Off Label Prescribing Flashcards
1
Q
Pramipexole
A
- D3 agonist
- Indications: Parkinson’s, restless leg syndrome
- Psychiatric uses: unipolar depression monotherapy/adjunct, bipolar depression adjunct
- D3 in mesolimbic DA tracts associated with rewards/pleasure
2
Q
Pramipexole SE
A
- Nausea
- HA
- Somnolence
- Orthostasis
- Edema
- Rare: psychosis, compulsive/hedonistic behavior, sleep attack, withdrawal related NMS
3
Q
Pregabalin
A
- Alpha 2 delta Ca channel antagonist
- Primary indications: diabetic neuropathy, SCI neuropathy, fibromyalgia, seizure adjunct
- Psychiatric uses: GAD, social anxiety disorder
4
Q
Pregabalin AE
A
- Somnolence
- Dizziness
- HA
- Weight gain
- Abnormal thinking
- Aesthenia
- Amnesia
- Rare: edema, abuse, hypersensitivity, ED
5
Q
GAD + Off-Label Options
A
- Quetiapine
- Lavender oil extract
6
Q
Social Anxiety Disorder + Off-Label Options
A
- Gabapentin
- Pregabalin
7
Q
Prazosin
A
- Alpha 1 antagonist
- Primary indication: hypertension
- Psychiatric use: PTSD augmentation
- Impacts nightmares, avoidance, hyperarousal
- Studied in combination with other therapies, not monotherapy
8
Q
Prazosin AE
A
- Dizziness
- Drowsiness
- HA
- Aesthenia
- Nausea
- Palpitations
- Rare: Edema, orthostasis, syncope, polyuria, constipation, xerostomia
9
Q
Prazosin vs Quetiapine
A
- Prazosin only studied in combination therapy
- Quetiapine studied for monotherapy and combination
- Prazosin can only be used for augmentation while Quetiapine can also be used when standard monotherapy isn’t working
- Prazosin is better tolerated than Quetiapine
10
Q
PTSD + Off-Label Options
A
- Mirtazapine
- Nefazodone
- Amitriptyline
- Imipramine
- Desipramine
11
Q
Lithium
A
- Primary indication: bipolar mania, bipolar mood stabilization
- Other psychiatric uses: augmentation of TCA therapy in major depressive disorder
12
Q
Lithium AE
A
- Nausea
- Diarrhea
- Cognitive dulling
- Tremor
- Drowsiness
- Hypothyroidism
- Renal dysfunction
- DI
- Rare: arrhythmia, seizure, coma, death
13
Q
Liothyronine
A
- Active thyroid hormone
- Primary indication: hypothyroidism, myxedema coma
- Psychiatric uses: augmentation of TCA therapy in major depressive disorder
14
Q
Liothyronine AE
A
- Arrhythmia
- Rare: Tachycardia, hypotension, MI, heart failure, HTN, osteoporosis
15
Q
Other Off-Label Depression Treatments
A
- Eicosapentaenoic Acid
- Modafinil
- Buspirone
- Buprenorphine
