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Antipsychotics
Thioridazine (Mellaril), Haloperidol (Haldol), Fluphenazine
(Prolixin), Chlorpromazine (Thorazine), Perphenazine (Trilafon),
Trifluoperazine (Stelazine), Thiothixene (Navane)
Mechanism of Action: Blockade of D2 Receptors
Used for: Schizophrenia, psychosis
Adverse Effects: ExtraPyramidal Syndrome (acute dystonia, akinesia,
akathisia, tardive dyskinesia), sedation, neuroleptic malignant
syndrome (rigidity, autonomic instability, hyperpyrexia)
Atypical Antipsychotics
Clozapine (Clozaril), Olanzapine (Zyprexa), Risperidone (Risperdal), Quetiapine (Seroquel), Aripiprazole (Abilify)
Mechanism of Action: Blockade of 5HT2 (serotonin) and dopamine receptors
Used for: schizophrenia, Obessive Compulsive DO, anxiety, depression
Adverse Effects: fewer ExtraPyramidal Syndrome effects
and anticholinergic effects. Clozapine can cause agraulocytosis (weekly
White Blood Counts need to be drawn for patients on Clozapine)
Mood Stabilizers
Lithium
Mechanism of Action: may inhibit phosphoinositol cascade
Used for: mood stabilization in bipolar
Adverse Effects: Tremor, hypothyroidism, polyuria, teratogenesis. (closely monitor serum levels)
Valproate or Valproic Acid (Depakote)
Mechanism of Action: augment GABA function in CNS by
increasing GABA synthesis, decreasing GABA breakdown, and enhancing
GABA’s postsynaptic efficacy. (GABA is an inhibitory neurotransimitter)
Used for: acute mania, and prophylaxis against mania in bipolar, treat impulse dyscontrol
Adverse Effects: sedation, tremor, ataxia, GastroIntestinal distress, thrombocytopenia and impaired platelet function
Carbamazepine (Tegretol)
Mechanism of Action: unknown, may alter sodium channels
Used for: 2nd line for treatment of mania
Adverse Effects: nausea, rash, mild leucopenia. Levels need to be monitored regularly
Antidepressants
TriCyclicAntidepressants (TCAs)
Imipramine(Tofranil), amitriptyline, desipramine(Norpramin), nortriptyline(Pamelor), clomipramine(Anafranil), doxepin
Mechanism of Action: Blocks reuptake of NE and serotonin
Used for: depression, bedwetting(imipramine), Obsessive Compulsive DO(Clomipramine)
Adverse Effects: sedation, tachycardia, urinary
retention, 3’C’s: Convulsions, Coma, Cardiotoxicity (arrhythmias),
respiratory depression, hyperpyrexia.
Medication
Selective Serotonin Reuptake Inhibitors
Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Fluvoxamine (Luvox), Citalopram (Celexa), Escitalopram (Lexapro)
Mechanism of Action: blocks serotonin reuptake
Used for: Depression
Adverse Effects: anxiety, insomnia, tremor, anorexia,
nausea, and vomiting. Serotonin syndrome if taken with MAOI’s
(Monoamine Oxidase Inhibitors) : hyperthermia, muscle rigidity,
Cardiovascular collapse.
*** takes 2-3 weeks to have effect ***
Monoamine Oxidase Inhibitors (MOIs)
Phenelzine (Nardil), Isocarboxazid, Tranylcypromine (Parnate)
Mechanism of Action: Monoamine oxidase inhibition
Used For: Atypical depression, anxiety,
hypochondriasis, hypertensive crisis if taken with tyramine containing
foods and meperidine, CNS stimulation.
Contraindicated with Selective Serotonin Reuptake Inhibors or
Beta-Agonists.
Heterocyclics
Trazodone (Desyrel): primary serotonin reuptake inhibition.
Adverse Effects: sedation, nausea, priapism, postural hypotension
Bupropion (Wellbutrin)
Mechanism of Action: dopamine and norepinephrine reuptake inhibitor.
Used for: Antidepressant, antianxiety, also for smoking cessation.
Adverse Effects: Tachycardia, agitation, dry mouth, aggravation of psychosis
Venlafaxine (Effexor)
Mechanism of Action: Works by inhibition serotonin and dopamine reuptake.
Used for: Depression and also for generalized anxiety disorder.
Adverse Effects: stimulation, agitation, headache, insomnia
Mirtazapine (Remeron)
Mechanism of Action: Alpha-2-antagonist (increases NE and 5HT release).
Used for: Depression
Adverse Effects: sedation, increased serum cholesterol, increased appetite.
Anxiolytics
Benzodiazepines
Xanax, Librium, Konopin, Valium, Dalmane, Ativan, Serax, Restoril, Halcion
Mechanism of Action: GABA Agonists
Used for: Anxiety, panic, insomnia
Adverse Effects: sedation, possible worsening of agitation, and produce withdrawl symptoms
Buspirone
Mechanism Of Action: 5HT1α receptor agonist, D2 receptor antagonist
Used for: generalized anxiety disorder
Adverse Effects: does not tend to cause sedation, no withdrawl syndrome. Dizziness, nervousness, and nausea
Psychostimulants
Dextroamphetamine (Dexedrine, Dextrostat), Methylphenidate (Ritalin,
Concerta, Methylin, Daytrana Patch), Pemoline (Cylert), Amphetamine
(Adderall), Lisdexamfetamine (Vyvanse)
Mechanism of Action: alteration of CNS function. Facilitates endogenous neurotransimitter release.
Used For: ADHD, Narcolepsy, some forms of Depression
Adverse Effects: tachycardia, insomnia, anxiety, hypertension, and diaphoresis, weight loss. Induces tolerance and psychological dependence.
Nonstimulant Adhd Medications
Atomoxetine HCL(Strattera)
Mechanism of Action: Increases the level of neurotransmitter norepinephrine
Used for: ADHD
Adverse Effects: Abdominal pain, decreased appetite, dizziness, fatigue, headache, mood swings, and nausea and vomiting.