This document provides a summary of medication guidelines for psychiatry. It lists normal thyroid levels and guidelines for adjusting levothyroxine doses. It also outlines therapeutic blood levels, starting doses, and monitoring for medications used to treat bipolar disorder like lithium, Depakote, Lamictal and antidepressants. Additional sections cover medication groups, terminology, pearls and toxicities to consider when prescribing psychiatric medications.
Psychiatry Cheat Sheet (MDD, GAD, Bipolar)Justin Berk
This student "cheat sheet" is designed to provide medical students with basic information regarding the diagnosis and treatment of basic psychiatric disorders including Depression, Anxiety, and Bipolar Disorder. It includes Questions to Ask, what to look for on a Physical Exam, Labs to Order, and basic Treatment Plans.
These guides are particularly designed for first and second-year medical students as an introduction to ambulatory care medicine and attempts to tie in the basic pathophysiology that is high-yield for USMLE Step 1.
Any and all feedback is very welcomed.
Schizophrenia and bipolar disorder are severe mental illnesses that affect millions of people in the US. Seroquel is an atypical antipsychotic approved to treat schizophrenia, acute manic episodes associated with bipolar disorder, and depressive episodes associated with bipolar disorder. It is available in different oral formulations and has the indication of being the first drug approved to treat both manic and depressive episodes of bipolar disorder. Common side effects include drowsiness, dry mouth, and weight gain. Major competitors of Seroquel include Risperdal, Zyprexa, Abilify, and Invega.
This document discusses various types of anti-anxiety drugs. It defines anxiety and differentiates it from anxiety disorders. Common anxiety symptoms are outlined. The main classes of anti-anxiety drugs discussed are benzodiazepines, which enhance the neurotransmitter GABA and have sedative and muscle relaxant effects. Common benzodiazepines like Xanax, Klonopin, and Valium are mentioned. Side effects of benzodiazepines include drowsiness, impaired coordination, and risks of dependence and withdrawal symptoms with long term use. Other anti-anxiety drugs discussed include barbiturates, azapirones, and beta blockers, which work by blocking stress hormones but don't treat the
Antidepressants are drugs that relieve symptoms of depression and were first developed in the 1950s. There are approximately 30 types that fall into 5 main categories and are used to treat various psychiatric disorders like depression, schizophrenia, anxiety, obsessive compulsive disorder, post-traumatic stress disorder, and eating disorders. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are commonly prescribed to treat conditions like generalized anxiety disorder, panic attacks, and bulimia nervosa.
This document summarizes the clinical uses of the antipsychotic drug quetiapine. It discusses quetiapine's approval for treating schizophrenia, bipolar disorder, depression, and other off-label uses. Key points include quetiapine being the first-line treatment for bipolar depression, its efficacy in reducing symptoms of schizophrenia and mania, and dosage guidelines for different conditions. Recent studies are cited showing quetiapine's benefits for outcomes in schizophrenia and improvements in working memory compared to other antipsychotics.
Second generation atypical anti-psychotic used for mental disorders more extensively for bipolar disorder. have very low side effects than other SGA Medications
Dr. Houghtalen presented on benzodiazepines. Key points include:
1. Benzodiazepines act on GABA receptors to have anxiolytic, sedative, and other effects. They are effective for conditions like insomnia, anxiety disorders, and alcohol withdrawal.
2. Adverse effects include impairment of driving, dizziness, and tolerance and abuse risk. SSRIs have side effects like weight gain and sexual dysfunction.
3. Benzodiazepines should be tapered slowly to avoid withdrawal symptoms worse than baseline conditions. Tapering challenges include both short- and long-acting drugs requiring weeks to months.
Psychiatry Cheat Sheet (MDD, GAD, Bipolar)Justin Berk
This student "cheat sheet" is designed to provide medical students with basic information regarding the diagnosis and treatment of basic psychiatric disorders including Depression, Anxiety, and Bipolar Disorder. It includes Questions to Ask, what to look for on a Physical Exam, Labs to Order, and basic Treatment Plans.
These guides are particularly designed for first and second-year medical students as an introduction to ambulatory care medicine and attempts to tie in the basic pathophysiology that is high-yield for USMLE Step 1.
Any and all feedback is very welcomed.
Schizophrenia and bipolar disorder are severe mental illnesses that affect millions of people in the US. Seroquel is an atypical antipsychotic approved to treat schizophrenia, acute manic episodes associated with bipolar disorder, and depressive episodes associated with bipolar disorder. It is available in different oral formulations and has the indication of being the first drug approved to treat both manic and depressive episodes of bipolar disorder. Common side effects include drowsiness, dry mouth, and weight gain. Major competitors of Seroquel include Risperdal, Zyprexa, Abilify, and Invega.
This document discusses various types of anti-anxiety drugs. It defines anxiety and differentiates it from anxiety disorders. Common anxiety symptoms are outlined. The main classes of anti-anxiety drugs discussed are benzodiazepines, which enhance the neurotransmitter GABA and have sedative and muscle relaxant effects. Common benzodiazepines like Xanax, Klonopin, and Valium are mentioned. Side effects of benzodiazepines include drowsiness, impaired coordination, and risks of dependence and withdrawal symptoms with long term use. Other anti-anxiety drugs discussed include barbiturates, azapirones, and beta blockers, which work by blocking stress hormones but don't treat the
Antidepressants are drugs that relieve symptoms of depression and were first developed in the 1950s. There are approximately 30 types that fall into 5 main categories and are used to treat various psychiatric disorders like depression, schizophrenia, anxiety, obsessive compulsive disorder, post-traumatic stress disorder, and eating disorders. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are commonly prescribed to treat conditions like generalized anxiety disorder, panic attacks, and bulimia nervosa.
This document summarizes the clinical uses of the antipsychotic drug quetiapine. It discusses quetiapine's approval for treating schizophrenia, bipolar disorder, depression, and other off-label uses. Key points include quetiapine being the first-line treatment for bipolar depression, its efficacy in reducing symptoms of schizophrenia and mania, and dosage guidelines for different conditions. Recent studies are cited showing quetiapine's benefits for outcomes in schizophrenia and improvements in working memory compared to other antipsychotics.
Second generation atypical anti-psychotic used for mental disorders more extensively for bipolar disorder. have very low side effects than other SGA Medications
Dr. Houghtalen presented on benzodiazepines. Key points include:
1. Benzodiazepines act on GABA receptors to have anxiolytic, sedative, and other effects. They are effective for conditions like insomnia, anxiety disorders, and alcohol withdrawal.
2. Adverse effects include impairment of driving, dizziness, and tolerance and abuse risk. SSRIs have side effects like weight gain and sexual dysfunction.
3. Benzodiazepines should be tapered slowly to avoid withdrawal symptoms worse than baseline conditions. Tapering challenges include both short- and long-acting drugs requiring weeks to months.
Antidepressants are the second most prescribed medication in the US, with 15 million Americans affected by depression each year. Depression is treated through medications and therapy. Antidepressants work by adjusting neurotransmitter levels in the brain like serotonin, dopamine, and norepinephrine. Common classes include SSRIs, SNRIs, TCAs, and MAOIs. While effective, antidepressants can cause side effects like nausea, insomnia, sexual dysfunction, and increased suicide risk initially. Doctors closely monitor patients to improve treatment outcomes and safety.
Risperidone is a second-generation antipsychotic medication that is effective and well-tolerated for treating tantrums, aggression, and self-injurious behavior in children with autism spectrum disorder. However, its use is highly controversial due to adverse effects like weight gain, hormonal issues, and long-term neurological problems. Risperidone's efficacy and side effects depend on factors like genetics and drug interactions, requiring close monitoring by medical professionals when used in autistic children.
The document discusses the pharmacology of antidepressant drugs. It begins by defining depression and its various types. It then covers the monoamine hypothesis of depression and classifications of antidepressant drugs. The mechanisms and side effects of various classes are described, including tricyclic antidepressants, SSRIs, SNRIs, MAOIs, and atypical antidepressants. Drug therapy for bipolar disorder involves lithium, anticonvulsants, and antipsychotics. Proper use and monitoring of antidepressant treatment is also outlined.
This document provides information on the treatment of schizophrenia and related psychotic disorders. It discusses the symptoms and diagnostic criteria for schizophrenia according to the DSM-IV. It describes the positive and negative symptoms as well as functional impairments. The document outlines the challenges in treating schizophrenia, including stigma, impaired insight, substance abuse, and medical comorbidities. It summarizes the evidence for effective treatments like antipsychotic medications and family psychoeducation. The document provides a history of antipsychotic medications, describing their mechanisms of action and side effect profiles. It compares first-generation "typical" antipsychotics to second-generation "atypical" antipsychotics.
Brain Chemistry And The Medical Treatment Of Major DepressionGiakas
This document discusses the biological basis and treatment of major depression. It covers the challenges in diagnosis and treatment selection. The roles of neurotransmitters like serotonin, norepinephrine, and dopamine are explained. Different medication options are presented, including single-action antidepressants, multi-action antidepressants, and augmentation strategies. Research focuses on the hippocampus and neuroplasticity changes related to depression. Antidepressants may work by upregulating neurotrophic factors and the CREB cascade to promote neurogenesis. Electroconvulsive therapy and vagus nerve stimulation are also reviewed as effective treatment options.
The document discusses several types of depression including major depressive disorder, dysthymic disorder, postpartum depression, seasonal affective disorder, and bipolar disorder. It then provides details on the prevalence, risk factors, causes, and screening tools for major depressive disorder. The remainder of the document discusses differential diagnoses, treatment options including pharmacotherapy and psychotherapy, specifics on different classes of antidepressants and their mechanisms of action, side effects, and drug interactions.
Risperidone is an antipsychotic medication developed in the 1980s-1990s and approved by the FDA in 1994. It is on the WHO's list of essential medicines. Risperidone is effective at decreasing hallucinations and delusions in psychotic patients, allowing them to function better. It is available in tablet, liquid, and injectable forms. Risperidone is metabolized in the liver and has an oral bioavailability of 70%. Common side effects include extrapyramidal symptoms, weight gain, and hyperprolactinemia. It is indicated for schizophrenia, bipolar mania, autism-related irritability, and other off-label uses, though has black box
Antipsychotic : Dr Rahul Kunkulol's Power point preparationsRahul Kunkulol
This document discusses the treatment of psychosis and schizophrenia with a focus on antipsychotic drugs. It begins by classifying psychiatric disorders and defining psychosis. Schizophrenia is described as a particular type of psychosis characterized by disturbances in thinking. The dopamine theory of schizophrenia is explained, which posits that psychosis is related to increased dopamine activity in the brain. Older antipsychotics are dopamine antagonists that can cause neurological side effects like tardive dyskinesia. Atypical antipsychotics have fewer side effects. Lithium is discussed as the drug of choice for treating mania in bipolar disorder.
This document provides information on psychoactive drugs used to treat psychiatric conditions. It defines psychoactive drugs as substances that act on the central nervous system, altering brain function and resulting in changes in perception, mood, consciousness, and behavior. The document then summarizes several classes of psychoactive drugs - antipsychotics, antidepressants, mood stabilizers, anxiolytics, stimulants, and depressants - listing their indications, mechanisms of action, side effects, and nursing responsibilities for each.
Pharmacological guidelines in the treatment of schizophreniaehab elbaz
This document provides pharmacological guidelines for treating schizophrenia. It discusses the different phases of treatment including prodrome, first episode, maintenance, and relapse. It offers recommendations on choosing medications, managing side effects, preventing relapse, and treating treatment-resistant cases. Electroconvulsive therapy may be an option for patients who do not respond to pharmacological interventions alone. The guidelines are meant to help develop an evidence-based approach to prescription while minimizing improper prescribing.
This document discusses anxiety and its treatment. It defines anxiety as an unpleasant emotional state accompanied by nervous behavior. It notes that neurotransmitters like GABA, norepinephrine, and serotonin play a role in anxiety, and that certain brain regions like the amygdala and hippocampus are involved. It describes several theories for the neurochemical basis of anxiety. It then discusses different classes of anxiolytic drugs like benzodiazepines, azapirones, antihistamines, and beta blockers that treat anxiety by enhancing GABA transmission or blocking the sympathetic nervous system. Finally, it provides examples of individual anxiolytic drugs and notes some of their side effects and interactions.
Comparison Of Drug Tx & Psycotherapy in the treatment of DepressionDMFishman
This document discusses and compares pharmacotherapy (medication) and psychotherapy in the treatment of depression. It outlines the diagnostic criteria for major depressive disorder and dysthymia. It then discusses the epidemiology and clinical course of depression before comparing different treatment approaches. Pharmacotherapies discussed include SSRIs, TCAs, and MAOIs. Psychotherapies discussed include cognitive-behavioral therapy and interpersonal therapy.
This document discusses mood disorders, specifically depression. It provides the DSM-IV criteria for a major depressive episode, including symptoms such as depressed mood, diminished interest, changes in appetite, insomnia, fatigue, feelings of worthlessness, difficulty concentrating, and suicidal thoughts. It also discusses treatment options, focusing on pharmacotherapy. SSRIs are considered a first-line treatment and details are provided about specific SSRIs, their mechanisms of action, indications, and precautions. Risk factors for suicide are briefly covered.
Risperidone is a second-generation antipsychotic medication that is effective and well-tolerated for treating tantrums, aggression, and self-injurious behavior in children with autism spectrum disorder. However, its use is highly controversial due to adverse effects like weight gain, hormonal issues, and long-term neurological problems. Risperidone's efficacy and side effects depend on factors like a person's genetics and other medications being taken, requiring close monitoring by medical professionals when prescribing it to treat autism.
1) The document describes two clinical cases where quetiapine was used. Case 1 involved a 56-year-old man with severe depression without psychosis, who showed improved motivation and functioning after starting quetiapine along with other medications.
2) Case 2 involved a 33-year-old woman with traits of borderline personality disorder and adjustment issues. She took her husband's quetiapine on occasion when feeling emotionally unstable and found it helped reduce her symptoms.
3) The document discusses how quetiapine's action on dopamine, serotonin, norepinephrine, glutamate and GABA systems may help explain its efficacy as an antidepressant when added to other antidepressants for conditions like major
Quetiapine (Neoquel) is an atypical antipsychotic medication approved by the FDA in 1998 to treat psychosis, schizophrenia, manic disorders, and bipolar depression. It works by antagonizing serotonin and dopamine receptors in the mesolimbic and mesocortical areas of the brain. Quetiapine has high bioavailability, fewer side effects than other antipsychotics, and is effective for both depressive and psychotic features, making it a useful first-line treatment option. Dosage varies based on the condition and must be adjusted for patients with certain medical comorbidities, drug interactions, or special populations.
This document discusses the treatment of psychiatric disorders through pharmacotherapy, psychotherapy, and somatic treatments. It focuses on the role of medications in treating various conditions like mood disorders, schizophrenia, anxiety, sleep disorders, substance use disorders, and others. It provides details on specific drug classes and examples used to treat each condition. It also covers electroconvulsive therapy (ECT) and discusses what it is, how it works, when it may be used, potential side effects, and the ECT administration and recovery process. Psychotherapies are also mentioned as important treatment options.
The document discusses psychotherapeutic agents used to treat mental disorders like depression and anxiety. It describes how these disorders are associated with imbalances in neurotransmitters in the brain like serotonin and dopamine. Several classes of psychotherapeutic drugs are outlined, including antidepressants like SSRIs, tricyclics, and MAOIs. Tricyclics work by blocking the reuptake of neurotransmitters to increase their levels in the brain. Side effects include sedation and hypotension. MAOIs are considered second line but can cause hypertensive crisis if taken with foods containing tyramine.
1) Antidepressant use has greatly increased over the last 30 years, with antidepressants now being the most commonly prescribed drug in the US. However, some experts argue they are overprescribed for issues that could be addressed through therapy or lifestyle changes.
2) Studies have found antidepressants to be only slightly more effective than placebo pills, but other analyses found flaws in how the original data was interpreted. The effectiveness of antidepressants does not depend on the severity of depression.
3) While antidepressants can help some people, there are concerns about overreliance on quick fix medication solutions rather than addressing underlying issues through therapy or lifestyle changes. Long term use should be reserved for severe cases.
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that work by inhibiting the reuptake of serotonin. SSRIs include fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, and escitalopram. They are highly selective for serotonin reuptake compared to other neurotransmitters. While SSRIs share the common mechanism of inhibiting serotonin reuptake, they differ in their pharmacokinetic properties such as half-life, metabolic pathways, and drug interaction potential. Adverse effects of SSRIs include nausea, sexual dysfunction, headaches, and weight changes.
Antidepressants are the second most prescribed medication in the US, with 15 million Americans affected by depression each year. Depression is treated through medications and therapy. Antidepressants work by adjusting neurotransmitter levels in the brain like serotonin, dopamine, and norepinephrine. Common classes include SSRIs, SNRIs, TCAs, and MAOIs. While effective, antidepressants can cause side effects like nausea, insomnia, sexual dysfunction, and increased suicide risk initially. Doctors closely monitor patients to improve treatment outcomes and safety.
Risperidone is a second-generation antipsychotic medication that is effective and well-tolerated for treating tantrums, aggression, and self-injurious behavior in children with autism spectrum disorder. However, its use is highly controversial due to adverse effects like weight gain, hormonal issues, and long-term neurological problems. Risperidone's efficacy and side effects depend on factors like genetics and drug interactions, requiring close monitoring by medical professionals when used in autistic children.
The document discusses the pharmacology of antidepressant drugs. It begins by defining depression and its various types. It then covers the monoamine hypothesis of depression and classifications of antidepressant drugs. The mechanisms and side effects of various classes are described, including tricyclic antidepressants, SSRIs, SNRIs, MAOIs, and atypical antidepressants. Drug therapy for bipolar disorder involves lithium, anticonvulsants, and antipsychotics. Proper use and monitoring of antidepressant treatment is also outlined.
This document provides information on the treatment of schizophrenia and related psychotic disorders. It discusses the symptoms and diagnostic criteria for schizophrenia according to the DSM-IV. It describes the positive and negative symptoms as well as functional impairments. The document outlines the challenges in treating schizophrenia, including stigma, impaired insight, substance abuse, and medical comorbidities. It summarizes the evidence for effective treatments like antipsychotic medications and family psychoeducation. The document provides a history of antipsychotic medications, describing their mechanisms of action and side effect profiles. It compares first-generation "typical" antipsychotics to second-generation "atypical" antipsychotics.
Brain Chemistry And The Medical Treatment Of Major DepressionGiakas
This document discusses the biological basis and treatment of major depression. It covers the challenges in diagnosis and treatment selection. The roles of neurotransmitters like serotonin, norepinephrine, and dopamine are explained. Different medication options are presented, including single-action antidepressants, multi-action antidepressants, and augmentation strategies. Research focuses on the hippocampus and neuroplasticity changes related to depression. Antidepressants may work by upregulating neurotrophic factors and the CREB cascade to promote neurogenesis. Electroconvulsive therapy and vagus nerve stimulation are also reviewed as effective treatment options.
The document discusses several types of depression including major depressive disorder, dysthymic disorder, postpartum depression, seasonal affective disorder, and bipolar disorder. It then provides details on the prevalence, risk factors, causes, and screening tools for major depressive disorder. The remainder of the document discusses differential diagnoses, treatment options including pharmacotherapy and psychotherapy, specifics on different classes of antidepressants and their mechanisms of action, side effects, and drug interactions.
Risperidone is an antipsychotic medication developed in the 1980s-1990s and approved by the FDA in 1994. It is on the WHO's list of essential medicines. Risperidone is effective at decreasing hallucinations and delusions in psychotic patients, allowing them to function better. It is available in tablet, liquid, and injectable forms. Risperidone is metabolized in the liver and has an oral bioavailability of 70%. Common side effects include extrapyramidal symptoms, weight gain, and hyperprolactinemia. It is indicated for schizophrenia, bipolar mania, autism-related irritability, and other off-label uses, though has black box
Antipsychotic : Dr Rahul Kunkulol's Power point preparationsRahul Kunkulol
This document discusses the treatment of psychosis and schizophrenia with a focus on antipsychotic drugs. It begins by classifying psychiatric disorders and defining psychosis. Schizophrenia is described as a particular type of psychosis characterized by disturbances in thinking. The dopamine theory of schizophrenia is explained, which posits that psychosis is related to increased dopamine activity in the brain. Older antipsychotics are dopamine antagonists that can cause neurological side effects like tardive dyskinesia. Atypical antipsychotics have fewer side effects. Lithium is discussed as the drug of choice for treating mania in bipolar disorder.
This document provides information on psychoactive drugs used to treat psychiatric conditions. It defines psychoactive drugs as substances that act on the central nervous system, altering brain function and resulting in changes in perception, mood, consciousness, and behavior. The document then summarizes several classes of psychoactive drugs - antipsychotics, antidepressants, mood stabilizers, anxiolytics, stimulants, and depressants - listing their indications, mechanisms of action, side effects, and nursing responsibilities for each.
Pharmacological guidelines in the treatment of schizophreniaehab elbaz
This document provides pharmacological guidelines for treating schizophrenia. It discusses the different phases of treatment including prodrome, first episode, maintenance, and relapse. It offers recommendations on choosing medications, managing side effects, preventing relapse, and treating treatment-resistant cases. Electroconvulsive therapy may be an option for patients who do not respond to pharmacological interventions alone. The guidelines are meant to help develop an evidence-based approach to prescription while minimizing improper prescribing.
This document discusses anxiety and its treatment. It defines anxiety as an unpleasant emotional state accompanied by nervous behavior. It notes that neurotransmitters like GABA, norepinephrine, and serotonin play a role in anxiety, and that certain brain regions like the amygdala and hippocampus are involved. It describes several theories for the neurochemical basis of anxiety. It then discusses different classes of anxiolytic drugs like benzodiazepines, azapirones, antihistamines, and beta blockers that treat anxiety by enhancing GABA transmission or blocking the sympathetic nervous system. Finally, it provides examples of individual anxiolytic drugs and notes some of their side effects and interactions.
Comparison Of Drug Tx & Psycotherapy in the treatment of DepressionDMFishman
This document discusses and compares pharmacotherapy (medication) and psychotherapy in the treatment of depression. It outlines the diagnostic criteria for major depressive disorder and dysthymia. It then discusses the epidemiology and clinical course of depression before comparing different treatment approaches. Pharmacotherapies discussed include SSRIs, TCAs, and MAOIs. Psychotherapies discussed include cognitive-behavioral therapy and interpersonal therapy.
This document discusses mood disorders, specifically depression. It provides the DSM-IV criteria for a major depressive episode, including symptoms such as depressed mood, diminished interest, changes in appetite, insomnia, fatigue, feelings of worthlessness, difficulty concentrating, and suicidal thoughts. It also discusses treatment options, focusing on pharmacotherapy. SSRIs are considered a first-line treatment and details are provided about specific SSRIs, their mechanisms of action, indications, and precautions. Risk factors for suicide are briefly covered.
Risperidone is a second-generation antipsychotic medication that is effective and well-tolerated for treating tantrums, aggression, and self-injurious behavior in children with autism spectrum disorder. However, its use is highly controversial due to adverse effects like weight gain, hormonal issues, and long-term neurological problems. Risperidone's efficacy and side effects depend on factors like a person's genetics and other medications being taken, requiring close monitoring by medical professionals when prescribing it to treat autism.
1) The document describes two clinical cases where quetiapine was used. Case 1 involved a 56-year-old man with severe depression without psychosis, who showed improved motivation and functioning after starting quetiapine along with other medications.
2) Case 2 involved a 33-year-old woman with traits of borderline personality disorder and adjustment issues. She took her husband's quetiapine on occasion when feeling emotionally unstable and found it helped reduce her symptoms.
3) The document discusses how quetiapine's action on dopamine, serotonin, norepinephrine, glutamate and GABA systems may help explain its efficacy as an antidepressant when added to other antidepressants for conditions like major
Quetiapine (Neoquel) is an atypical antipsychotic medication approved by the FDA in 1998 to treat psychosis, schizophrenia, manic disorders, and bipolar depression. It works by antagonizing serotonin and dopamine receptors in the mesolimbic and mesocortical areas of the brain. Quetiapine has high bioavailability, fewer side effects than other antipsychotics, and is effective for both depressive and psychotic features, making it a useful first-line treatment option. Dosage varies based on the condition and must be adjusted for patients with certain medical comorbidities, drug interactions, or special populations.
This document discusses the treatment of psychiatric disorders through pharmacotherapy, psychotherapy, and somatic treatments. It focuses on the role of medications in treating various conditions like mood disorders, schizophrenia, anxiety, sleep disorders, substance use disorders, and others. It provides details on specific drug classes and examples used to treat each condition. It also covers electroconvulsive therapy (ECT) and discusses what it is, how it works, when it may be used, potential side effects, and the ECT administration and recovery process. Psychotherapies are also mentioned as important treatment options.
The document discusses psychotherapeutic agents used to treat mental disorders like depression and anxiety. It describes how these disorders are associated with imbalances in neurotransmitters in the brain like serotonin and dopamine. Several classes of psychotherapeutic drugs are outlined, including antidepressants like SSRIs, tricyclics, and MAOIs. Tricyclics work by blocking the reuptake of neurotransmitters to increase their levels in the brain. Side effects include sedation and hypotension. MAOIs are considered second line but can cause hypertensive crisis if taken with foods containing tyramine.
1) Antidepressant use has greatly increased over the last 30 years, with antidepressants now being the most commonly prescribed drug in the US. However, some experts argue they are overprescribed for issues that could be addressed through therapy or lifestyle changes.
2) Studies have found antidepressants to be only slightly more effective than placebo pills, but other analyses found flaws in how the original data was interpreted. The effectiveness of antidepressants does not depend on the severity of depression.
3) While antidepressants can help some people, there are concerns about overreliance on quick fix medication solutions rather than addressing underlying issues through therapy or lifestyle changes. Long term use should be reserved for severe cases.
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that work by inhibiting the reuptake of serotonin. SSRIs include fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, and escitalopram. They are highly selective for serotonin reuptake compared to other neurotransmitters. While SSRIs share the common mechanism of inhibiting serotonin reuptake, they differ in their pharmacokinetic properties such as half-life, metabolic pathways, and drug interaction potential. Adverse effects of SSRIs include nausea, sexual dysfunction, headaches, and weight changes.
1. Choice of anti-epileptic drugs depends on seizure type and patient needs, starting with low doses of a single drug and gradually increasing. Combination therapy may be used if seizures are not controlled.
2. Treatment should begin early and be the simplest regimen. Drugs should be gradually withdrawn after at least 3 years of seizure freedom.
3. Carbamazepine and phenytoin are first-line treatments for generalized tonic-clonic seizures, while valproate is preferred for absence seizures and myoclonic seizures.
- Hot flashes are characterized by excessive vasodilatation of peripheral vasculature in response to a small increase in core body temperature, resulting in sensations of heat. They can be managed through lifestyle changes like diet modification, exercise, and stress relief techniques.
- For mild cases, avoiding triggers and lifestyle changes may be sufficient. For moderate to severe cases, herbal medications like black cohosh can be tried. If ineffective, SSRIs/SNRIs like escitalopram are first-line pharmacological options. Gabapentin or clonidine may be used if SSRIs/SNRIs provide inadequate relief or side effects.
- Management involves identifying triggers, incorporating
This document discusses various psychopharmacological agents used to treat psychiatric conditions. It begins by outlining the indications for antidepressants such as SSRIs, SNRIs, TCAs, and novel agents. It then discusses guidelines for antidepressant use and classifications. Specific antidepressants are described in detail including their pros and cons. The document also discusses mood stabilizers like lithium and anticonvulsants, outlining their indications, classes, and factors to consider when selecting them. Side effects and monitoring requirements are provided for various medications.
The document reviews first and second generation antipsychotics, how they work, their side effect profiles, and monitoring recommendations. It discusses the metabolic side effects of various antipsychotics like olanzapine and clozapine which can increase risks of diabetes, dyslipidemia, and weight gain. Monitoring of weight, glucose, lipids is recommended when prescribing antipsychotics to manage these metabolic risks.
This document provides information on various antidepressant medications, including tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRs). It lists several TCAs and SSRIs, and then provides details for each individual drug, including brand names, dosage forms, strengths, manufacturers, indications, contraindications, half-lives, and dosing information. The document is intended to educate about different antidepressant options and their proper use and dosing.
This document provides an outline on depression, antidepressant drugs, and related nursing care. It discusses types of depression like major depressive disorder and dysthymic disorder. It then covers the four main classes of antidepressant drugs - SSRIs, TCAs, atypical antidepressants, and MAOIs. For each drug class, it discusses mechanisms of action, indications, dosages, drug interactions, side effects, and relevant nursing considerations. The document aims to inform nurses on properly assessing, treating and caring for patients taking antidepressants.
This document discusses several considerations for drug therapy in older adults. It addresses risks and benefits of treatment options for sleep complaints, urinary tract infections, and analgesics. It emphasizes discussing options with patients, managing underlying conditions, and using non-pharmacological therapies when possible for insomnia. For UTIs it discusses assessing symptoms, risk of resistance, renal function, drug interactions, and treatment duration. For analgesics it covers balancing pain relief with function, risks of different classes, and starting low and slow. It promotes shared decision making and a patient-centered approach.
This document provides an overview of treatment options for various headache conditions. It begins with disclosures and objectives from the speaker. It then outlines treatments for migraine (including during pregnancy/lactation), chronic migraine, medication overuse headache, tension-type headache, and cluster headache. Specific acute and preventive migraine treatment options are discussed in detail, along with principles, evidence, formulations, and troubleshooting. Other topics covered include chronic daily headache classification and secondary causes.
The document discusses SSRIs and SNRIs as treatments for depression. It provides information on:
- How SSRIs and SNRIs work to increase serotonin and norepinephrine levels in the brain through inhibiting reuptake.
- Examples of common SSRIs and SNRIs including citalopram, escitalopram, fluoxetine, sertraline, duloxetine, and venlafaxine.
- Typical dosing ranges and side effects of various antidepressants.
- Special considerations for using antidepressants in certain patient populations and medical conditions.
- Guidelines from studies and organizations like NICE on treating depression and anxiety with antidepressants.
This document discusses the case of a 45-year-old male patient brought to the emergency department in an agitated state. His symptoms meet the diagnostic criteria for schizophrenia. He is initially treated with haloperidol to control his agitation. After 2 weeks, his symptoms improve and he is started on an atypical antipsychotic for long-term stabilization. The document then discusses various first and second generation antipsychotics, their mechanisms of action, indications, side effects, and monitoring considerations.
This document provides information on medication management for patients with persistent pain. It discusses various classes of medications including acetaminophen, NSAIDs, antidepressants (TCAs, SNRIs, SSRIs), anticonvulsants (gabapentin, pregabalin), and various opioids. It provides dosing guidelines and cautions for each class. The document aims to help physicians appropriately manage medications for patients with persistent pain while mitigating risks.
This document summarizes different classes of antidepressants and mood stabilizers. It discusses how antidepressants like SSRIs, SNRIs, and TCAs work to block neurotransmitter reuptake in the brain. It provides examples of common medications in each class and their indications and side effects. Mood stabilizers discussed include lithium, anti-convulsants like carbamazepine, valproate, and lamotrigine which are used to treat bipolar disorder.
Sertraline 50 mg film coated tablets smpc- taj pharmaceuticalsTaj Pharma
Sertalin Taj Pharma : Uses, Side Effects, Interactions, Pictures, Warnings, Sertalin Dosage & Rx Info | Sertalin Uses, Side Effects -: Indications, Side Effects, Warnings, Sertalin - Drug Information - Taj Pharma, Sertalin dose Taj pharmaceuticals Sertalin interactions, Taj Pharmaceutical Sertalin contraindications, Sertalin price, Sertalin Taj Pharma Sertalin 50mg Tablets SMPC- Taj Pharma . Stay connected to all updated on Sertalin Taj Pharmaceuticals Taj pharmaceuticals Hyderabad.
This document provides an overview of the pharmacology of antidepressants. It discusses the history of antidepressant development beginning in the 1950s. It then classifies antidepressants and describes the mechanisms of action, pharmacokinetics, pharmacological actions, adverse effects and recent advances for various classes including tricyclic antidepressants, SSRIs, SNRIs, atypical antidepressants. It provides details on specific drugs within each class.
SSRIs and SNRIs are commonly used to treat depression. SSRIs work by blocking the reuptake of serotonin, increasing levels of the neurotransmitter in the brain. Common SSRIs include fluoxetine, paroxetine, sertraline, and citalopram. SNRIs like venlafaxine also block the reuptake of serotonin and norepinephrine. These drugs are generally well-tolerated but side effects may include nausea, insomnia, sexual dysfunction, and agitation. Guidelines recommend SSRIs as first-line treatment for moderate to severe depression.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central19various
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
1. 1
Psychiatry Cheat Sheet Jazzlyn Gallardo, D.O.
Normal TSH: 0.45 – 5.10 mIU/l
Check TSH again 4-6 weeks after each thyroid dose change.
Levothyroxine: starting dose 25 mcg/d
Take thyroid meds on empty stomach as soon as patient gets up in the morning at least one hour
before eating, which helps with absorption; don’t ever take thyroid meds with vitamins
Therapeutic blood levels
Lithium: 0.5-1.0 mEq/l, run towards the lower end to minimize side effects
Depakote: 50-125 mcg/ml
Lamictal: 3-14 mcg/ml
Anafranil (TCAs): 220-500 ng/ml
Bipolar ‘Ceiling’ Drugs
Lithium: start at 300 mg qhs with food in stomach (“little old lady” dose) or 600-900 mg qhs in
younger, healthier patients, & titrate upwards depending on clinical response, side effects, & blood
levels, better for euphoric, rather than irritable, patients
Depakote (valproic acid) – good for rapid cycling (4 or more moodswings per year)/mixed state/irritable
mood in Bipolar with 500 mg qhs starting dose & Depakote titration upwards depending on clinical
response, side effects, & blood levels
o Must start Depakote titration again at low dose if patient stops medication
Tegretol (carbamazepine)/Trileptal(oxcarbazepine) - second-line ceiling drugs
Neuroleptics (preferably second generation)
Bipolar ‘Floor’ Drugs
Lithium
Lamictal (good for concommitant seizures)
Anti-depressants (generally not used as mono-therapy in Bipolar Disorder)
Lithium Management
“Little old lady” dose or for children: starting dose of 300 mg qhs (for healthy patients 600-900 mg
qhs); Emergency: start at 600-900 mg qhs
Titrate upward in 300 mg/d increments
Obtain blood levels 7-10 days after initiating or changing the dosage of lithium (up or down).
o Instruct patient to get blood work done 12 hours after they have taken their last dose (trough).
For lithium-induced hypothyroidism, do not discontinue lithium, instead supplement with
levothyroxine, starting at 25 mcg/d, checking results with repeat TSH in 4-6 weeks
Also get creatinine clearance (CrCl) & TSH every 6-12 months for anyone on lithium plus other
appropriate screening LAB
Lamictal Management
Start at 25 mg qhs (12.5 mg qhs if on concomitant Depakote with corresponding half-strength increased
doses thereafter) for 2 weeks, 50 mg qhs for next 2 weeks, 100 mg qhs for next 2 weeks on Lamictal
Initial target dose at 200 mg qhs (get blood levels after 7-10 days at this dose, 12 hours after dose)
Increase by 100 mg/d thereafter as needed, but not sooner than 2 weeks at each dose (only 50 mg/d
increase if concurrently on Depakote)
2. 2
o To allow the body to get used to the drug and to avoid Stevens-Johnson Syndrome (life-
threatening rash)
o Must restart original titration protocol at 25 mg qhs if they miss Lamictal more than 3 days in a
row
Side effects: tremor, dizziness, word-finding problems, rash
Medications that need Tapering (basically everything except LiCO3)
Medication Groups
Atypical Antipsychotics/Second-generation neuroleptics
Abilify (aripiprazole)
Geodon (ziprasidone)
Seroquel (quetiapine) – start 25 mg po qhs then increase by 25-100 mg/day
Zyprexa (olanzapine) – start 5 mg po qhs, may adjust by 5 mg/day prn
o if still cannot sleep within 3 hours of first dose, add another 5 mg
o *Seroquel and Zyprexa have the most anti-histaminic properties, and are therefore weight
gainers
OTHERS:
Risperdal (risperidone)
Latuda (lurasidone)
Clozaril (clozapine)
Serotonin-Norepinephrine Re-Uptake Inhibitors (SNRIs) for depression, OCD, panic disorder, anxiety,
chronic pain
Effexor (venlafaxine) - cheaper than Pristiq; start at 25 mg bid (take after breakfast & after lunch, may
cause upset stomach)
Cymbalta (duloxetine) - still more expensive than Effexor; starting dose 30-60 mg; may cause upset
stomach
Pristiq (desvenlafaxine) - first active metabolite of venlafaxine, just more expensive
Fetzima (levomilnacipran) – as expensive as Pristiq
_
Selective Serotonin Re-Uptake Inhibitor (SSRIs): for depression, OCD, panic disorder, anxiety
Prozac (fluoxetine) – preferred; long half-life (if patient misses dose, won’t go into discontinuation
syndrome); relatively weight neutral; associated with decreased libido (or other sexual dysfunction, like
delayed orgasm)
o start at 10-20 mg po qam, take with food in stomach; can go up in 10-20 mg/d increments not
more than every 2 weeks
Zoloft (sertraline)
Luvox (fluvoxamine)
Lexapro (escitalopram) – not used as much due to potential QTc prolongation
Celexa (citalopram) – not used as much due to potential QTc prolongation
Paxil (paroxetine) – may cause severe discontinuation syndrome, weight gain
____________________________________________________________________________________
Remeron (Mirtazapine) – helpful for anxious depression with insomnia, starting dose: 30 mg qhs
α2 Antagonist (increases release of NE and serotonin) and potent 5-HT2 and 5-HT3 receptor antagonist
sedation, weight gain
3. 3
Tri-Cyclic Antidepressants (potentially dangerous/toxic---monitor with blood levels): tertiary TCA’s
block reuptake of NE and serotonin like an SNRI; treat major depression, fibromyalgia, anxiety disorders,
enuresis, *Check patient’s pupil size for mydriasis/miosis to get a sense of their anticholinergic tone (larger
pupils with greater anti-cholinergic effect). * Can precipitate manic episodes in Bipolars
Anafranil (clomipramine) – for OCD; increase by 25 mg/d increments not more than every 2 weeks
Elavil (amitriptyline) – tertiary TCA
Tofranil (imipramine) – for enuresis
____________________________________________________________________________________
MAO Inhibitors: increase levels of NE, serotonin, dopamine
Parnate (tranylcypromine) – has amphetamine-like effects; used if patient has failed on multiple, other
anti-depressants
Nardil (phenelzine) – for anxiety/depression used if patient has failed on multiple, other anti-
depressants
* Hypertensive crisis with tyramine ingestion (in many foods, such as wine and cheese and aged
protein products) and decongestants like Sudafed
Contraindicated with SSRIs or other antidepressants.
* Can precipitate manic episodes in Bipolars
Benzodiazepines
Xanax (alprazolam)
Klonopin (clonazepam)
Others include Ativan, Valium, Dalmane, Librium, Halcion, Serax
CNS Stimulant
Concerta (methylphenidate)
Others include Ritalin, Dexedrine, Vyvanse
____________________________________________________________________________________
Strattera (atomoxetine) (NE re-uptake inhibitor, like Wellbutrin), both can be used as alternative
treatments in ADHD/ADD
Beta Blockers
Inderol (propranolol) – reduce drug-induced tremor; start at 10 mg bid/tid; titrate up in 10 mg
increments, contraindications include asthma & diabetes
Others include atenolol, metoprolol
Sleeping Aids
Melatonin - mild; good starting point; start with 3 mg one hour before bed; can be an adjunct to
Remeron or Seroquel
trazadone
Antihistamines
Sedating neuroleptics: Zyprexa, Seroquel
4. 4
Sedating antidepressants: Remeron
Tertiary tricyclics (potentially dangerous/toxic)
Weight gain: Seroquel, Depakote, mirtazapine, Paxil
Weight neutral: Prozac, Lamictal, Tegretol
Cogentin (benztropine) – anticholinergic remedy for extrapyramidal side effects from neuroleptics; H1
antagonist
start at 1 mg bid, titrating upwards to 2 mg bid
Terminology
Mixed state: feeling depressed yet manic “high” symptoms at the same time
Reduced by Depakote/ Atypical Antipsychotics (Second-generation neuroleptics)
o
Pharmacokinetic drug-drug interaction: one drug affects the blood level of the second drug
o Example: Depakote and Lamictal
Pharmacodynamic drug-drug interaction: two drugs accomplish the same action or side effect
o Cross-tolerance: one can be used to withdraw another
Recurrence: new episode of symptoms after having been taken off the medicine for more than 6
months
Relapse: old/original episode coming back less than 6 months after being taken off the medication
Response: 50% improvement in symptoms
Remission: PHQ-9 score of 4 or less (minimal to no depression or anxiety)
Serotonin syndrome: occurs with any drug that increases serotonin (e.g., MAO inhibitors, SSRI’s, SNRI’s)
– hyperthermia, myoclonus, cardiovascular collapse, flushing, diarrhea (serotonin receptors activated in
GI tract), seizures.
Pearls
Anxiety and panic disorders generally respond to serotonergic drugs not norepinephrine ones.
Anti-convulsants/SNRI’s have anti-pain properties (especially chronic pain).
Generic drugs may be "porcelain clangers" (go through patient unabsorbed)
“The dose that got them well, keeps them well.” You typically don’t reduce the dose if they’re doing
well.
Zyprexa and Seroquel: more sedation
Abilify, Geodon: less weight gain, more likely to cause EPS, less sedation
Clozaril/clozapine must get CBCs each week; terrible weight gain; seizures; gold standard for refractory
psychosis with potentially less Tardive Dyskinesia (TD).
Anticholinergic effects in tertiary TCAs
Blind as a bat (blurred vision)
Dry as a bone (dry mouth)
o Remedy: tart substances; sugarless candy/gum or water with unsweetened lemon juice
Red as a beet (flushing)
Mad as a hatter (confusion)
Hot as a hare (hyperthermia)
5. 5
Can’t see (vision changes)
Can’t pee (urinary retention)
Can’t sh*t (constipation)
Toxicities
Typical Antipsychotics/Neuroleptics
o Highly lipid soluble and stored in body fat; thus, very slow to be removed from body
o Extrapyramidal system (EPS) side effects
4 hours: acute dystonia – muscle spasm, stiffness, oculogyric crisis
4 days: akinesia – parkinsonian symptoms
4 weeks: akathisia (restlessness)
4 months: tardive dyskinesia – stereotypic oral-facial movements and twisting/tapping
of the lower extremities due to long-term antipsychotic use; often irreversible
o Endocrine side effects (e.g., dopamine receptor antagonism hyperprolactinemia
galactorrhea)
o Side effects arising from blocking receptors
Muscarinic – dry mouth, constipation
Alpha adrenergic – hypotension
Histamine – sedation
Atypical antipsychotics
o Fewer extrapyramidal/TD side effects than traditional antipsychotics
o olanzapine/clozapine/quetiapine - significant weight gain (insulin resistance and
hyperlipidemia)
o Clozaril/clozapine – agranulocytosis (requires weekly WBC monitoring)
o Geodon/ziprasidone – QTc prolongation
o Seroquel/quetiapine – cataracts
o Risperidal/risperidone – highest risk of all atypicals for developing EPS and hyperprolactinemia