By dr.safeyya alchalabi Psychotropic drugs By dr.safeyya alchalabi

Psychotropic drugs Mood stabilizers Anxiolytic (antipsychotic) depressants Anxiolytic Neuroleptics (antipsychotic) Mood stabilizers

Antidepressants Monoamine oxidize Inhibitors MAOIs Tricyclic Antidepressant TCAs Selective Serotonin Reuptake Inhibitors SSRIs Selective Norepinephrine Reuptake Inhibitors SNRIs Dual Action Antidepressants Atypical antidepressant Mood Stabilizers

orthostatic hypotension TCA antihistaminic sedation weight gain anticholinergic dry mouth dry eyes constipation memory deficits urinary retention antiadrenergic orthostatic hypotension sexual dysfunction cardiotoxicity QT lengthening Side effect

orthostatic hypotension MAOI orthostatic hypotension weight gain dry mouth sedation sexual dysfunction sleep disturbance Hypertensive crisis Serotonin Syndrome Side effect

SSRI Side effect GI upset anxiety restlessness insomnia fatigue sexual dysfunction anxiety restlessness nervousness insomnia fatigue dizziness discontinuation syndrome

SSRI Fluoxetine Sertraline Paroxetine Paxil Fluvoxamine Citalopram Prozac Fluoxetine Zoloft Sertraline Paxil Paroxetine Luvo Fluvoxamine Celexa Citalopram Lexapro Escitalopram

Mood Stabilizers Indications Classes Lithium, anticonvulsants, Bipolar cyclothymia schizoaffective impulse control intermittent explosive disorders Lithium, anticonvulsants, antipsychotics Classes

lithium Only medication to reduce suicide rate. Rate of completed suicide in BAD ~15% Effective in long-term prophylaxis of both mania and depressive episodes in 70+% of BAD I pts Factors predicting positive response to lithium Prior long-term response or family member with good response Classic pure mania Mania is followed by depression

lithium baseline creatinine, TSH CBC In women check a pregnancy test Before starting get baseline creatinine, TSH CBC In women check a pregnancy test

lithium Steady state achieved after 5 days- Monitoring: Steady state achieved after 5 days- check 12 hours after last dose, once stable check 3 months TSH and creatinine 6 months.

Lithium side effects Most common are GI distress including reduced appetite, nausea/vomiting, diarrhea Thyroid abnormalities Non significant leukocytosis Polyuria/polydypsia secondary to ADH antagonism. In a small number of patients can cause interstitial renal fibrosis. Hair loss, acne Reduces seizure threshold, cognitive slowing, intention tremor

Lithium toxicity Mild- levels 1.5-2.0 see vomiting, diarrhea, ataxia, dizziness, slurred speech, nystagmus. Moderate-2.0-2.5 nausea, vomiting, anorexia, blurred vision, clonic limb movements, convulsions, delirium, syncope Severe- >2.5 generalized convulsions, oliguria and renal failure