Fluvoxamine

GENERAL Preparations Generic and brand name Luvox. Class SSRI (selective serotonin reuptake inhibitor). Used in Bulimia, depression, obsessive-compulsive disorder (panic disorder, other anxiety disorders, developmental disorders). Mechanism of action Blocks the reuptake of serotonin by presynaptic neurons. PRECAUTIONS Warnings When taken with other serotonin reuptake inhibitors, fluvoxamine can cause the serotonin syndrome, which consists of potentially dangerous alterations in pulse, blood...

Olanzapine

GENERAL Preparations Brand name Zyprexa and orally disintegrating Zyprexa Zydis. Class Atypical antipsychotic. Used in Bipolar disorder, psychotic disorders (Alzheimer's disease, severe anxiety, developmental disorders). Mechanism of action Blocks a subset of dopamine and serotonin receptors. PRECAUTIONS Warnings All antipsychotics can cause neuroleptic malignant syndrome, a rare, but severe and potentially fatal reaction consisting of fever, muscle rigidity, mental status changes, and...

Risperidone

GENERAL Preparations Brand name Risperdal in pills and liquid form, long-acting injectable Risperdal Consta, and orally disintegrating Risperdal M-tabs. Class Atypical antipsychotic. Used in Bipolar disorder, psychotic disorders (Alzheimer's disease, severe anxiety, developmental disorders). Mechanism of action Blocks a subset of dopamine and serotonin receptors. PRECAUTIONS Warnings All antipsychotics can cause neuroleptic malignant syndrome, a rare but severe and potentially fatal reaction...

Buspirone

GENERAL Preparations Brand name Buspar only. Class Antianxiety agent. Used in Anxiety disorders (Alzheimer's disease, developmental disorders, tardive dyskinesia). Mechanism of action Blocks a subset of presynaptic and postsynaptic serotonin and dopamine receptors. PRECAUTIONS Tests needed before starting None. Alcohol The simultaneous use of buspirone and alcohol causes no specific adverse consequences, but alcohol should be avoided because it worsens anxiety and depression. DRUG INTERACTIONS...

Aripiprazole

GENERAL Preparations Brand name Ability only in pills. Class Atypical antipsychotic. Used in Bipolar disorder, psychotic disorders (Alzheimer's disease, severe anxiety, developmental disorders). Mechanism of action Blocks a subset of dopamine and serotonin receptors. PRECAUTIONS Warnings All antipsychotics can cause neuroleptic malignant syndrome, a rare but severe and potentially fatal reaction consisting of fever, muscle rigidity, mental status changes, and alterations in pulse and blood...

Fluoxetine

GENERAL Preparations Generic, brand names Prozac, Sarafem, and, in com-biniation with olanzapine, Symbyax. Class SSRI (selective serotonin reuptake inhibitor). Used in Bulimia, depression, obsessive-compulsive disorder, panic disorder, and other anxiety disorders (ADHD, developmental disorders). Mechanism of action Blocks the reuptake of serotonin by presynaptic neurons. PRECAUTIONS Warnings When taken with other serotonin reuptake inhibitors, fluoxetine can cause the serotonin syndrome, which...

Bupropion

GENERAL Preparations Generic, and brand names Wellbutrin, Wellbutrin SR (sustained release), Wellbutrin XL (extended release), and Zyban. Class Antidepressant. Used in Depression, nicotine dependence (ADHD). Mechanism of action Inhibits reuptake of norepinephrine and dopamine by presynaptic neurons. PRECAUTIONS Don't use if you have Epilepsy, as bupropion may increase the frequency of seizures. Use extra caution if you have Anorexia or bulimia, as there is a higher incidence of seizures if you...

Donepezil

GENERAL Preparations Brand name Aricept only. Class Cognitive enhancer. Used in Alzheimer's disease. Mechanism of action Inhibits the enzyme cholinesterase, which breaks down acetylcholine. PRECAUTIONS Use extra caution if you have Asthma or other lung disease, epilepsy, heart block, or ulcers, as donepezil may worsen the medical problem liver problems, as it may lead to higher levels of donepezil. Tests needed before starting The diagnosis of Alzheimer's needs to be established through a...

Cyproheptadine

GENERAL Preparations Generic and brand name Periactin in pills and liquid form. Class Antihistamine. Used in Cyproheptadine improves the ability to achieve orgasm in some people who experience sexual dysfunction induced by SSRIs. It can increase the rate of weight gain in hospitalized patients with anorexia. Mechanism of action Blocks postsynaptic histamine and serotonin receptors. PRECAUTIONS Use extra caution if you have Asthma, congestive heart failure, edema, epilepsy, glaucoma, heart...

Valproate

GENERAL Preparations Generic, brand names Depakote and Depakote ER (extended release) in pills and sprinkles, and Depakene in liquid form. Class Mood stabilizer. Used in Bipolar disorder. Mechanism of action Valproate has many actions in the brain on receptors, neurotransmitter concentrations, ion channels, and second messenger systems, but it is unknown which effect stabilizes mood. PRECAUTIONS Warnings Rarely, liver failure, pancreatitis (inflammation of the pancreas), and thrombocytopenia...

Oxcarbazepine

GENERAL Preparations Brand name Trileptal only in pills and liquid. Class Mood stabilizer. Used in Bipolar disorder. Mechanism of action Oxcar-bazepine has many actions in the brain on receptors, neurotransmitter concentrations, ion channels, and second messenger systems, but it is unknown which effect stabilizes mood. PRECAUTIONS Warnings Oxcarbazepine can cause serious skin reactions that are potentially fatal, though quite rare. Oxcarbazepine causes hyponatremia in about 1 percent of people...

Nefazodone

GENERAL Preparations Brand name Serzone only. Class Antidepressant. Used in Depression. Mechanism of action Blocks the reuptake of norepinephrine and serotonin into presynaptic neurons. PRECAUTIONS Warnings Rarely, nefazodone has caused liver failure and death. Use extra caution if you have Asthma, low blood pressure, congestive heart failure, edema, epilepsy, glaucoma, heart disease, hyperthyroidism, enlarged prostate or urinary retention, as nefazodone can worsen the symptoms of these...

Mirtazapine

GENERAL Preparations Generic and brand name Remeron. Class Antidepressant. Used in Depression (insomnia). Mechanism of action Blocks presynaptic receptors leading to increased norepinephrine and serotonin. PRECAUTIONS Warnings Mirtazapine can cause agranulocytosis, a severe reaction that is potentially fatal (see chapter 19). Use extra caution if you have Bipolar disorder, as mirtazapine may cause a manic episode epilepsy, as mirtazapine may increase the frequency of seizures low blood...

Nadolol

GENERAL Preparations Generic and brand name Corgard. Class Beta-blocker. Used in Antipsychotic-induced akathisia, lithium-induced tremor (developmental disorders). Mechanism of action Blocks the beta-adrenergic receptors on muscle and brain cells. PRECAUTIONS Don't use if you have Asthma, as nadolol may worsen breathing heart block (an abnormal heart rhythm), heart failure, or a slow heart rate, as nadolol may worsen heart block and dangerously affect heart function. Use extra caution if you...

Quetiapine

GENERAL Preparations Brand name Seroquel only. Class Atypical antipsy-chotic. Used in Psychotic disorders (severe anxiety, Alzheimer's disease, bipolar disorder, developmental disorders, insomnia). Mechanism of action Blocks a subset of dopamine and serotonin receptors. PRECAUTIONS Warnings All antipsychotics can cause neuroleptic malignant syndrome, a rare but severe and potentially fatal reaction consisting of fever, muscle rigidity, mental status changes, and alterations in pulse and blood...

Rivastigmine

GENERAL Preparations Brand name Exelon only in tablets. Class Cognitive enhancer. Used in Alzheimer's disease. Mechanism of action Inhibits the enzyme cholinesterase, which breaks down acetylcholine. PRECAUTIONS Use extra caution if you have Asthma, as rivastigmine may worsen breathing problems heart problems in which the heart beats too slowly, such as bradycardia, the sick sinus syndrome, or certain forms of heart block, as rivastigmine may cause your heart to beat too slowly seizures, as...

Treatment Options for Anxiety

There are a number of things you can do to help anxiety. These other aids are generally far more helpful for you in the long run than any medication, but only if you pursue them conscientiously. Diet A proper diet can improve anxiety. It is important to eat balanced meals (with some protein and carbohydrates such as grains and vegetables) three to four times a day and avoid the ingestion of products high in sugar. The reason for this is somewhat complex but is important to understand. The body...

Opiates

Opiates are drugs derived from the juice of the poppy plant, such as opium, codeine, and morphine. Synthetic opioids include heroin, hydrocodone (Vicodin), meperidine (Demerol), oxycodone (Percodan), and propoxyphene (Darvon). The drugs share a common effect in the brain they bind to receptors in brain cells to produce drowsiness, pain relief, and euphoria. Dependence on opiates has occurred for centuries, but the effects have been getting more pronounced as new drugs that are increasingly...

Chlorpromazine

GENERAL Preparations Generic and brand name Thorazine in pill and liquid form. Class Standard antipsychotic of the phenothiazine group. Used in Psychotic disorders, bipolar disorder (Alzheimer's disease, severe anxiety, severe ADHD, developmental disorders, insomnia). Mechanism of action Blocks post-synaptic dopamine receptors. PRECAUTIONS Warnings All antipsychotics can cause neuroleptic malignant syndrome, a rare, but severe and potentially fatal reaction consisting of fever, muscle rigidity,...

Pimozide

GENERAL Preparations Generic and brand name Orap. Class Standard an-tipsychotic. Used in Psychotic disorders. Mechanism of action Blocks postsynaptic dopamine receptors. PRECAUTIONS Warnings Pimozide can cause irregular heart rhythms. Sudden unexpected deaths have occurred in people on pimozide and it is possible that this is the cause. The manufacturer does not provide information about the frequency of this occurrence. All antipsychotics can cause neuroleptic malignant syndrome, a rare, but...

Haloperidol

GENERAL Preparations Generic in pills. Brand name Haldol in liquid and long-acting injectable concentrate. Class Standard antipsychotic. Used in Bipolar disorder, developmental disorders, psychotic disorders (Alzheimer's disease, severe anxiety, severe ADHD). Mechanism of action Blocks postsynaptic dopamine receptors. PRECAUTIONS Warnings All antipsychotics can cause neuroleptic malignant syndrome, a rare but severe and potentially fatal reaction consisting of fever, muscle rigidity, mental...

Trifluoperazine

GENERAL Preparations Generic and brand name Stelazine in pills and liquid form. Class Standard antipsychotic of the phenothiazine group. Used in Psychotic disorders, bipolar disorder (Alzheimer's disease, severe anxiety, severe ADHD, developmental disorders). Mechanism of action Blocks postsynaptic dopamine receptors. PRECAUTIONS Warnings All antipsychotics can cause neuroleptic malignant syndrome, a rare but severe and potentially fatal reaction consisting of fever, muscle rigidity, mental...

Imipramine

GENERAL Preparations Generic and brand name Tofranil. Class Tricyclic an-tidepressant. Used in ADHD, bulimia, depression, panic disorder, other anxiety disorders. Mechanism of action Blocks the reuptake of norepinephrine and serotonin into presynaptic neurons. PRECAUTIONS Don't use if you have Heart block (an abnormal heart rhythm) or if you recently had a heart attack, as imipramine may worsen heart block and dangerously affect heart function. Use extra caution if you have Bipolar disorder, as...

Clomipramine

GENERAL Preparations Generic and brand name Anafranil. Class Tricyclic antidepressant. Used in Bulimia, depression, obsessive-compulsive disorder (other anxiety disorders). Mechanism of action Blocks the reuptake of serotonin by presynaptic neurons. PRECAUTIONS Do not use if you have Heart block (an abnormal heart rhythm) or if you recently had a heart attack, as clomipramine may worsen heart block and dangerously affect heart function. Use extra caution if you have Bipolar disorder, as...

Thioridazine

GENERAL Preparations Generic and brand name Mellaril in tablets and liquid form. Class Standard antipsychotic of the phenothiazine group. Used in Psychotic disorders (Alzheimer's disease, severe anxiety, severe ADHD, bipolar disorder, developmental disorders, insomnia). Mechanism of action Blocks postsynaptic dopamine receptors. PRECAUTIONS Warnings All antipsychotics can cause neuroleptic malignant syndrome, a rare but severe and potentially fatal reaction consisting of fever, muscle rigidity,...

Diphenhydramine

GENERAL Preparations Generic and brand name Benadryl in pills and liquid form. Class Antihistamine. Used in Insomnia, antipsychotic-induced dystonia (pseudoparkinsonism). Mechanism of action Blocks postsynaptic histamine receptors. PRECAUTIONS Use extra caution if you have Asthma, congestive heart failure, edema, epilepsy, glaucoma, heart disease, hyperthyroidism, low blood pressure, peptic ulcer disease, enlarged prostate or urinary retention, as diphen-hydramine can worsen the symptoms of...

Loxapine

GENERAL Preparations Generic in pills, brand name Loxitane in pills and liquid form. Class Standard antipsychotic. Used in Bipolar disorder, psychotic disorders Alzheimer's disease, severe anxiety . Mechanism of action Blocks postsynaptic dopamine receptors. PRECAUTIONS Warnings All antipsychotics can cause neuroleptic malignant syndrome, a rare but severe and potentially fatal reaction consisting of fever, muscle rigidity, mental status changes, and alterations in pulse and blood pressure....