Drugs & Doses: Mental Health

Question 1

Pharmacological Options for Depression/Anxiety - Options + Dosing of Each.

Answer 1

SSRI - escitalopram 10mg PO mane up to 20mg PO mane/sertraline 50mg PO mane up to max 150/200mg daily

SNRI - e.g venlafaxine CR 75mg (not for OCD)

Mirtazepine - 15-30mg nocte (good for elderly who need to eat more)

Question 2

Which two medications have the lowest transmission in breast milk?
Whieh three medications have the highest transmission in breast milk?

Answer 2

Sertraline + paroxetine lowest transmission in breast milk

Fluoxetine, Escitalopram, Citalopram highest

Question 3

Pharmacological Options for OCD

Answer 3

First Line - Fluvoxamine/Sertraline

2nd Line - Clomipramine

Question 4

Pharmacological Option for Bulimia + Dosing

Answer 4

Fluoxetine 20-60mg daily

Question 5

Pharmacological Options for ADHD

Answer 5

1. Methyphenidate (Ritalin) Fast + Concerta (Slow)
2. Dexamphetamine

Question 6

Pharmacological Management of Non-Generalised Social Anxiety Disorder - Medication + Dosing

Answer 6

Propranolol 10-40mg, 30-60mins prior to event

Question 7

Pharmacological Management of Bipolar Depression

Answer 7

SSRI PLUS prophylaxis of BPD (lithium, olanzapine, risperidone, quetiapine)

Question 8

Management Options of Bipolar Depression in Pregnancy.

Answer 8

1. Lamotrigine
2. Quetiapine + Risperidone.
3. Lithium if above fails, risk of cardiac defects most in weeks 3-8

Question 9

Pharmacological Options for Management of Acute Mania

Answer 9

Olanzapine, risperidone, haloperidol

Question 10

How to manage hyperprolactinaemia secondary to antipsychotic?

Answer 10

1. Decrease Dose/Change
2. Add Dopamine agonist - bromocriptine or cabergoline
3. Add small dose aripiprazole - with specialist input