Most popular ones:
All addictive. For short term use only. DO NOT STOP ABRUPTLY, patients must be weaned off these meds or they will have SEIZURES.
This med does NOT give the tranquilizer effect that the benzodiazepines do.
BuSpar’s action is unknown.
*Takes 2 weeks to take effect
*Side effects are slurred speech and dizziness
PROPRANOLOL (Inderal) (common one)
*Typically used to treat heart conditions and hypertension, but sometimes used to control “performance anxiety”
CHECK PATIENT’S BP and PULSE before administering
*6-8 weeks to take effect, continued for 6-12 months (or more)
THREE main groups of antidepressants:
2.Monoamine Oxidase Inhibitors (MAOIs) MY FAVE!!!!!!!!!
3.Selective Serotonin reuptake inhibitors (SSRIs)
* SIDE EFFECTS: anticholinergic in nature (dry mouth, constipation), blurred vision, dizziness, drowsiness, tachycardia, dysrhythmias, hypotension, increased suicide risks the first few weeks of therapy
Side effects: anticholinergic effects, dry mouth, orthostatic hypotension, headache
DO NOT TAKE THESE MEDS WITH NASAL DECONGESTANTS or with FOOD CONTAINING high levels of TYRAMINE (a precursor to norepinephrine)
AVOID THESE FOODS: AGED CHEESE, AVACADOS, YOGURT, SOUR CREAM, CHICKEN & BEEF LIVERS (DAMMIT!), pickled herring, corned beef, bean pods, bananas, raisins, figs, smoked & processed meat, yeast supplements, chocolate (NOOOOOOOOO!), MSG, soy sauce, beer, red wines, & caffeine (depressed just reading these!)
Hypertensive crisis & DEATH can occur if patient cosumes these foods. Signs: stiff neck, nausea, vomiting
When this med is stopped, wait @ WEEKS before starting any new meds.
Side effects: excitation, n & v, decreased libido, anorexia & weight loss, increased suicide risk first few weeks of therapy
Side Effects: anxiety, abnormal dreams, dizziness, nervousness
Used to treat bipolar, psychoses, agitation, schizophrenia
****They block DOPAMINE RECEPTORS in the brain (which are the immediate precursors to norepinephrine). These affect neurotransmitters that allow for communication between nerve cells.
Adverse reactions: hypotension, dizziness, fainting, dry mouth, possible impotence in men, photosensitivity, blood dyscrasias (abnormal values)
THERE ARE MORE ADVERSE REACTIONS! SEE NEXT CARD!
1. Dystonia: difficult or bad muscle tone in head & neck, swallowing problems, tongue sticks out
2.Akathisia- inability to sit down. restlessness.
3. Pseudo-Parkinsonism: side effects like tremors & “stiff face” that resemble Parkinson’s disease. Occur a few weeks to a few months after therapy. May be controlled by anti-Parkinsonism med.
4.Tardive Dyskinesia: rhythimical, involuntary movements of tongue, face, mouth, jaw, trunk, extremities. No effective tratment.
5.NEUROLEPTIC MALIGNANT SYNDROME (NMS): uncommon reaction to neuroleptics, but could cause death. Muscle rigidity, hyperpyrexia (fever), fluctuations in BP, altered or loss of consciousness. NEEDS IMMEDIATE MEDICAL CARE!
clozapine (Clozaril) (lowers WBC count (agranulocytosis), monitor blood work every 1-2 weeks)
used for bipolar disorder, calms patient in manic phase
Controls flight of ideas, restlessness, etc
LITIUM IS A SALT, maintain a diet with NORMAL sodium intake, restricting sodium INCREASES Litium toxicity. Have patients monitor selves for edema, regular weights!
Side effects: Thirst, nausea, vomiting, hair loss, tremors, weight gain, hypothyroidism
NARROW THERAPEUTIC RANGE INCREASES LIKELIHOOD OF TOXICITY!
******THERAPEUTIC RANGE OF LITHIUM: .5-1.5 mEq/L******
Valporic Acid (Depakote)
Side effects: nausea, vomiting, indigestion, drowsiness, dizziness, prolonged bleeding, headache, confusion
These meds should NOT be stopped abruptly
These patients should avoid ETOH (ALCOHOL!)
Therapeutic Blood Levels:
+Tegretol: 6-12 mcg/ml
+Depakene & Depakote: 50-100 mcg/ml
Side effects: increased or irregular heart rate, hypertension, hyperactivity, dry mouth, hand tremor, rapid speech, diaphoresis, confusion, depression, seizures, suicidal ideation, insomnia
DO NOT GIVE TO PATIENTS WITH ALCOHOLISM, MANIA or display suicidal or homicidal thoughts
DO NOT USE with heart disease or glaucoma
MAY impair judgement, drive with caution
DO NOT USE with MAOIs ( may cause hypertensive crisis)
Take at least 6 hours before sleep to avoid sleep disturbances