Psych Review Rx Flashcards
Classes of Medications
Antidepressants
Anxiolytics
Antipsychotics
Mood Stabilizers
Stimulants
Dementia Medications
Classes of Antidepressants
Selective Serotonin Reuptake Inhibitor (SSRI)
Serotonin Norepinephrine Reuptake Inhibitor (SNRI)
Tricyclic Antidepressants (TCA)
Dopamine
Other
MAOI
SSRIs
Special Considerations
Fluoxetine (Prozac) - PMDD - Longest Half Life Sertraline (Zoloft) - *OCD (high doses) Citalopram (Celexa) Escitalopram (Lexapro) Paroxetine (Paxil) - Weight gain more likely - Discontinuation syndrome likely - Teratogenic Fluvoxamine (Luvox) - Shortest Half life
SNRIs
Venlafaxine (Effexor)
Desvenlafaxine (Pristiq)
Duloxetine (Cymbalta)
Milnacipran (Savella)
Levomilnacipran (Fetzima)
Appropriate Diagnosis
SNRI
Major Depressive Disorder
Anxiety Disorders
Adjustment Disorder
Neuropathic Pain
SNRIs
Special Considerations
Venlafaxine (Effexor)
- Withdrawal Syndrome
- Hypertension
- Hyperkalemia
Desvenlafaxine (Pristiq)
Duloxetine (Cymbalta)
- Diabetic Peripheral Neuropathy
- Fibromyalgia
- Musculoskeletal pain
- Osteoarthritis
Milnacipran
- Fibromyalgia
Levomilnacipran
- Major Depressive Disorder
TCA’s
Amitriptyline Amoxapine Clomipramine Desipramine Doxepin Imipramine Nortriptyline
Appropriate Diagnosis
SNRI
Major Depressive Disorder
Obsessive Compulsive Disorder
Anxiety Disorders
TCA Special Considerations
Amitriptyline
- Sleep
- Migraines
Amoxapine
Clomipramine
- OCD
Desipramine
Doxepin
- Puritis
Imipramine
- Enuresis
Nortriptyline
Dopamine Acting Antidepressants
Bupropion (Wellbutrin)
Appropriate Diagnosis
Bupropion
Major Depressive Disorder
Nicotine Addiction*
Bipolar Depression
Sexual Dysfunction*
Adult ADHD
Bupropion Special Considerations
Avoid in seizure disorder
Avoid in eating disorders
Can add to other serotonergic antidepressants
Also has action on norepinephrine
Not associated with weight gain
Helpful to treat multiple problems at once
Other Antidepressants
Mirtazapine (Remeron)
Trazodone (Deseryl)
Appropriate Diagnosis
Other Antidepressants
Major Depressive Disorder
Anxiety Disorders
Insomnia
Other Antidepressants Special Considerations
Mirtazapine
- Appetite Stimulant
- Antiemetic
- More sedating at lower doses
Trazodone
- At doses required for depression, very sedating
- Priapism
MAOI
MAOI is never the answer
Classes of Anxiolytics
Antidepressants
Benzodiazepines
Beta-blockers
Propranolol (Non-selective)
Antihistamines
Hydroxyzine (Non-addictive)
Other
Buspirone
Benzodiazepines
Diazepam (Valium) Lorazepam (Ativan) Clonazepam (Klonopin) Alprazolam (Xanax) Chlordiazepoxide (Librium) Oxazepam (Serax) Temazepam (Restoril) Midazolam (Versed) Triazolam (Halcion)
Benzodiazepines Special Considerations
Clonazepam
- Longest half life
- Best for long term prophylaxis
Alprazolam
- Best for infrequent prn use
- Addicting
REVERSAL AGENT: Flumazenil
Chlordiazepoxide
- Etoh Withdrawal
- Liver impairment
Midazolam
- No Clinical psychiatric use
- Shortest half life
Classes of Antipsychotics
1st Generation (Typical)
2nd Generation (Atypical)
1st Generation Antipsychotics
*Chlorpromazine (Thorazine)
*Haloperidol (Haldol)
Thioridazine (Mellaril)
Fluphenazine (Prolixin)
Trifluoperazine (Stelazine)
Thiothixene (Navane)
Perphenazine (Trilafon)
Loxapine (Loxitane)
Pimozide (Orap)
Appropriate Diagnosis
1st Generation Antipsychotics
Schizophrenia
Schizoaffective Disorder
Substance Induced Psychosis
Brief Psychotic Disorder
Psychotic Agitation
BEST for Positive Symptoms
2nd Generation Antipsychotics
Aripiprazole (Abilify) Clozapine (Clozaril) Lurasidone (Latuda) Paliperidone (Invega) Olanzapine (Zyprexa) Quetiapine (Seroquel) Risperidone (Risperdal) Ziprasidone (Geodon)
Appropriate Diagnosis
2nd Generation Antipsychotics
Schizophrenia
Schizoaffective Disorder
Substance Induced Psychosis
Mood Stabilizer (mania and depression)
Brief Psychotic Disorder
Psychotic Agitation
Second Generation AntipsychoticsSpecial Considerations
Clozapine (Clozaril)
- Agranulocystois
Risperidone (Risperdal)
- Gynocomastia
- Galactorhea
Olanzapine (Zyprexa)
- Weight Gain/Sedation
Best for Negative Symptoms
Quetiapine (Seroquel) - Sedation Ziprasidone (Geodon) - Weight Neutral - QT Prolongation
Aripiprazole (Abilify)
- Akesthesia
Antipsychotics Side Effects
1st Generation
- Neurologic
= Tardive Dyskinesia, Dystonia etc.
= Often Use Benztropine for side effects
2nd Generation
- Metabolic
= Weight gain, Diabetes, Hypertension, Hyperlipidemia
Mood Stabilizers
Lithium
Lamotrigine
Valproic Acid
Carbamazepine
Mood Stabilizers Special Considerations
Lithium
- Renal Impairment
- Interactions
Valproic Acid
- Weight Gain
- Hepatotoxicity
- Teratogenic
Lamotragine
- Stevens-Johnson Syndrome
Carbamazepine
- Agranulyocytosis
- Induces own metabolism
Appropriate Diagnosis
Mood Stabalizers
Bipolar Disorders
Sedatives
Zolpidem (Ambien)
Zaleplon (Sonata)
Ramelteon (Rozerem)
Eszopiclone (Lunesta)
Appropriate Diagnosis
Sedatives
Insomnia
Sedatives Special Considerations
Zolpidem
- Odd Behaviors
- Addictive
Ramelteon
- Melatonin based
Stimulants
Amphetamine (Adderall)
Modafinil (Provigil)
Dextroamphetamine (Dexedrine)
Methylphenidate (Ritalin, Concerta)
Dexmethylphenidate (Focalin)
Lisdexamfetamine (Vyvanse)
Atomoxetine (Strattera)
Appropriate Diagnosis
Stimulants
ADHD
Narcolepsy
Stimulants Special Considerations
Amphetamine
- Addictive
- Stunts Growth
Modafinil
- Addictive
- Nacrolepsy
Atomoxetine
- Not Addictive
Neurocognitive Agents
Donepezil
(Aricept)
Rivastigmine
(Exelon)
Memantine
(Namenda)
Galantamine
(Razadyne)
Appropriate Diagnosis
Neurocognitive Agents
Dementia
Mild Cognitive Impairment
Neurocognitive Agents Special Considerations
Does not reverse, slows progression
