Anxiety & Sleep
___, the most common type of sleep disorder, is closely related to anxiety. Both disorders must be considered equally for effective management
Insomnia
This mood disorder is characterized by sad or despondent feelings and is the most common MH disorder of older adults
Depression, MDD
Sertraline (Zoloft), SSRI
This medication class is now considered first line for the management of bipolar disorder due to its relative safety and efficacy
Anti- seizure mood stabilizers (Depakote, Lamictal))
Hallucinations, delusions, aggression & disorganized thought/ speech pattern are examples of ___ ___ of schizophrenia
Positive symptoms
Name the class... at low doses they cause drowsiness, at moderate doses they inhibit seizure activity & promote sleep, and at high doses can be used to induce anesthesia
Barbiturates
This CAM, approved for use in depression, insomnia, and kidney damage, interactions with many medications and can result in serotonin syndrome if used in combination with an SSRI
St. John's Wort
Caused by an accumulation of serotonin in the CNS, this can occur after the 1st dose of an SSRI or several weeks post initiation
Serotonin Syndrome (SES)
Name the drug: Effective in managing the purely manic or depressive episodes of bipolar disorder, this medication has a low therapeutic index and requires serum monitoring q4-5 days post initiation or dosage change
Lithium carbonate
Characteristic of an indifferent personality, lack of emotion and withdrawal from social interactions are examples of ___ ___ of schizophrenia
negative symptoms
The medications in this drug class bind to the GABA- receptor Cl- channel to intensify the effects of GABA (a natural inhibitory neurotransmitter)
Benzodiazepines
This nonpharmacological treatment of depression focuses on a patient's disturbed personal relationships that exacerbate their depression
Interpersonal therapy
Name the drug and class: This antidepressant, approved for the management of both MDD & GAD, can have dose adjustments weekly but has a max dose of 20mg/day
Escitalopram (Lexapro), SSRI
Name the drug and class: this medication's ER formulation is approved for the prevention of migraines and mania associated w/ bipolar disorder but may result in hepatic failure, requiring liver function test monitoring during the first 6 months of treatment
Valproic Acid (Depakote), Anti- epileptic, GABA antagonist
This atypical antipsychotic is the first line treatment for schizophrenia but can cause menstrual disorders in women and gynecomastia in men
Risperidone (Risperdal)
This sedative hypnotic, used for both anxiety and insomnia management, is contraindicated for use in patient's with acute narrow angle glaucoma or liver disease
Lorazepam (Ativan)
This nonpharmacological therapy is effective, but considered a last resort in the treatment of both MDD and schizophrenia
Electroconvulsive therapy (ECT)
Name the drug and class: This antidepressant, indicated for use in MDD in adults & nocturnal enuresis in children, is notorious for causing anticholinergic effects but may also result in serious adverse effects such cardiac dysrhythmias
Imipramine (Tofranil), TCA
Name the drug and class: this medication stimulates the reticular activating system to enhance focus and attention, but has abuse potential and should not be used in patient's with motor tics because it can worsen them.
Methylphenidate (Concerta), CNS Stimulant
This condition, a serious adverse effect of typical antipsychotics, includes potential symptoms of high fever, confusion, rigidity, diaphoresis, & unstable BP.
Neuroleptic malignant syndrome (NMS)
This region of the brain helps regulate consciousness, sleep, and alertness
Thalamus
Name the class and ONE drug: these medications are approved for use in the treatment of MDD and inhibit the absorption of both serotonin and NorEpi
SNRIs, Duloxetine (Cymbalta), Venlafaxine (Effexor); DESVENLAFAXINE MILNACIPRAN (Savella) LEVOMILNACIPRAN (Fetzima)
Name the drug and class: This antidepressant, indicated for use in depression and panic disorder, requires a "wash out period" of other medications at least 2 wks prior to initiation and can result in hypertensive crisis if taken w/ foods that contain tyramine
Phenelzine (Nardil), MAOI
Name the class and ONE drug: Not as effective as stimulants in managing ADD, but have a longer duration or action and fewer AEs associated with use
Non- stimulants: Atomoxetine (Straterra), Clonidine (Kapvay), Guanfacine (Intuniv), Atypical antidepressants (Bupropion, Imipramine)
Name the four major categories of Extrapyramidal symptoms (EPS)
Acute dystonia, akathisia, secondary parkinsonism, tardive dyskinesia