This is a document I created to train non-medical staff on the importance of knowing the basics on psychiatric medications.

1. What Psychotherapists Should
Know About Psychotropic
Medication
Daniel B. Martinez, M.D.
Medical Director
Pilsen Wellness Center, Inc.

2. The Medical Model

3. Biological
Psychological
P h l i l
Sociological
Cultural
Spiritual

4. Single Ph
Si l Photon Emission Tomography
E i i T h
Images (c) Dr. Amen

5. Normal
N l
Images (c) Dr. Amen

6. Images (c) Dr. Amen

7. ENCOURAGE COMPLIANCE!!!
suntimes, 05

8. washington.edu

9. source

10. Dopamine
D i
Rewards
Attention
Motivation
Drive
Pleasure
Strahl,
Strahl 2000

11. Norepinephrine
N i hi
Mood
Interest
I t t
Motivation
Energy

12. Serotonin
S t i
Sex
Concentration
Hunger
Interest
Mood
Pain
Sleep
p

13. Classes of Medications
Cl f M di ti
Class: Neurotransmiter: Affects:
Antipsychotics Dopamine Psychosis
Antidepressants Serotonin Mood
Norepinephrine
Antimanic Polarization of Mood
neuron
Benzodiazepines GABA Anxiety

14. Have you decided for yourself?

20. Classes of Medications
Cl f M di ti
Class: Neurotransmiter: Affects:
Antipsychotics Dopamine Psychosis
Antidepressants Serotonin Mood
Norepinephrine
Antimanic Polarization of Mood
neuron
Benzodiazepines GABA Anxiety

21. Antipsychotic therapy:
Historical perspective in the United States
Reserpine
Chlorpromazine
Fluphenazine
Quetiapine
Thioridazine
Haloperidol Olanzapine
Risperidone Aripiprazole
Clozapine Ziprasidone
1950
19 0 1960 1970
19 0 1980 1990 2000 2002
Kaplan HI et al. Kaplan and Sadock’s Synopsis of Psychiatry. 7th ed.1994.
Black DW et al. Introductory Textbook of Psychiatry. 2001.

22. AAntipsychotics
-Major Tranquilizers
-Block Dopamine
-Decrease Psychosis
-Induce Parkinsonism
d k

23. Atypicals and Reported Dangers
Clozaril -Agranulocytosis, Seizures
Respirdal -EPS,
-EPS Hyperprolactinemia
Zyprexa -Weight, Diabetes
Geodon
d -EKG problems
bl
Seroquel -Cataracts
Abilify -Deaths

24. Anti-psychotics
A ti h ti
Typical (e.g. Haldol)
Anticholinergic side effects (thorazine)
Extrapyramidal side effects
Atypical (e.g. Zyprexa and Respirdal)
Sedation, weight gain, dizziness,
S d ti i ht i di i
orthostatic hypotension

25. Antidepressants
A tid t
Multimechanism Serotonin
Effexor Prozac
Welbutrin
e but Paxil
a
TCA Zoloft
Remeron Luvox
Cymbalta Lexapro
Celexa

26. Selective Serotonin Reuptake Inhibitors
Prozac The most common side effects of SSRI
medications are: Nausea, diarrhea,
Paxil headache, restlessness, insomnia,
Zoloft anxiety, sexual dysfunction,
perspiration, tremor, insomnia,
Luvox sleepiness, dry mouth.
Celexa
Lexapro

27. Anxiety Di d
A i t Disorders
Serotonin Benzodiazepines
Prozac Valium
Paxil Ativan
Zoloft Xanax
Luvox Klonopin
Celexa Librium
Lexapro

28. Bipolar Disorder Medications
Lithium .6-1.2 mEq/L tremor, N/V, kidney,
thyroid, acne,
y , ,
sedation
Depakote 50-120ug/ml N/V, wt,sedation,
hair loss
Tegretol 6-12 ug/ml sedation, N/V, rash

29. Look t for:
L k out f
Coma, kidney, Heart -Lithium
Liver, Pancreas, Skin, Ovary, Blood-Depakote
Blood, Skin, Liver -Tegretol

30. Benzodiazepines’
p
5 Dangerous Ds
Dependence
Disinhibition
Dizziness
Depression
Deficits in Memory

31. ADHD Treatments
Dopamine Norepinepherine
Ritaline And Dopamine
Concerta Adderall
Focalin Vyvanse
Norepinephrine
Strattera
a2-agonist Intunive

32. Attention Deficit Hyperactivity
yp y
Disorder
Stimulants (Ritalin, Dexedrine, Adderall, Concerta,
Cylert)
Blood Pressure Medication (clonidine and
Tenex)
)
Wellbutrin
Tricyclic Anti-Depressants (Imipramine,
(Imipramine
Desipramine)
Strattera (atomoxetine)

33. HHOW ABOUT NATURAL MEDS?
Omega-3
DHEA
St. John's Wort
Melatonin
l

35. Sun-Times 6/04

36. Multi-mechanism Antidepressants
Effexor -weight loss, insomnia, nausea, sleepiness, anxiety, decreased
appetite. Other side effects include: blurry vision, dizziness, constipation,
seizures, changes in blood pressure, decreased energy, sweating, sexual
dysfunction, dry mouth, yawning.
Welbutrin -Nausea, vomiting, sweating, dry mouth, nervousness,
constipation, dizziness
constipation dizziness. Other side effects include: seizure insomnia, motor
seizure, insomnia
tics, rash.
Tricyclic Antidepressants -weight gain, weight loss, sleepiness, irritability
and aggression, dizziness sexual dysfunction changes in breast size
aggression dizziness, dysfunction, size,
nightmares, stuttering, sensitivity to the sun. Severe side effects include:
seizures, irregular heart beats, rash, hallucinations.
Remeron- b careful with weight gain
R be f l ih i h i
Serzone – be careful with liver failure

37. Child Issues
Diagnostic nosology difficult to apply to children
and adolescents.
Symptom/Syndrome treatment should be the
focus when there is diagnostic uncertainty.
Reconsider the intervention every 6-12 months.
6 12
Start low and go slow.

38. Figiuring out Prescriptions

39. Pharmacy Abbreviations
p.o. By mouth
i.m.
im Intramuscularly
Tab tablet
Cap Capsulel
Liq Liquid
Elix Elixer

40. More Pharmacy Abbreviations
Am morning
Pm evening (afternoon)
Hs at bedtime
Q every
Prn as needed

41. Even more Abbreviations
qD once daily
Bid twice daily
Tid three times daily
Qid f times d l
d for daily
Q6h every six hours
Qod every other day
Tsp teaspoon (5ml)Tbsp tablespoon
(15ml)

42. Medication
Sig. (Directions)
#
Number