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MEDICATIONS

Common Medications by Type/Purpose

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CAUTION: Some newly approved drugs by the FDA have turned out to have an extreme sedative effect on a few patients. (Officially, the FDA has approved only three for bipolar use: Depakote, Lithium, Zyprexa.)

There are several families of medications and chemicals that affect the brain (see Glossary). Medications can typically have 'side affects' (some nominal, some good, some bad). Each medication must be carefully prescribed and monitored over the long term.

This is not an exhaustive list but commonly prescribed. Each person is a unique case. Most of these medications were not available ten years ago and something not working may have an alternate. Different brand names (and web links) for the same chemical compound are listed on one line followed by the chemical nomenclature.

Medication information has also been extracted from NAMI and NDMD literature. Further medication data is available from the National Depressive and Manic-Depressive Association, the overall Top 200 Medications prescribed, or the valuable Psychoactive Drugs (arranged by diagnosis).

Click here for Papers on Medications by NAMI.

BIPOLAR WARNING: Steroids, hallucingenic drugs, or head trauma can act as a trigger for BiPolar. Drug addiction is one progressive sign of mental illness. Do NOT treat Bipolar disorder solely with anti-depressants. Bipolar patients also need a mood stabilizer.

Having TROUBLE paying for Meds? Try: PhRMA (Phramaceutical Research and Manufacturers of Amrica). This on-line service is FREE and completely confidential.


Medication Categories (adapted from Blue Cross of California formulary list 6/2002)

ANXIETY and SEDATION

"Anxiety: An abnormal and overwhelming sense of apprehension and fear, often marked by physiological signs (as sweating, tension, and increased pulse), by doubt concerning the reality and nature of the threat, and by self-doubt about one's capacity to cope with it." - (c)1987,Merriam-Webster (Dictionary)
  • Ambien (zolpidem tartrate, non-benzodiazepin) - Sedative introduced in 1994
  • Ativan (lorazepam ... benzo-diazepin component) - Anti-anxiety sedative - Also injectable version

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CONVULSIONS and PARKINSON

Mood Stabilizers: These anti-convulsants also combat the manic phase of manic-depressive illness (bipolar). GABA (gamma-aminobutyric acid) is a neurotransmitter that inhibits nerve-cell excitation.
  • Cogentin (benz-tropine) - AntiParkinson agent
  • Depakote (divalproex sodium) - Not Addictive - FDA approved 1995 for manic episodes - Affects GABA - Also used for Epilepsy (since 1983), Seizures, Convulsions. Response can take 10 days. Possible side affect: Hair loss. Caution- Interacts with: Aspirin, Tegretol, Valium
  • Lomatil - Mood stabilizer
  • Topamax (topiramate, topomax) - Mood stabilizer - Enhances GABA - Used for partial onset seizures of epilepsy, binge-eating, and bipolar disorder - Also used 'off-label' to lower cognition skills, slow down thoughts, migraines, and weight loss
Other Mood Stabilizers per NIMH (2000):
  • Lamictal (lamotrigine) - Mood Stabilizer - Affects NMDA - also used for Epilepsy - Requires 4 weeks of increasing dosages for body to adapt - alternative to Lithium - Age 18+
  • Neurontin (gaba-pentin) - Mood Stabilizer - Affects GABA - also used for Epilepsy and Diabetic nerve damage - Age 12+
  • Tegretol, Epitol, Atretol (carbamazepine) - Mood Stabilizer - Affects GABA and serotonin - Used for Epilepsy, Seizures, Convulsions, and Trigeminal neuralgia (severe jaw pain) - Response can take 7 to 21 days. AVOID using hot spas as high heat dissipates the effectiveness.

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DEPRESSION

SSRI and SSNRI Anti-depressants

SSRI medications are Selective Serotonin Re-Uptake Inhibitors. Also used for: Panic Disorder, OCD, Bulimia. It takes 3 weeks for SSRIs to take effect.

Kaiser Health, as of 6/7/99, tends to use SSRI medications the most for anti-depressants. Since the mid-90's, these have been the first line of treatment. SSNRI mediations are the newer Selective Serotonin Noradrenergic Re-Uptake Inhibitors

Side-effects of these may include some of these sometimes-opposite symptoms: loss of appetite, weight gain, nausea, constipation, diarrhea, anxiety, nervousness, restlessness, tremor, insomnia, drowsiness, fatigue, headache, flushing, sweating, dry mouth, diminished sexual drive.

WARNING: Do NOT treat Bipolar disorder solely with anti-depressants. Bipolar patients also need a mood stabilizer.

    These are the mid-1990's SSRIs:

  • Celexa (citalopram HydroBromide - SSRI) - FDA approved in 1998 for depression - Single dose lasts 1 week - Avoid with MAO Inhibitors and Tricyclics (TCA)
  • Paxil (paroxetine HCl - SSRI)
  • Prozac (fluoxetine HCL - SSRI) - New Lilly formula allows it to be taken once a week
  • Zoloft (sertraline HCL - SSRI) - Used for OCD and Post-Traumatic Stress Disorder - Avoid with MOA Inhibitors

    These are the newer generation SSNRIs:

  • Effexor (venlafaxine HCl - SSNRI) - Affects norepinephrine as well as serotonin - Also used for: Generalized Anxiety Disorder (11/12/01 May work better if taken at night if patient complains of sleepiness during the day.) - Also available in extended release capsules(XR)
  • Luvox (fluvoxamine maleate) - Age 8+ - Used for obsessive compulsive disorder (OCD)
  • Serzone (nefazodone HCl - SSRIB)- ALERT: LIVER FAILURE (Bristol-Meyer Squibb pulled it off market 6/14/04)

MAO Inhibitor Anti-depressants

MAOI are Monamine Oxidase Inhibitors and an older class of medications.

Affects serotonin, dopamine, and norepinephrine. Also used for: Panic Disorder. Side-effects: These older medications, in general, have dangerous interactions with aged wines or cheeses. Do not use with Zoloft, Celexa, Remeron, or Metadate.

  • Nardil
  • Parnate

Tricyclic-Heterocyclic Anti-depressants (TCA)

Affects either serotonin and norepinephrine depending on medication. Also used for: Panic Disorder, OCD

Side-effects of these Tricyclic's may include some of these sometimes-opposite symptoms: dry mouth, blurred vision, constipation, difficulty urinating, increased sweating, decreased sweating, rapid heart rate, dizziness when standing up, drowsiness, weight gain, impotence.

    First generation of cyclics:

  • Elavil, Endep (ami-trip-tyline)
  • Norpramin, Pertofrane (des-ipramine, a Heterocyclic) - Age 6+
  • Pamelor (nor-trip-tyline)

    Other cyclics:

  • Anafranil (clom-ipramine) - Age 10+ ... Also used for OCD
  • Sinequan (doxepin) - Age 12+
  • Surmontil
  • Tofranil (im-ipramine) - Also used for bed-wetting
  • Vivactil (pro-trip-tyline)

Tetracyclic Anti-depressants

  • Remeron (mirtazapine) - Affects serotonin and norepinephrine - Avoid with MOA Inhibitors

Atypical Anti-depressants

These are the second generation of cyclics for those who did not respond well to the older medications.
  • Wellbutrin (bupropion HCl - NDRI) - Affects dopamine and norepinephrine. Also used for: Smoking cessation
  • Desyrel (trazodone) - For sleep
  • Remeron (mirtazapine) - Affects serotonin and norepinephrine - Avoid with MOA Inhibitors

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MANIA

  • lithium carbonate, lithium citrate and derivatives (Cibalith-S - Lithonate - Lithobid - Eskalith) - Not Addictive - FDA approved for bipolar. Affects serotonin. Also used for Depression, Bulimia, PMS, Sexual addictions. Response can take 14 days - Age 12+ ... Caution- Interacts with: Vasotec, Dexedrine, Paxil, Prozac, Zoloft, Caffeine, Tegretol

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PSYCHOTIC

"Psychosis(n): Fundamental mental derangement (as paranoia) characterized by defective or lost contact with reality - psychotic (adj or n)" - (c)1987,Merriam-Webster (Dictionary)

Atypical Anti-psychotics

Affects dopamine and serotonin in the brain. It takes 4 to 6 weeks for antipsychotics to take effect.
  • Clozaril (clozapine) - For schizophrenia- Some risks if switch to another antipsychotic
  • Seroquel (quetiapine fumerate) - $500/month
  • Zeldox, Geodon (ziprasidone HCL) - Used for Schizophrenia
  • Zyprexa (olanzapine) - Not Addictive - Introduced 1996 - FDA approved in 2000 for bipolar - highly sedative for some, ravenous appetite in others. Caution- Interacts with: Tegretol, Valium, Luvox, Prilosec. Possible interaction with antihistamines -Also used for Schizophrenia
  • Zyprexa with aripiprazole

Neuroleptics (Atypical Anti-psychotics)

These are used for symptoms of highly disorganized thinking and/or catatonic behavior. Nicotine appears to quiet the voices and over 90% of schizophrnia patients tend to smoke. However smoking, like self-medicating, is an unhealthy and imprecise delivery mechanism of nicotine.

  • Risperdal (risperidone) - Affects dopamine and serotonin - Since 1996 - For SOME schizophrenia patients, this stops the voices (11/2001 confirmed locally by experiment ... after reading the book: "The Day the Voices Stopped" ... but does not have same effect for all patients nor is it long term) - Possible side effects: blurry vision, weight gain - Can crush pills and dissolve in orange juice - A 2-week injection may be soon available - Age 18+
  • Orap (pimozide) - anti-psychotic - Not drug of first choice - Age 12+

Older Conventional (Typical) Anti-psychotics

Older conventional (known as 'Typical') are more likely to cause neurologic side effects that often make people uncomfortable. As a result, many use Atypical medications instead.
  • Haldol, Haldol Decanoate, Halperon (haloperidol) - major tranquilizer - Also available by monthly injection (10/8/01 - Local patient gladly accepted injection, when he would not take daily pills)
  • Loxitane (loxapine)
  • Mellaril (thioridazine)
  • Moban (molindone)
  • Navane (thiothixene)
  • Prolixin (fluphenazine) - Also available by monthly injection
  • Stelazine (tri-fluoperazine)
  • Thorazine (chlorpromazine) - major tranquilizer - Used since 1950
  • Trilafon (perphenazine)

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STIMULANTS

These central nervous system stimulants paradoxically also slow down a person with ADD/ADHD - Always AVOID with use of MOA Inhibitors
  • ADDerall (mixed amphetamine salts)
  • Cylert (pemoline) - also used for Chronic Fatigue - Addiction a problem with adults
  • Dexedrine, Dexampex, Dexedrine, Ferndex, Oxydess II, Robese (dextro-amphetamine) - Age 3+
  • Ritalin, Metadate, Concerta (methylphenidate HCl) - Reduced effectiveness after puberty - AVOID with use of herbal medicines

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Not yet categorized for this web page ...

  • Deseryl - Affects serotonin
  • Vestra (SNRI) - Affects norepinephrine - FDA approved in 2000

Rev. 9/14/05 - Copyright(c)2000-2005, WebMaster

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