Here are some notes on psychiatric medications that the NCLEX often asks about as well as some useful info.

For many of the psychiatric medications, the following apply:

a) There may be an adverse and unexpected psychological response. Mental health should be monitored carefully.

b) With many psychiatric medications, particularly antidepressants, there is an increased risk of suicidal thoughts or worsened depression, especially in those under 25.

c) Sudden stopping may result in withdrawal.

d) Full benefit can take a matter of weeks.

Also useful: cardiovascular medications.

Alprazolam (Xanax)

Condition(s): Anxiety, various psychiatric - GABA
Side Effects: Drowsiness, difficulty concentrating, dry mouth
Note: Potentially habit forming, gradual withdrawal, sudden discontinuation can cause serious side effects, possible psychiatric response not rec. pregnancy or breast-feeding, benzodiazepine

Amitriptyline (Elavil)

Condition(s): Depression, various psychiatric - Tricyclic
Side Effects: Nausea, weakness, drowsiness
Note: Tricyclic, may cause suicidal thoughts under 25, monitor mental health with use, may take weeks to achieve full effect, may cause withdrawal, cardiac arrhythmia potential, overdose potentially fatal

Clozapine

Condition(s): Schizophrenia, various psychiatric - dopamine blocker
Side Effects: Sedation, tremor, drooling, constipation
Note: May cause low white blood cell count, seizures, myocarditis, drop blood pressure. May have higher risk when used in elderly with dementia. May take weeks for full effect. Blood sugar rise uncommon, may cause movement disorder (more...)

Cogentin

Condition(s): Tremors, Parkinson's Disease - Anticholinergic
Side Effects: Are somewhat common, drowsiness, dry mouth, constipation
Note: Some food interactions, take at least 1 hour before antacids, rarely habit forming, may take few days for effect, may make sunlight sensitive, used to counter side effects of several psychiatric medications

Dexedrine

Condition(s): ADHD - stimulant
Side Effects: Headache, abdominal pain, initial heart rate increase
Note: Schedule II, no automatic refills, may be habit forming, contraindicated by anxiety and psychosis, certain heart disease, and glaucoma, is preg cat C, off label depression, weight loss

Diazepam (Valium)

Condition(s): Anxiety, various psychiatric, seizures - GABA
Side Effects: Drowsiness, difficulty concentrating, dry mouth
Note: Potentially habit forming, gradual withdrawal, sudden discontinuation can cause serious side effects, possible psychiatric response, not rec. pregnancy or breast-feeding, benzodiazepine

Fluoxetine (Prozac)

Condition(s): Depression, various mental health - SSRI
Side Effects: Increased risk of suicidal thinking in under 25, Sexual effects, nausea, dizziness, insomnia
Note: 3-6 weeks to achieve full effect, monitor for mental side effects initial use, may have alcohol interaction, use during pregnancy may cause issues, MAO and other interaction

Haldol

Condition(s): Schizophrenia, various psychiatric - Dopamine blocker
Side Effects: Nausea, Agitation, sedation, weight gain
Note: Potential concerns: Elderly with dementia may have higher risk for serious side effects, effect on baby/withdrawal, feeling of restlessness, potential NMS, long term use possible movement disorder, may inc. prolactin, diabetes blood sugar (more..)

Lithium

Condition(s): Bipolar, various psychiatric
Side Effects: Diarrhea, nausea, muscle weakness
Note: Mood stabilizer, very narrow therapeutic range, monitor labs carefully, may take 1-3 weeks for full effect, frequent testing at first to achieve target levels, stopping suddenly not recommended

Methylphenidate (Ritalin)

Condition(s): ADHD - stimulant
Side Effects: Headache, abdominal pain, initial heart rate increase
Note: Schedule II, no automatic refills, may be habit forming, is contraindicated by anxiety and psychosis, certain heart disease, and glaucoma, is preg cat C, monitor mental health, off-label depression use

Mixed amphetamine (Adderall)

Condition(s): ADHD - stimulant
Side Effects: Headache, abdominal pain, initial heart rate increase
Note: Schedule II, no automatic refills, may be habit forming, is contraindicated by anxiety and psychosis, certain heart disease, and glaucoma, is preg cat C, monitor mental health, off-label depression use

Phenobarbital

Condition(s): Anti-seizure, Anxiety - GABA
Side Effects: Dizziness, headache, nausea, uncommon mental health/mood
Note: May be habit forming, prefer to limit anxiety use, can cause withdrawal, alcohol interaction, possible different effect elderly/young, barbiturate

Risperidone

Condition(s): Schizophrenia, various psychiatric - Dopamine blocker
Side Effects: Nausea, Agitation, sedation, weight gain
Note: Elderly with dementia may have higher risk for serious side effects, may have effect on baby/withdrawal, may cause feeling of restlessness, long term use may cause movement disorder, may inc. prolactin, diabetes blood sugar (more..)

Tranylcypromine (Parnate)

Condition(s): Depression, various psychiatric - MAOI
Side Effects: Dry mouth, constipation, insomnia
Note: May cause suicidal thoughts under 25, monitor mental health with use, may take weeks to achieve full effect, may cause withdrawal, tyramine interaction, hypertensive crisis pot.

Others:

  • Aripiprazole
  • Quetiapine
  • Sertraline
  • More...

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