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Mental Health Medications Cheat Sheet

Mental Health Medications Cheat Sheet

TCAs (Tricyclic Antidepressants)

  • Examples: Amitriptyline, Doxepin
  • Primary Use: Depression
  • Side Effects (SE):
    • Anticholinergic effects (dry mouth, constipation, urinary retention)
    • Orthostatic hypotension
    • Seizure risk
  • NCLEX Considerations:
    • Increased suicide risk early in treatment.
    • Advise patients to make slow position changes (due to orthostatic hypotension).

SSRIs (Selective Serotonin Reuptake Inhibitors)

  • Examples: Fluoxetine, Sertraline, Escitalopram, Paroxetine, Citalopram
  • Primary Uses: Depression, anxiety, PTSD (Post-Traumatic Stress Disorder), OCD (Obsessive-Compulsive Disorder)
  • Side Effects (SE):
    • Sexual dysfunction
    • Insomnia
    • Weight gain
    • Increased suicidal ideation (SI) risk (especially in younger individuals)
    • Serotonin syndrome
  • NCLEX Considerations:
    • Therapeutic effects typically take 4–6 weeks to manifest.
    • Patients should not stop abruptly to avoid withdrawal symptoms.

SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)

  • Examples: Duloxetine, Venlafaxine, Desvenlafaxine
  • Primary Uses: Depression, anxiety, neuropathic pain
  • Side Effects (SE): Similar to SSRIs (e.g., sexual dysfunction, insomnia, weight gain, serotonin syndrome).
  • NCLEX Considerations: Taper slowly to avoid significant withdrawal symptoms.

MAOIs (Monoamine Oxidase Inhibitors)

  • Examples: Phenelzine, Isocarboxazid
  • Primary Use: Depression (considered second-line treatment)
  • Side Effects (SE):
    • Hypertensive crisis, particularly when consuming tyramine-rich foods.
    • Tyramine Foods to Avoid: Aged cheese, wine, beer, chocolate, cured meats.
  • NCLEX Considerations:
    • Strict contraindication with SSRIs, TCAs, and over-the-counter (OTC) cold medications due to risk of serotonin syndrome or hypertensive crisis.

Lithium

  • Primary Use: Bipolar disorder (effective for both mania and depression phases)
  • Side Effects (SE):
    • Tremor
    • GI upset
    • Weight gain
    • Polyuria (increased urination)
  • NCLEX Considerations:
    • Toxicity: Occurs at serum levels greater than 1.5 mEq/L.
    • Maintain adequate fluid and salt intake to prevent toxicity.
    • Avoid NSAIDs (non-steroidal anti-inflammatory drugs), diuretics, and caffeine, as they can increase lithium levels.

Other Mood Stabilizers

  • Examples: Lamotrigine, Valproic acid
  • Primary Use: Bipolar disorder
  • Specific Considerations:
    • Lamotrigine: Risk of severe skin rash, including Stevens-Johnson syndrome. Patients should report any rash immediately.
    • Valproic acid: Potential for hepatotoxicity, pancreatitis, and thrombocytopenia.
  • NCLEX Considerations: Monitor liver function tests (LFTs) and complete blood count (CBC) regularly for patients on valproic acid.

Typical Antipsychotics

  • Examples: Haloperidol, Chlorpromazine
  • Primary Use: Schizophrenia (primarily targets positive symptoms like hallucinations and delusions)
  • Side Effects (SE):
    • EPS (Extrapyramidal Symptoms): Dystonia, akathisia, tardive dyskinesia.
    • NMS (Neuroleptic Malignant Syndrome): A medical emergency characterized by fever, muscular rigidity, altered mental status (confusion), and elevated creatinine kinase (\uparrow CK).
  • NCLEX Considerations: Treat EPS with anticholinergic medications like benztropine or antihistamines such as diphenhydramine.

Atypical Antipsychotics

  • Examples: Clozapine, Olanzapine, Risperidone, Quetiapine
  • Primary Uses: Schizophrenia, bipolar disorder
  • Side Effects (SE):
    • Weight gain
    • Metabolic syndrome (increased risk of diabetes, dyslipidemia)
    • Sedation
  • NCLEX Considerations:
    • Clozapine: Significant risk of agranulocytosis (severe decrease in white blood cells). Requires weekly monitoring of White Blood Cell (WBC) count.

Benzodiazepines

  • Examples: Lorazepam, Alprazolam, Diazepam, Clonazepam
  • Primary Uses: Acute anxiety, seizures, alcohol withdrawal
  • Side Effects (SE):
    • Sedation
    • Respiratory depression
    • Dependence
    • Withdrawal seizures if stopped suddenly
  • NCLEX Considerations:
    • Intended for short-term use only due to dependence risk.
    • Must be tapered off slowly to prevent severe withdrawal symptoms.

Buspirone

  • Primary Use: Generalized Anxiety Disorder (GAD)
  • Side Effects (SE): Dizziness, nausea, headache (HA)
  • NCLEX Considerations:
    • No risk of dependence or withdrawal symptoms.
    • Not sedating.
    • Takes several weeks for its full anxiolytic effect to develop.

ECT (Electroconvulsive Therapy)

  • Primary Uses: Severe depression, suicidal patients, bipolar disorder (especially refractory cases)
  • Side Effects (SE): Temporary memory loss, headache, muscle aches
  • NCLEX Considerations (Pre- and Post-Procedure):
    • Pre-op: NPO (nothing by mouth), obtain informed consent, administer atropine pre-operatively to reduce secretions and counteract vagal stimulation.
    • Post-op: Monitor vital signs (VS) and maintain a patent airway.