Psychiatric Medications

Question 1

Chlordiazepoxide

Answer 1

1) Brand name: librium
2) Dose range: 10-100mg/day
3) Onset of Effect: Intermediate
4) Elimination Half-life: >100 hours
5) Active Metabolite N-desmethyldiazepam
6) Chlordiazepoxide and diazepam are commonly used for alcohol withdrawal because of their long half-life. Dosing may be fixed according to a tapering schedule of individualized according to the patient’s symptoms.

Question 2

Paroxetine

Answer 2

1) Starting dose 10mg for anxiety disorders
2) Alway taper because of significant anticholinergic rebound
3) Prominant AEs: Sedations, weight gain
4) Other AE’s: increased appetie, nausea, delayed ejaculation, diarrhea
5) FDA approved for GAD, panic disorder, PTSD, OCD and Social anxiety disorder
6) Brand name: Paxil
7) Dose range: 10-50mg
8) Paxil CR: 25-62.5mg
9) Inhibitor: 2D6* 3A4*
10) Substrate: 2D6
11) Can increase serum concentration s of metoprolol, haloperidol, risperidone and tamoxifen.
12) May inhibit the conversion of tramadol and hydrocodone to active metabolites and reduce efficacy
13) Category D in pregnancy, related to cardiovascular abnormalities
14) minimal concentration in breast milik