mental health medications

haloperidol & chlorpromazine

• schizophrenia, treats positive symptoms

• TEACHING: EPS - acute dystonia, akathisia, pseudoparkinsonism

• tardive dyskinesia: involuntary repetitive movements

risperidone, olanzapine, quetiapine, & aripiprazole

• schizophrenia: treats positive and negative symptoms

• high metabolic risk !!

• TEACHING: monitor weigh, blood glucose, and lipids

clozapine

• schizophrenia

• requires CBC monitoring for agranulocytosis (LOW WBC count) : report fever/infection

cholinesterase inhibitors (donepezil & rivastigmine)

• dementia to slow symptom progression (mainly in alzheimer’s)

SSRIs/SNRIs (sertraline, escitalopram, venlafaxine)

• anxiety for long-term management

• TEACHING: 4-6 weeks for full effect, DO NOT stop abruptly

benzodiazepines (lorazepam, alprazolam)

• anxiety for short-term use only

• causes sedation, avoid alcohol while taking, DO NOT stop abruptly (seizures)

benzodiazepines

• alcohol withdrawal to prevent seizures/DTs

• thiamine (vitamin B1) is given BEFORE glucose to prevent wernicke’s encephalopathy

methadone or buprenorphine (MAT)

• opioid withdrawal to reduce cravings

naloxone (narcan)

reverses opioid overdose - priority emergency medication

fluoxetine

• bulimia to reduce binge-purge cycles

• takes several weeks for effect, consistent daily use is important

SSRIs (sertraline & paroxetine)

• PTSD - first line medication

• TEACHING: takes several weeks for effect, consistent daily use, DO NOT stop abruptly

prazosin

• PTSD-related nightmares

• TEACHING: can cause orthostatic hypotension (especially with first dose) - take at bedtime and rise slowly

SSRIs (sertraline, fluoxetine, escitalopram)

• depressive disorder

• TEACHING: 4-6 weeks for full effect, DO NOT stop abruptly, watch for worsening mood or increased suicidal thoughts in first weeks

SNRIs (venlafaxine, duloxetine) are alternative options

lithium

• bipolar disorder - mood stabilizer

• TEACHING: high toxicity risk (signs: N/V, diarrhea, tremor SEVERE: confusion, seizures, arrhythmia), consistent salt and fluid intake (dehydration/low sodium increase toxicity risk), avoid NSAIDs

valproic acid, carbamazepine (anticonvulsant mood stabilizers)

• alternative option for bipolar disorder

• TEACHING: monitor liver and CBC