psychopharmacology

SSRIs

N/V, sedation, weigth gain, transitory hair loss, transient increase in LFTs

• cholinesterase inhibitor
• used for mild to moderate Alzheimer's

• cholinesterase inhibitor
• mild to mod Alzheimer's

• cholinesterase inhibitor
• mild to mod Alzheimer's

• *atypical antipsychotic
• *agranulocytosis
• *hypersalivation that can cause aspiration despite anticholinergic activity
• *myocarditis
• only antipsychotic shown to decrease risk of suicide

• Thorazine
• low-potency typical antipsychotic
• orthostatic hypotension
• bluish skin discoloration
• photosensitivity
• can treat N/V and intractable hiccups

retinitis pigmentosa

• higher risk of seizure
• metabolite is an antidepressant
• mid-potency typical neurleptic

• mid-potency typical neurleptic
• can reduce anxiety

midpotency neuroleptic

• high potency neuroleptic
• used for Tourette d/o

*high potency typical neuroleptic

• high potency typical neuroleptic
• associated with heart block, ventricular tachycardia, and other cardiac effects

• atypical antipsychotic
• *prolactinemia
• *orthostatic hypotension and reflex tachycardia

• atypical antipsychotic
• *sedation
• *orthostatic hypotension

• atypical antipsychotic
• weight gain

• atypical antipsychotic
• less likely to cause weight gain

• atypical antipsychotic
• *unique mechanism of partial D2 agonism
• *can be more activating (akathisia) and less sedating
• *less potential for weight gain

• newer atypical antipsychotic
• *metabolite of risperidone

long-acting rejectable form of paliperidone

• (Saphris)
• *atypical antipsychotic

atypical antipsychotic

• QTc prolongation
• liver fxn-monitor LFTs
• metabolic syndrome
• hyperglycemia
• some anti-HAM effects

• atypical antipsychotics
• TCAs(general widening of QRS, QT, and PR intervals avoid in patients with preexisting cardiac disese)

• tx for benzo overdose
• can precipatate seizures in those with pre-existing seizure d/o

• SE
• insomnia is best known
• others- GI distress, HA, decrease appetite, emergence of tics

Haloperidol

• amphetamines
• if cataplexy is present SSRIs and TCAs or antidepressants in general

• Barbituates
• Carbamazepine
• Griseofulvin
• Phenytoin
• Quinidine
• Rifampin (rev up enzyme)
• St. John's Wort

• Protease inhibitors
• Isoniazid
• Cimetidine
• Ketaconazole
• Erythromycin
• Grapefruit Juice
• Sulfonamides

many different treatments but clonidine and beta blockers particularly good for hyperarousal

• dopaminergic via decrease reuptake of dopamine and other stuff
• used for parkinsons
• used for neuroleptic malignant syndrome
• (could also use bromocriptine or dantrolene)

supportive care then consider dantrolene or maybe amatidine or bromocriptine (dopaminergic agents)

• Fluphenazine deconate (2x/month)
• Haloperidol deconate (2x/month)
• Risperidone depot (2x/month)
• Paliperidone depot (1x/month)