Mental Health Drugs_Contra-indications/Side effects/withdrawal Flashcards
Benzodiazepines abrupt withdrawal safe?
If physical dependence exists then abrupt withdrawal may result in benzodiazepine withdrawal
Lithium Contra-Indications?
Addison's disease Cardiac insufficiency Dehydration Family/personal history of brugada's syndrome Low sodium diet Rhythm disorder Untreated hypothyroidism
Abrupt withdrawal of Lithium?
Not recommended
If lithium is to be discontinued, the dose should be reduced gradually over a period of at least 4 weeks (preferably over a period of up to 3 months).
If stopped abruptly consider switch to antipsychotic or valproate
Benzodiazepines Contra-Indications?
Acute pulmonary insufficieny
Marked Neuromuscular weakness
Sleep apnoea Syndrome
Unstable myasthenia Gravis
Not for use alone to treat chronic psychoses
Not for use alone to treat chronic depression (or associated anxiety)
Respiratory Depression
Abrupt withdrawal of Fluoxetine?
Not recommended
Clozapine Abrupt withdrawal?
Not recommended
On planned withdrawal reduce dose over 1-2 weeks to avoid risk of rebound psychosis
SSRI Common Side effects BNF
Abdo pain constipation diarrhoea GI effects Nausea Vomiting
Benzodiazepines Side effects?
Amnesia Ataxia Confusion Dependence Drowsiness next day lightheadedness next day Muscle weakness Paradoxical increase in aggression
Fluoxetine Contra-Indication
Poor controlled epilepsy
Patients in manic phase
Clozapine Contra-indications
Alcohol and Drug Psychosis Bone Marrow disorders Coma History of Agranulocytosis History of circulatory collapse History of neutropenia Paralytic Ileus Severe Cardiac Disorders Severe CNS depression Uncontrolled Epilepsy
Clozapine Side effects?
Anorexia; constipation; hypersalivation; malaise; speech disorders; urinary incontinence
Fluoxetine Very Common Side effects - medicines.org
Sleep problems Headache nausea diarrhoea tiredness
Fluoxetine Common side effects - medicines.org
anorexia weight loss akathisia decreased libido/erectile dysfunction Sleep disturbances diaphoresis tremor rapid/irregular heartbeat flushing