Psych Meds

Lithium Carbonate (Eskalith)

Implication

• therapeutic range 0.6 to 1.2 mEq

• use birth control because harmful to fetus

Side Effects

• headache, drowsiness, dizziness, tremors, twitching, ataxia, seizure, slurred speech, restlessness, confusion, dry mouth, anorexia, GI upset, hypotension, blurred vision, muscle weakness, hypothyroidism

Indications

• for manic phase of bipolar disorder

• prevention of psychosis during manic phase

Lorazepam (Ativan) (Benzodiazepine)

Side Effects

• insomnia, drowsiness, dizziness, confusion, headache, anxiety, tremor, stimulation, fatigue, depresion, photophobia, blurred vision, bradypnea, tachycardia, hypotension, dry mouth

Indication

• anxiety

Phenelzine Sulfate (Nardil) (MAOI antidepressant)

Implication

• to avoid high-tyramine foods

Interaction

• additive effect

• Drug-Food -tyramine-rich foods (hypertensive crisis)

  • Cheese, cure/processed meats, pickled food, alcoholic drinks, and citrus

Indication

• depression in treatment-resistant patients, atypical depression, patients with mixed anxiety-depression

Risperidone (atypical antipsychotic, serotonin/dopamine antagonist)

Implication

• orthostatic hypotension

• Careful with OTC drugs

• avoid ultraviolet light or sunlight

• decrease in positive and/or negative symptoms

Indication

• Psychotic disorder, agitated aggressive behavior in dementia, bipolar disorder

Methadone HCI

Side Effects

• drowsiness, dizziness, confusion, headache, sedation, euphoria, GI upsets, increased urinary output, dysuria, rash bruising, sweating, flushed, respiratory depression, tinnitus, diplopia, palpitations, bradycardia, change in BP

Indications

• Narcotic withdrawal, severe pain, opioid maintenance therapy

Naloxone

Implications

• only works with narcotics

• have resuscitative equipment nearby

Indication

• Narcotic-induced respiratory depression

Amitriptyline HCI (Elavil)

Implication

• monitor for cheeking

• small overdose can cause toxicity

• monitor for suicide risk, meds energize the patient

Side Effects

• sedation, ataxia, confusion, delirium, insomnia, excitement, headache, anticholinergic, blurred vision, dry mouth, decreased tearing, difficulty urinating, decreased sweating, orthostatic hypotension, weight gain, sexual dysfunction, GI upset

Indication

• depression

• chronic pain

Aripiprazole (Abilify)

Side effects

• not that serious side effects

• weight gain

• sedation

• anxiety

Indication

• atypical antipsychotic

• schizophrenia, bipolar disorder , positive-negative symptoms

Buprenorphine (Buprenex)

Interaction

• Additive CNS depression

Indication

• management of moderate to severe pain

• opioid detoxification

Buspirone HCI (Buspar)

Implications

• Assist with ambulation during beginning of therapy, drowsiness, dizziness occur

Interactions

• MAOI: increase BP

• don’t mix with alcohol

Side Effects

• hypotension

• numbness, dizziness , depression, tremors, excitement, involuntary movements, confusion

Indiaction

• anxiety disorder

Chlorpromazine HCI (Thorazine)

Interaction

• Alcohol and other CNS depressants (barbiturates, antihistamines, antianxiety or antidepressant drugs) - increased CNS depression, increased risk for EPSEs

Side Effects

• Parkinsonism, akathisias, dystonias, tardive dyskinesia

• weight gain

• ocular pain

Indication

• psychotic disorders, mania, schizophrenia

Clozapine (Clozaril)

Interaction

• agranulocytosis

Side Effects

• agranulocytosis

• special monitoring system from past fatalities

Contraindications

• history of clozapine-induced agranulocytosis

Indications

• management of schizophrenia refractory to other antipsychotics

Diazepam (Valium) (Benzodiazepine)

Side Effect

• dizziness, drowsiness, confusion, headache, anxiety

Pharmacokinetics

• very fast onset

Contraindications

• narrow-angle glaucoma

indications

• anxiety, acute alcohol withdrawal

Donepezil (Aricept)

Interaction

• NSAID - increased risk of GI bleed

Side Effects

• potential for seizures

• Gi bleeding

Indication

• treatment of mild to moderate dementia of the Alzheimer type

Haloperidol (Haldol)

Interactions

• Alcohol and other CNS depressants (barbiturates, antihistamines, antianxiety or antidepressant drugs) - increased CNS depression, increased risk for EPSEs

• Anticholinergics - increased risk for excessive atropine-like side effects or toxic effects

Side Effects

• akathisias, dystonias, tardive dyskinesia, NMS, blurred vision, impaired vision, irregular pulse, arrhythmias

Indication

• antipsychotic

• Psychotic disorders

• short term treatment of hyperactive children with excessive motor activity

Fluoxetine (Prozac) (SSRI antidepressant)

Implication

• Assess BP, pulse q4h, VS q4H in patients with CV disease

• wait in between switching meds from fluoxetine and MAOI

• Therapeutic effect might take several days to weeks

Contraindication

• MAOIs - serotonin syndrome

ndication

• depression, bulimia, premenstrual dysphoric disorder

Escitalopram (Lexapro) (SSRI antidepressant)

Interaction

• MAOIs - fatal serotonin syndrome

Indications

• major depressive disorder, short term treatment of general anxiety disorder