Psych Flashcards
Which benzodiazepines enhance which amino neurotransmitter?
Gaba, decreases neuronal excitement
How to prescribe Buspar. Used in what treatments?
Buspirone (Buspar) is used primarily for Generalized Anxiety Disorder (GAD).
Initial dose: 7.5 mg twice daily
Titrate: In increments of 5 mg every 2–3 days
Usual dose range: 20–30 mg/day in divided doses
Max dose: 60 mg/day
Non-controlled substances for treatment of insomnia
Trazodone
Ramelteon
Hydroxyzine
Melatonin
How frequently do you dose Buspar versus similar medications due to its shorter half-life?
Due to its short half-life (approx. 2–3 hours), Buspar is typically dosed 2–3 times daily, unlike SSRIs/SNRIs which are often once daily.
controlled substances for treatment of insomnia
Zolpidem (Ambien)
Eszopiclone (Lunesta)
Sonata
Temazepam
Triazolam
Common side effects for stimulants used to treat ADD and ADHD
Decreased appetite
Insomnia
Anxiety
Elevated heart rate/BP
Irritability
Tics
Weight loss
Which stimulants are used for ADD and ADHD in adults specifically?
Methylphenidate (Ritalin, Concerta)
Amphetamine salts (Adderall, Vyvanse), dexmethyphenidate (focalin)
Which non-stimulants are used for ADD and ADHD in adults specifically?
Atomoxetine (Strattera)
Bupropion (Wellbutrin)
Guanfacine (Intuniv)
Clonidine (Kapvay)
Which receptors are blocked for atypical antipsychotics
D2 (dopamine) receptors & serotonin (5HT2A) receptor
In atypical antipsychotic use, which lab value increases?
Glucose, triglycerides, cholesterol LDL, prolactin (esp risperidone and palperidone) liver enzymes AST/alt
Monitor for metabolic syndrome
What is the half-life of Ativan (lorazepam)
~12 hours
10-20 hours
What is the half-life of Alprazolam (Xanax)
6-12 hours
What is the half-life of Clonazepam (Klonopin)
~18–50 hours
What is the half-life of Valium (Diazepam)
~30–60 hours (plus active metabolites)
Which medications cause sexual dysfunction as a side effect
SSRIs (e.g., fluoxetine, sertraline)
SNRIs (e.g., venlafaxine, duloxetine)
TCAs
Which medication is indicated in depression and fibromyalgia?
Duloxetine (Cymbalta) — an SNRI.
What is the SSRI FDA safety warning?
Increased risk of suicidality in children, adolescents, and young adults (up to age 24), especially in the first few weeks of treatment.
What are the common side effects in SSRIs?
GI upset
Headache
Insomnia or sedation
Sexual dysfunction
Weight changes
Agitation
SI risk in youth
What are the common side effects in Tricyclic antidepressants
Anticholinergic effects (dry mouth, constipation, urinary retention)
Sedation
Weight gain
Orthostatic hypotension
Cardiac arrhythmias (QT prolongation)
What are the common side effects in SNRIs?
Hypertension (especially with venlafaxine)
Insomnia
Nausea
Dry mouth
Sex dysfxn
What are the common side effects in Norepinephrine Dopamine Reuptake Inhibitors (Wellbutrin)?
Insomnia
Dry mouth
Weight loss
Seizure risk at high dose
Anxiety or agitation
Less sexual dysfunction (advantage)
What patient history questions do you need to ask when starting Wellbutrin?
History of seizures or seizure disorder
Eating disorders (e.g., bulimia, anorexia)
Alcohol use disorder
Head trauma history
Concurrent MAOI use
Abrupt discontinuation of alcohol or sedatives
What is the best treatment for GAD and Depression?
First-line: SSRIs or SNRIs
Examples:
Sertraline (Zoloft)
Escitalopram (Lexapro)
Duloxetine (Cymbalta)
Venlafaxine (Effexor XR)
