Anxiety
SSRI least likely to cause weight gain
What is Fluoxetine (Prozac)?
Prozac is the SSRIs that is the leastlikely to cause weight gain. SNRIs andWellbutrin are less likely to cause weightgain than SSRIs.
First line category of treatment for an 8year old male diagnosed with attention-deficit/hyperactivity disorder
What are stimulants?
Psychostimulants are the most effective medication optionfor treating attention-deficit/hyperactivity disorder (ADHD)and are widely accepted as first-line therapy. Behavioraltherapy is recommended before considering medicationsfor children under the age of 6, and may be considered forolder children but may not add much benefit in this agegroup, particularly when there is a good response tomedication.
This medication shows equal long-termefficacy to a benzodiazepine for treatment ofgeneralized anxiety disorder (GAD)
What is Buspar (Buspirone)?
Benzodiazepines work much faster than SSRIs/SNRIs/Buspar. However, multiple studies show that Buspar has similar efficacy to benzodiazepines when used chronically and has a much better safety profile.
Only two medications acceptable forabortive therapy of migraines duringpregnancy
What are Acetaminophen andMetoclopramide?
SSRI most likely to cause GI upset,particularly diarrhea.
What is Sertraline (Zoloft)?
Zoloft is the antidepressant most likely tocause diarrhea. SNRIs are more likely ingeneral to cause GI upset than SSRIs.
A 28 y/o man presents to your clinic. He reports symptoms of inattention including difficulty focusing, difficulty organizing tasks and activities, being forgetful in daily activities and frequently losing things. These symptoms are very impairing and have been going on since 10th grade. He has no other mental health concerns and does not use any substances. According to the DSM V, this patient is missing this clinical criteria for diagnosis.
45-year-old male presents for follow-up ofmigraine headaches, which had previouslyresponded well to occasional as-neededuse of ibuprofen but have recentlyworsened in severity and frequency. He isinterested in trying an abortive therapy.
Name one condition where Triptan usewould be CONTRAINDICATED
What are...
Coronary artery disease
Cerebrovascular disease,
Peripheral vascular disease
Patients with uncontrolled or multiple cardiovascular risk factors
Patients with certain high-risk migrainesyndromes, including basilar and hemiplegicmigraines
Class of medications that has evidencefor treating depression, irritablebowel syndrome and headaches
What are Tricyclic Antidepressants?
While SSRIs remain first line for depression, TCAscan be considered in certain patients withdepression who have illnesses such as headachesor IBS as they are less likely to cause headaches,GI disturbance and sexual side effects. They aremore likely to cause sedation, weight gain andcardiac abnormalities and can be fatal in overdose
Levels of this class of psychotropic medicationcan be decreased in those who smoke cigarettesdue to cigarette smoke increasing the activity ofthe CYP 1A2 enzyme making it particularlyimportant to evaluate smoking status whenprescribing these medications.
What is antipsychotic medications(particularly Clozapine and Olanzapine)?
Smoking can decrease levels of Olanzapine andClozapine. Therefore, it may be necessary to increasethe dose if someone starts smoking and, conversely,decrease the dose if someone successfully stopssmoking.
SSRI that is most likely to cause QTprolongation and should be avoided incombination with other QT prolongingagents such as antipsychotics or tramadol
What is Celexa (Citalopram)?
Prolongation of the QT interval is an important medication adverseeffect to consider. This is particularly true in patients taking multiplemedications, because this effect can be additive and increases therisk of life-threatening arrhythmias such as torsades de pointes.Among commonly used antidepressants, citalopram and escitaloprammay prolong the QT interval. Other SSRIs, as well as bupropion,venlafaxine, and mirtazapine, do not have this effect. Both tricyclicantidepressants and antipsychotics, commonly used in patients alsotaking SSRIs, can cause QT prolongation, making their combined useproblematic.
This antipsychotic medication received FDAapproval in May 2023 for the treatment ofagitation associated with majorneurocognitive disorder or dementia
What is Rexulti (brexpiprazole)?
Rexulti was approved for agitation in the setting of dementia but should still be used with caution given the risks of using antipsychotics in this population.
Like all antipsychotics, this medication still carries a black box warning for increased risk of mortality when used in those with dementia.
This smoking cessation medicationpreviously carried a black box warning foran increased risk of seriousneuropsychiatric events like depressionand suicidality, but this warning wasremoved in 2016.
What is Chantix (Varenicline)?
It is extremely important to screen and counsel patientswith psychiatric illness on tobacco cessation as thesepatients are more likely to die of complicationssecondary to tobacco use and are less likely to receivetreatment. Chantix can be used in those who havemental health diagnosis but should be followed veryclosely.