2: Psychotropics

amphetamine/dextroamphetamine

C2

Adderall/XR

qam

ADHD, Narcolepsy

• take in AM to avoid insomnia

• decreased appetite

• increased HR

• dry mouth

• headache

methylphenidate

C2

Ritalin/LA, Concerta

qam

ADHD, Narcolepsy

• takein AM to avoid insomnia

• decreased appetite

• increased HR

• dry mouth

• headache

escitalopram

Lexapro

qd

Depression, anxiety

• headache

• insomnia or drowsiness

• sexual dysfunction

fluoxetine

Prozac, Sarafem

qd

Depression, OCD, Panic, Bipolar, Bulimia Nervosa, (Sarafem) PMDD

• sexual dysfunction

• anorexia

• diarrhea

• asthenia

duloxetine

Cymbalta

qd

Depression, Anxiety, diabetic peripheral neuropathic pain, chronic musculoskeletal pain

• insomnia or drowsiness

• take w food

sertraline

Zoloft

qd

Depression, Panic, OCD, PTSD, PMDD, Social phobia

• headache

• insomnia > drowsiness

• sexual dysfunction

• take w food

bupropion

Wellbutrin/SR/XL, Zyban

SR: 1 tab qd for 3-7 days, then 1 bid

XL: 150mg qd for 3-7 days, then 300mg qd

Depression, SAD, (Zyban) smoking cessation

• insomnia

• begin 1 week before smoking

olanzapine

Zyprexa

qd

Bipolar, Schizophrenia, Treatment-resistant depression (+ fluoxetine)

• drowsiness

• weight gain

• increased blood sugar and/or cholesterol

• movement disorders

• decreased sex drive

quetiapine

Seroquel

pd

Bipolar, Schizophrenia, Depression

• drowsiness

• weight gain

• increased BP and HR

• increased appetite

• dizziness

aripiprazole

Abilify

qd

Bipolar, Schizophrenia, Treatment-resistant depression (adjunct), Irritability (in autism)

• drowsiness or insomnia

• weight gain

• movement disorders

lamotrigine

Lamictal

qd or bid

Seizures, Bipolar

• nausea/vomiting

• drowsiness/dizziness

• skin rash (Stevens-Johnson Syndrome) TITRATE

• visual disturbances

divalproex sodium

Depakote/DR/ER

DR: tid

ER: qd

Seizures, Bipolar, Migraine prevention

• drowsiness/dizziness

• tremor

• muscle weakness

• upset stomach, take w food

levetiracetam

Keppra/XR

bid

XR: qd

Seizures

• drowsiness/dizziness

• asthenia

• headache

trazodone

Desyrel

depression: bid, tid

insomnia: qhs

Depression, Insomnia (non-FDA)

• drowsiness

• take w food to increase abs

zolpidem

C4

Ambien/CR

qhs

Insomnia (short-term)

• take within 20 min of bedtime

• get > 8h rest, next day drowsiness

• risk of abnormal sleep behaviors