hyperreflexia, diaphoresis, tremor, and hyperthermia. It often follows combining serotonergic drugs and requires stopping the agents and urgent supportive care.

A rare, severe reaction to dopamine-blocking drugs featuring high fever, muscle rigidity, altered consciousness, and autonomic instability. Management includes stopping the antipsychotic, cooling, hydration, and sometimes dantrolene or bromocriptine.

Drug-induced movement abnormalities such as dystonia, parkinsonism, akathisia, and tremor, caused mainly by dopamine D2 blockade. Acute forms are treated by lowering the dose, switching agents, or adding anticholinergic medication.

Involuntary, often persistent movements, especially of the tongue, lips, and face, appearing after prolonged dopamine-blocking treatment. It may be irreversible and is managed by dose reduction, switching drugs, or newer agents such as VMAT2 inhibitors.

A cluster of withdrawal symptoms, such as dizziness, flu-like malaise, insomnia, and paresthesias, after abruptly stopping certain psychotropics, particularly short-half-life antidepressants. It is prevented by gradual tapering rather than sudden cessation.

Poisoning from excessive lithium levels, presenting with tremor, vomiting, diarrhea, ataxia, confusion, and seizures. Risk rises with dehydration, renal impairment, and interacting drugs; severe cases need hemodialysis.

A change in a drug's effect caused by another substance, including prescription drugs, over-the-counter products, or food. Interactions may be pharmacokinetic, such as enzyme inhibition, or pharmacodynamic, such as additive sedation.

A mood disorder defined by at least one manic episode, often with depressive episodes. Mania involves elevated or irritable mood with increased energy, decreased need for sleep, and impaired judgment lasting at least a week or requiring hospitalization.

A mood disorder requiring at least two weeks of depressed mood or anhedonia plus other symptoms such as sleep, appetite, energy, concentration, and suicidal ideation changes, causing significant impairment.

A psychotic disorder with positive symptoms such as hallucinations and delusions, negative symptoms such as flat affect and avolition, and cognitive deficits, lasting at least six months with functional decline.

An atypical antipsychotic reserved for treatment-resistant schizophrenia because of superior efficacy, but requiring regular absolute neutrophil count monitoring for agranulocytosis risk. It also carries risks of myocarditis, seizures, and severe constipation.

A medication that prevents or reduces manic and depressive mood episodes, such as lithium, valproate, or lamotrigine. Choice depends on episode polarity, pregnancy plans, renal and hepatic status, and monitoring requirements.

A nine-item self-report questionnaire that screens for depression severity and includes a suicide-ideation item. Scores guide treatment decisions but do not by themselves establish a diagnosis.

A structured clinical assessment of appearance, behavior, speech, mood, affect, thought process and content, perception, cognition, insight, and judgment. It provides the descriptive evidence used to support psychiatric diagnosis and safety planning.

The process of systematically comparing conditions that could explain a patient's presentation, including medical and substance-related causes, before settling on a psychiatric diagnosis. It reduces misdiagnosis and guides testing.

An acute, fluctuating disturbance of attention and awareness, usually caused by a medical condition, medication, or withdrawal. It is a medical emergency that must be distinguished from primary psychiatric illness.

A reversible, substance-specific syndrome of maladaptive behavioral and physical changes following recent use of a psychoactive substance. It frequently mimics psychiatric disorders and must be considered in acute presentations.

A structured clinical inquiry into suicidal thoughts, plans, intent, means access, prior attempts, and protective factors, used to estimate acute and chronic risk and to guide safety planning and level of care.

A structured, time-limited psychotherapy that targets distorted thoughts and maladaptive behaviors maintaining distress. It is first-line for depression, anxiety disorders, and several other conditions and is often combined with medication.

A therapy approach that helps patients re-engage in valued, rewarding activities to counter avoidance and inactivity in depression. It is evidence-based, practical, and often delivered in brief formats.

A collaborative, person-centered counseling style that strengthens a patient's own motivation and commitment to change by exploring ambivalence. It is widely used for substance use and health behavior change.

The collaborative emotional bond and shared agreement on goals and tasks between clinician and patient. A strong alliance predicts better engagement, adherence, and psychotherapy outcomes.

Systematically teaching patients and families about a condition, its treatment, and self-management. It improves adherence, reduces relapse, and is a core component of care for bipolar disorder, schizophrenia, and chronic depression.

A set of strategies that help patients recognize early warning signs, maintain treatment, and respond to emerging symptoms before full recurrence. It includes written plans, adherence support, and family involvement.

Legal detention of a person for psychiatric evaluation or treatment without consent, permitted only when statutory criteria such as dangerousness or grave disability are met. Clinicians must know their state's procedures and due-process protections.

A patient's voluntary agreement to treatment after receiving understandable information about the nature, risks, benefits, and alternatives, and demonstrating decision-making capacity. It is both an ethical and legal requirement.

The ethical and legal duty to protect patient information from unauthorized disclosure. Exceptions include imminent danger, mandated reporting, and certain court orders, which must be applied according to law.

A legal obligation for clinicians to report suspected child abuse, elder abuse, or dependent-adult abuse to designated authorities. Reporting duties and thresholds vary by jurisdiction and override ordinary confidentiality.