Simplified 1st Line Tx Flashcards
ADHD: 4-6 YO
Parental training and behavioral interventions
ADHD: >6 YO
Stimulant med; methylphenidate preferred
Multi-modal always best. CBT not proven effective in children.
Complicated EtOH withdrawal
Correct electrolytes/fluids; parenteral thiamine
Benzos
Anticonvulsants if needed
Acute EtOH withdrawal (not complicated)
(1st line depends on patient’s needs)
Disulfram (PO every day)
Naltrexone (depot injection, I think?)
Acamprosate (TID)
Cocaine abuse
No FDA approved meds
NA/CA
Rehab
Therapy
Tx comorbid psych conditions
Opioid abuse
Buprenorphine
also, methadone, naltrexone [must be off opioids for several days first]
Post-Acute EtOH withdrawal
CBT
OCD
SSRI - esp Fluvoxamine + CBT
PTSD
SSRI (esp sertraline, fluoxetine, paroxetine)
Prolonged exposure therapy
Cognitive processing therapy
Borderline personality disorder
DBT (more effective than CBT)
Personality disorders other than BPD
CBT (patients often resistant, especially antisocial)
Bipolar: acute mania with psychosis
Mood stabilizer (lithium or valproate) + 2nd gen antipsychotic (risperidone can be given IM and good for angry outbursts)
Or haldol
Benzo if necessary
Bipolar: acute mania, no psychosis
2nd gen antipsychotic such as risperidone
Bipolar: maintenance therapy
Psychotherapy + lithium is first line
Schizophrenia
2nd gen antipsychotic - risperidone preferred