Psychopharm comps
Terms
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- Mania-Drugs to treat
- Lithium (ESkalith) gold standard, also Depakot and tegratol (Carbamazide) (neurontin, , lamictol-not on terms)
- Lithium toxicity
- Ed close to LD.Need blood monitoring. dose tapered off as Mania decraeses, because metabolism decreases
- LI+ Side effects
-
1.Serious and dangerous- Thirst and polyurea-may indicate intoxication
2.Disturbing but not dangerous: Weight gain, fatigue, dry mouth, tremor (most disturbing) swoleen ankles, cog. effects - Tegratol and depakot were what before they were mood stabilizers?
- Anti SZ. meds, they also have a little antidepressant effect
- Zyprexa and ,mania
- works well according to Rickles, problem is a huge appetite and weight gain, normally a novel antipsychotic
- Antipsychotics, Traditional
- Thorazine, haldol, mellaril
- Antipsychotics, novel
- Clozapine, zyprexa, seroquel,Risperidone, gedeone belify
- Why are the novel antipsychotics better?
- Less TD and EPS. Less anticholinergic effects, Block DA and 5HT, more balanced
- Why TD and EPS
- Traditional antipsychotics block DA not only in the mesolimbic system (which decreases positive Schiz sxs, but also the mesocortical-making negative sxs worse and in the nigrostriatal-where they create a parkinson like syndrome called EPS or TD
- Novel antipsychotic down side
- Increase prolactin, can't use in women with history of hormone sensitive breast cancer, bring on type II diabetes.
- Antipsychotics also work for
- PSychotic, agitated depression, borderline, somatisizing
- If SSRI's and BZ's don't work for nervous nellies give what?
- Mood stabilizers-neurontin
- Meds and PD
- work 20 percent of the time, perhaps there is underlying deoression etc..or narcissist may be better
- When NOT to use psychotherapy without meds
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1. Schizophrenia
2. Manic Episode
3. MAjor depression - PSychotherapy treatment-Axis I vs. II
- We treat axis II disorders. clinical responsibility to think about the meds