Anxiety
Two categories of medicines most effective for both panic disorder and GAD
What are SNRI's and SSRI's?
Medications used to treat episodic migraines
What are Abortive therapies?
- triptans, ergotamine, TCAs, NSAIDs
- CGRP (Ubrogepant)
First-line mood stabilizer for bipolar disorder
What is Lithium?
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-term efficacy to a benzodiazepine for treatment of generalized 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?
antipsychotic is FDA-approved for bipolar depression
What is Quetiapine?
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.
What is age less than 12?
Herbal Supplement, if combined with SSRI's, could cause serotonin syndrome
What is St. John's Wort?
45-year-old male presents for follow-up of migraine headaches, which had previously responded well to occasional as-needed use of ibuprofen but have recently worsened in severity and frequency. He is interested in trying an abortive therapy.
Name one condition where Triptan use would 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 migraine syndromes (basilar and hemiplegic migraines)?
Serious potential side effect of lamotrigine that requires immediate medical attention?
What is Stevens-Johnson Syndrome?
Also may increase risk of suicidal thoughts
Class of medications that has evidence for treating depression, irritable bowel syndrome and headaches
What are Tricyclic Antidepressants?
While SSRIs remain first line for depression, TCAs can be considered in certain patients with depression who have illnesses such as headaches or IBS as they are less likely to cause headaches, GI disturbance and sexual side effects. They are more likely to cause sedation, weight gain and cardiac abnormalities and can be fatal in overdose.
Reasonable management strategy for 7-year-old child on immediate-release stimulants who experiences appetite suppression.
What is dosing after meals?
SSRI's indicated for moderate to severe childhood anxiety (name two of three)
What are Fluoxetine (Prozac), Sertraline (Zoloft) or Escitalopram (Lexapro)?
Name 2 medications that can be added to a regimen in a patient with chronic migraines
What are preventive therapies?
- anti-convulsants (Topiramate, valproate)
- anti-hypertensives (propanolol, verapamil)
- CGRP antagonists (erenumab)
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 adverse effect to consider. This is particularly true in patients taking multiple medications, because this effect can be additive and increases the risk of life-threatening arrhythmias such as torsades de pointes. Among commonly used antidepressants, citalopram and escitalopram may prolong the QT interval. Both tricyclic antidepressants and antipsychotics, commonly used in patients also taking SSRIs, can cause QT prolongation, making their combined use problematic
ADHD medication is preferred in patients with a history of substance use disorder
What is Atomoxetine?
Intervention equally as effective for treatment of anxiety as addition of benzodiazepines or buspar
What is Physical activity?
Common side effect of topiramate used for migraine prophylaxis
What is cognitive slowing?
This antipsychotic medication received FDA approval in May 2023 for the treatment of agitation associated with major neurocognitive 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. https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-treat-agitation-symptoms-associated-dementia-due-alzheimers-disease
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.
Common side effect of stimulant medications
What is Insomnia?