Mental Health Medications

Question 1

SSRIs (Selective Serotonin Reuptake Inhibitor)

Answer 1

• Used for Major Depressive Disorder (MDD), OCD, PTSD, Panic Disorder, Social Anxiety
• Side Effects: Suicidal thoughts, sexual dysfunction, drowsy, indigestion, nausea
• Ex: Sertraline (Zoloft), Citalopram (Celexa), Fluoxetine (Prozac)

*Don’t take with other anti-depressants or St. John’s Wort; leads to Serotonin Syndrome

Question 2

Duloxetine (Cymbalta)

Answer 2

• Used for MDD, neuropathic pain associated with diabetic neuropathy, generalized anxiety, fibromyalgia, chronic low back pain
• Side effects: Anxiety, fatigue, dec weight, headache, abnormal vision, dry mouth

Question 3

Venlafaxine (Effexor)

Answer 3

• Used for preventing or treating major depression (End of Life)
• Side effects: Weakness, dizziness, anxiety, abnormal dreams, weight loss, edema, dyspnea, dry skin

Question 4

Trazodone (Oleptro)

Answer 4

• Used for Depression

- Side effects: drowsy, dizziness, blurred vision, hypotension, tachycardia, urinary retention

Question 5

Bupropion (Wellbutrin)

Answer 5

• Used for Depression, Seasonal Affective Disorder, Substance Abuse, Glaucoma, Smoking, Cardiac Disease, Heart Failure
• Side Effects: Headache, agitation, dizziness, confusion, HTN, palpitations, tachycardia

Question 6

Tricyclic Antidepressants

Answer 6

• Used for insomnia, depression
• side effects: suicidal thoughts, lethargy, sedation, seizures, thrombocytopenia
• Ex: Amitriptyline, Doxepin, Nortriptyline
• Monitor HypoTN, dry mouth
• Notify HCP of urinary retention

Question 7

MAOIs (Monoamine oxidase inhibitors)

Answer 7

• Used for treating depression
• side effects: fatigue, muscle aches, insomnia, high BP, reduced libido
• examples: Phenelzine, isocarboxazid, tranylcypromine
• Monitor for HTN Crisis (BP/HR), hypoglycemia
• Avoid Tyramine Foods (Cured Meat, Aged Cheese, Pickled Herring, Yogurt, Beer/Wine)

Question 8

St John’s Wort

Answer 8

• Herbal Medicine
• Used for depression, menopause symptoms, and Somatic symptom disorder (Severe Anxiety with physical symptoms)
• side effects: Agitation and anxiety, Dizziness, Diarrhea, constipation, stomach discomfort, Dry mouth
• Avoid Alcohol
• Serotonin Syndrome if taken with other anti-depressants

Question 9

Lithium (mood stabilizer)

Answer 9

• Used for Bipolar disorder
• side effects: Incontinence, thirst, hand tremors, unsteady gait
• Therapeutic levels: 0.5-1.5 (0.6-1.2 long term use)
• Inc fluids (2000-3000 mLs/day)
• Don’t decrease salt intake

Question 10

Adjunct Meds for Bipolar Disorder

Answer 10

-Taken with another medication
-Examples:
Anticonvulsants (stable mood/tx mania)
-Carbamazepine, Divalproex Sodium
Antidepressants (tx depression)
-SSRIs, Tricycle meds, MAOIs, Herbal
Antipsychotics (psych, hallucinations, delusions)
-clozapine, risperidone

Question 11

Haloperidol

Answer 11

• antipsychotic medicine used for mental disorders (schizophrenia)
• side effects: drowsiness, headache, insomnia
• Monitor BP, Pulse, WT gain, I/Os
• Report NMS syndrome
• Greatest risk for EPS/tardive dyskinesia symptoms (causes arrhythmias)

Question 12

Clozapine

Answer 12

Antipsych medication

• Used for schizophrenia
• side effects: tachycardia, headache, weight gain, nausea
• Monitor for NMS Syndrome, extrapyramidal symptoms, blood dycrasias
• Monitor wt gain, dry mouth, CNS Effects

Question 13

Adjunct meds for Anti-psychotics

Answer 13

• Used with other medications*
• Benztropine (EPS)
• Anticonvulsants
• Antidepressants
• Benzodiazepines (Helps with Agitation and anxiety)

Question 14

Alcohol

Answer 14

• Chlordiazepoxide: Tx of alcohol withdrawal
  * Routine Schedule
  * Side effects: Lethargy, drowsy, dizzy
  * OD: Flumazeril (used for seizures)
• Lorazepam: Tx of Alcohol withdrawal
  • Caution with elderly
  • Side effects: dizzy, drowsy, lethargy
  • OD: Flumazeril
  • For short term use; if using long term, don’t stop abruptly (will induce seizures)

Question 15

Nicotine

Answer 15

• Nicotine Patch
  
  • Management of smoking cessation
  • Remove at bedtime, rotate site
  • Monitor site for allergies

Question 16

Anti-Anxiety Medications

Answer 16

Alprazolam (Xanax)

• Used for anxiety, panic disorders
• side effects: Insomnia, orthostatic hypotension, blurred vision, dry mouth, wt loss/gain

Diazepam (Valium)

• Used to treat anxiety disorders, alcohol withdrawal symptoms, or muscle spasms and stiffness
• side effects: drowsiness, mood/behavior changes, confusions, hallucinations, worsening depression or anxiety

Lorazepam (Ativan)

• Used to treat anxiety disorders
• side effects: drowsiness, mood changes, behavior changes, confusion, hallucinations, risk of suicide