Medications

Only treats positive symptoms of schizophrenia, no therapeutic effect on the negative symptoms

most common side effects are the extrapyramidal side effects

• Akathisia
• Akinesia
• Dystonias
• Pseudo-parkinsonism
• Tardive dyskinesia
• Neuroleptic malignant syndrome

*anticholinergics are used to prevent/manage these symptoms

Motor restlessness, inability to remain still

can also occur as a subjective feeling

treated by beta blockers or benzodiazepines

Absence of movement or difficulty with movement

Muscle spasms

spastic movements of the neck and back

treated by antihistamines

• shuffling and slow gait
• mask-like facial expression
• tremors
• pill-rolling movements of the hands
• stooping posture
• rigidity

treated by anti-parkinsonism meds (anticholinergics) and dopamine

• involuntary and abnormal movements of the mouth, tongue, face, and jaw
• may progress to the limbs
• irreversible condition
• may occur in months after antipsychotic medication use

a potentially lethal side effect of antipsychotic medication that requires emergency treatment

• manifested symptoms include:
• -hyperthermia
• -muscle rigidity
• -tremors
• -altered consciousness
• -tachycardia
• -hypertension
• -incontinence

• -effective in treating the positive and negative symptoms of schizophrenia
• -minimal to no risk of EPS
• -decreased risk for tardive dyskinesia
• -often chosen as a first line of treatment for schizophrenia
• -can cause weight gain
• -can cause metabolic abnormalities that increase risk for cardiac conditions and diabetes mellitus

• Lithium
• Anticonvulsants

• drug of choice for controlling manic episodes in clients with bipolar disorder
• instruct pt to maintain constant sodium intake; Na depletion will decrease renal excretion of lithium, which will cause the drug to accumulate and lead to lithium toxicity
• serum lithium must be monitored frequently because the therapeutic levels and the toxic levels are very close
• in clients with mania, lithium reduces euphoria, hyperactivity, and other symptoms but does not cause sedation
• Antimanic effects are usually seen 5-7 days after initial doses, although the full effect does not occur for 2-3 weeks
• when used with benzodiazepine it will cause sedation
• when used with antipsychotic meds short term it will rapidly decrease psychoses symptoms
• ADVERSE EFFECTS:
• -fine hand tremors
• -GI upset
• -polydipsia
• -muscle weakness (myasthenia)

• TOXICITY:
• -coarse hand tremors
• -persistent GI upset-confusion
• -hyperirritabilty of muscles
• -ECG changes
• -sedation
• -incoordination

• Valproic acid (Depakote)
• Carbamazepine (Tegretol)
• Lamotrigine (Lamictal)

Depakote has become a first line of treatment for bipolar disorder, but it can cause hepatotoxicity and thrombocytopenia (risk of bleeding)

Carbamazepine can cause agranulocytosis with increased risk of infection

Lamictal can cause Stevens-Johnson sydrome

• Tricyclic antidepressants (TCAs)
• Monoamine oxidase inhibitors (MAOIs)
• Selective serotonin reuptake inhibitors (SSRIs)
• Atypical antidepressants

• blocks norepinephrine and serotonin reuptake, therefore intensifying their effects
• can elevate mood, increase activity and alertness, decrease a client's preoccupation with morbidity, improve appetite, and regulate sleep patterns
• effects seen 1-3 weeks after initial dose, but maximum effects occur after 6-8 weeks

• -first-line of treatment for depression
• -effective for OCD treatment
• -fewer side effects than TCAs and MAOIs and works faster
• -effects can be seen after 1-3 weeks
• -DOES NOT cause hypotension, sedation, or anticholinergic effects (like TCAs)

• Side Effects:
• -nausea
• -insomnia
• -sexual dysfunction-serotonin syndrome

• •Monoamines: a type of organic compound, including the neurotransmitters norepinephrine, epinephrine, dopamine, and serotonin and many different drugs and food substances
• •Monoamine oxidase (MAO): an enzyme that destroys monoamines
• •Monoamine oxidase inhibitors (MAOIs): drugs that prevent the destruction of monoamines by inhibiting the action of MAO

• used as a 2nd or 3rd choice to treat major depression
• has some very dangerous side effects, pts need to avoid certain foods (ex: dairy, alcohol, etc) and drugs (cold remedies, other antidepressants, etc)

Hypertensive crisis can occur when pt ingests tyramine-rich foods

• orthostatic hypotension
• sedation
• cardiac toxicity
• seizures
• hypomania
• sexual dysfunction
• hypertensive crisis from dietary tyramine (MAOIs)
• drug interactions
• anticholinergic effects:
• -dry mouth
• -blurry vision
• -constipation
• -urinary retention
• -tachycardia

• SSRIs (first choice treatment)
• TCAs
• Beta adrenergic blockers
• Antihistamines
• Antiepileptics
• Buspar

overactivation of the central serotonin receptors, caused by either too high a dose or interaction with other drugs.

• SIDE EFFECTS:
• -abdominal pain
• -diarrhea
• -sweating
• -fever
• -tachycardia
• -elevated blood pressure
• -altered mental state (delirium)
• -myoclonus (muscle spasms)
• -increased motor activity
• -irritability
• -hostility
• -mood change

• Severe manifestation can induce:
• -hyperpyrexia (excessively high fever)
• -cardiovascular shock
• -death

• -increases effectiveness of GABA
• -few drug interactions
• -anti-anxiety
• -may reduce REM sleep

• SIDE EFFECTS:
• -ataxia
• -drowsiness
• -impaired cognition, memory, and coordination

• SEVERE EFFECTS:
• -sedation and death may occur when alcohol and benzodiazepines are used together

• WITHDRAWAL SYMPTOMS:
• -difficulty concentrating
• -fatigue
• -irritability
• -insomnia
• -muscle aches
• -sweating
• -tremors

• -serotonin partial agonist used in short-term treatment of anxiety
• -side effects rarely occur and generally decrease over time as the body adapts to the medication
• -does not induce immediate calming effect

• SIDE EFFECTS:
• -dizziness
• -drowsiness
• -headache
• -nausea
• -nervousness
• -lightheadedness
• -excitement

• -calming effect on the CNS
• -effective in treatment of physical symptoms of anxiety, such as tremors and tachycardia

• -sedative effects
• -used to treat lower levels of anxiety
• -anticholinergic side effects (blurry vision, urinary hesitancy, etc)