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The physician’s psychoactive medication resource guide
25% of your patients taking an antidepressant will have
weight gain and the weight gain is directly caused by the antidepressant.
Other medications that are listed on this site include; antipsychotics, ADHD medications and mood
What is an antipsychotic?
An antipsychotic is a type of drug used to treat symptoms of psychosis. These include hallucinations (sights,
sounds, smells, tastes, or touches that a person believes to be real but are not real), delusions (false
beliefs), and dementia (loss of the ability to think, remember, learn, make decisions, and solve problems).
Most antipsychotics block the action of certain chemicals in the nervous system. Also called antipsychotic
agent and neuroleptic agent.
What medications are used to treat psychosis?
Antipsychotic medications are used to treat schizophrenia and schizophrenia-related disorders. Some of
these medications have been available since the mid-1950's. They are also called conventional "typical"
antipsychotics. Some of the more commonly used medications include:
Perphenazine (generic only)
Fluphenazine (generic only).
In the 1990's, new antipsychotic medications were developed. These new medications are called second
generation, or "atypical" antipsychotics.
One of these medications was clozapine (Clozaril). It is a very effective medication that treats psychotic
symptoms, hallucinations, and breaks with reality, such as when a person believes he or she is the
president. But clozapine can sometimes cause a serious problem called agranulocytosis, which is a loss of
the white blood cells that help a person fight infection. Therefore, people who take clozapine must get their
white blood cell counts checked every week or two. This problem and the cost of blood tests make treatment
with clozapine difficult for many people. Still, clozapine is potentially helpful for people who do not respond
to other antipsychotic medications.
Other atypical antipsychotics were developed. All of them are effective, and none cause agranulocytosis.
The antipsychotics listed here are some of the medications used to treat symptoms of schizophrenia.
Note: The FDA issued a Public Health Advisory for atypical antipsychotic medications. The FDA determined
that death rates are higher for elderly people with dementia when taking this medication. A review of data
has found a risk with conventional antipsychotics as well. Antipsychotic medications are not FDA-approved
for the treatment of behavioral disorders in patients with dementia.
What are the side effects?
Some people have side effects when they start taking these medications. Most side effects go away after a
few days and often can be managed successfully. People who are taking antipsychotics should not drive
until they adjust to their new medication. Side effects of many antipsychotics include:
Dizziness when changing positions
Sensitivity to the sun
Menstrual problems for women.
Atypical antipsychotic medications can cause major weight gain and changes in a person's metabolism. This may increase a person's risk of getting
diabetes and high cholesterol.1 A person's weight, glucose levels, and lipid levels should be monitored regularly by a doctor while taking an atypical
Typical antipsychotic medications can cause side effects related to physical movement, such as:
Persistent muscle spasms
Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements a person
can't control. The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be
cured. Sometimes people with TD recover partially or fully after they stop taking the medication.
Every year, an estimated 5 percent of people taking typical antipsychotics get TD. The condition happens to fewer people who take the new, atypical
antipsychotics, but some people may still get TD. People who think that they might have TD should check with their doctor before stopping their
What is attention deficit hyperactivity disorder?
Here is what the National Institute of Mental Health has to say about ADHD.
"Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and
adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity).
ADHD has three subtypes:1
Most symptoms (six or more) are in the hyperactivity-impulsivity categories.
Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.
The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity
are present, although hyperactivity-impulsivity may still be present to some degree.
Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but
they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not
notice that he or she has ADHD.
Combined hyperactive-impulsive and inattentive
Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.
Most children have the combined type of ADHD.
Treatments can relieve many of the disorder's symptoms, but there is no cure."
Common side effects of stimulants for ADD & ADHD:
Feeling restless and jittery
Loss of appetite
Irritability, mood swings
Stimulant medications may also cause personality changes. Some people become withdrawn, listless, rigid, or less spontaneous and talkative.
Others develop obsessive-compulsive symptoms. Since stimulants raise blood pressure and heart rate, many experts worry about the dangers of
taking these ADD/ADHD drugs for extended periods.
ADD / ADHD Stimulant safety concerns
Stimulant Medication Red Flags
Call your doctor right away if you or your child experience any of the following symptoms while taking stimulant medication for ADD or ADHD:
shortness of breath
seeing or hearing things that aren’t real
suspicion or paranoia
Beyond the potential side effects, there are a number of safety concerns associated with the stimulant medications for ADD/ADHD.
Effect on the developing brain — The long-term impact of ADD/ADHD medication on the youthful, developing brain is not yet known.
Some researchers are concerned that the use of drugs such as Ritalin in children and teens might interfere with normal brain
Heart-related problems — ADD/ADHD stimulant medications have been found to cause sudden death in children and adults with heart
conditions. The American Heart Association recommends that all individuals, including children, have a cardiac evaluation prior to starting
a stimulant. An electrocardiogram is recommended if the person has a history of heart problems.
Psychiatric problems — Stimulants for ADD/ADHD can trigger or exacerbate symptoms of hostility, aggression, anxiety, depression,
and paranoia. People with a personal or family history of suicide, depression, or bipolar disorder are at a particularly high risk, and should
be carefully monitored when taking stimulants.
Potential for abuse — Stimulant abuse is a growing problem, particularly among teens and young adults. College students take them
for a boost when cramming for exams or pulling all-nighters. Others abuse stimulant meds for their weight-loss properties. If your child is
taking stimulants, make sure he or she isn’t sharing the pills or selling them.
What are Mood Stabilizers?
A mood stabilizer is a psychiatric medication used to treat mood disorders characterized by intense and sustained mood shifts, typically bipolar
disorder. Used to treat bipolar disorder, mood stabilizers suppress swings between mania and depression. Mood-stabilizing drugs are also used in
borderline personality disorder and Schizoaffective disorder.
The term "mood stabilizer" does not describe a mechanism, but rather an effect. More precise terminology is used to classify these agents.
Drugs commonly classed as mood stabilizers include:
Many agents described as "mood stabilizers" are also categorized as anticonvulsants. The term "anticonvulsant mood stabilizers" is sometimes
used to describe these as a class. Although this group is also defined by effect rather than mechanism, there is at least a preliminary understanding
of the mechanism of most of the anticonvulsants used in the treatment of mood disorders.
Valproic acid (Depakene), divalproex sodium (Depakote), and sodium valproate (Depacon, Epilim) – Available in extended release form.
This drug can be very irritating to the stomach, especially when taken as valproic acid. Liver function and CBC (complete blood count)
should be monitored.
Lamotrigine (Lamictal) – Particularly effective for bipolar depression. Usual dose is 100–200 mg daily, which can be built up by 25 mg
every 2 weeks. The patient should be monitored for signs and symptoms of Stevens–Johnson syndrome, a very rare but potentially fatal
Carbamazepine (Tegretol) – CBC (complete blood count) should be monitored, as carbamazepine can lower white blood cell count.
Therapeutic drug monitoring is required. Carbamazepine was approved by the US Food and Drug Administration as a bipolar disorder
treatment in 2005, but had been widely used previously.
Oxcarbazepine (Trileptal) – Oxcarbazepine is not FDA approved for bipolar disorder. Still, it appears to be effective in about one-half of
patients with bipolar disorder and be well tolerated.
Riluzole (Rilutek) is not FDA approved as a treatment for bipolar disorder. This drug is often used for Lou Gehrig’s disease,but also is a
potential candidate for bipolar disorder therapy. Riluzole has been shown to have antidepressant properties in a number of recent studies
of mood and anxiety disorders. Riluzole was tested for bipolar depression by Dr. Husseini Manji and colleagues. They gave the drug to 14
acutely depressed bipolar patients alongside lithium for eight weeks. A significant improvement was found, with no evidence of a switch
into mania. "These results suggest that riluzole might indeed have antidepressant efficacy in subjects with bipolar depression," say the
team. Safety monitoring includes regular liver function tests and people with liver disease such as hepatitis should be monitored especially
Gabapentin (Neurontin) is not FDA approved as a treatment for bipolar disorder. Randomized controlled trials suggest that Gabapentin is
not an effective treatment, but many psychiatrists continue to prescribe it, it is reported because of positive but "low-quality" literature
Topiramate (Topamax) is not FDA approved for bipolar disorder, either; and a 2006 Cochrane review concluded that there is insufficient
evidence on which to base any recommendations regarding the use of topiramate in any phase of bipolar illness.
Lithium – Lithium is the "classic" mood stabilizer, the first to be approved by the US FDA, and still popular in treatment. Therapeutic drug
monitoring is required to ensure lithium levels remain in the therapeutic range: 0.6 or 0.8-1.2 mEq/L (or millimolar). Signs and symptoms of
toxicity include nausea, vomiting, diarrhea, and ataxia. The most common side effects are lethargy and weight gain. The less common
side-effects of using lithium are blurred vision, slight tremble in the hands, and a feeling of being mildly ill. In general, these side-effects
occur in the first few weeks after commencing lithium treatment. These symptoms can often be improved by lowering the dose.
Some atypical antipsychotics (risperidone, olanzapine, quetiapine, paliperidone, and ziprasidone) also have mood stabilizing effects and
are thus commonly prescribed even when psychotic symptoms are absent.
It is also conjectured that omega-3 fatty acids may have a mood stabilizing effect. Compared with placebo, omega-3 fatty acids appear
better able to augment known mood stabilizers in reducing depressive (but perhaps not manic) symptoms of bipolar disorder; additional
trials would be needed to establish the effects of omega-3 fatty acids alone.
Sometimes mood stabilizers are used in combination, such as lithium with one of the anticonvulsants.
(Mood Stabilizer definition and information was taken from Wikepedia)