Psychpharm Quick Reference PDF

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QUICK REFERENCE TO PSYCHIATRIC MEDICATIONS® DEVELOPED BY JOHN PRESTON, PSY.D., ABPP To the best of our knowledge recommended doses and side effects listed below are accurate. However, this is meant as a general reference only, and should not serve as a guideline for prescribing of medications. Please check the manufacturer’s product information sheet or the P.D.R. for any changes in dosage schedule or contraindications. (Brand names are registered trademarks.)

ANTIDEPRESSANTS

Usual Daily Dosage Range

NAMES Generic

Brand

desipramine amitriptyline nortriptyline clomipramine trazodone nefazodone fluoxetine bupropion sertraline paroxetine venlafaxine desvenlafaxine fluvoxamine mirtazapine citalopram escitalopram duloxetine vilazodone atomoxetine vortioxetine levomilnacipran MAO INHIBITORS phenelzine tranylcypromine selegiline

Norpramin Elavil Aventyl, Pamelor Anafranil Oleptro Generic Only Prozac4, Sarafem Wellbutrin4 Zoloft Paxil Effexor4 Pristiq Luvox Remeron Celexa Lexapro Cymbalta Viibryd Strattera Trintellix Fetzima Nardil Parnate Emsam(patch)

Sedation

ACH1

Selective Action On Neurotransmitters2 5-HT DA

NE

150-300 mg 150-300 mg 75-125 mg 150-250 mg 150-400 mg 100-300 mg 20-80 mg 150-400 mg 50-200 mg 20-50mg 75-350 mg 50-400mg 50-300mg 15-45 mg 10-40mg 5-20mg 20-80mg 10-40 mg 60-120mg 10-20mg 40-120 mg

low high mid high mid mid low low low low low low low mid low low low low low mid low

low +++++ high ++ mid +++ high 0 none 0 none 0 none 0 none ++ none 0 low + none +++ none +++ low 0 mid +++ none 0 none 0 none +++ low 0 low +++++ none 0 none +++

30-90 mg 20-60mg 6-12mg

low low low

none none none

0 ++++ ++ +++++ ++++ +++ +++++ 0 +++++ +++++ +++ +++ +++++ +++ +++++ +++++ +++ +++++ 0 +++++ ++

0 0 0 0 0 0 0 ++ + 0 + + 0 0 0 0 0 0 0 + 0

+++ +++ +++

+++ +++ +++

+++ +++ +++

1

ACH: Anticholinergic Side Effects NE: Norepinephrine, 5-HT: Serotonin, DA: Dopamine (0 = no effect, + = minimal effect, +++ = moderate effect, +++++ = high effect) 3 Uncertain, but likely effects 4 Availableinstandardformulationandtimerelease(XR,XLorCR).Prozacavailablein90mgtimereleased/weeklyformulation

2

BIPOLAR DISORDER MEDICATIONS Generic

NAMES  Brand

Daily DosageRange

Serum1 Level

lithiumcarbonate Eskalith,Lithonate 600-2400 0.6-1.5 olanzapine/ fluoxetine  Symbyax 6/25-12/50mg4 (2) carbamazepine Tegretol,Equetro 600-1600 4-10+

NAMES Generic Brand

Daily DosageRange

divalproex Depakote lamotrigine Lamictal oxcarbazepineTrileptal

Serum1 Level

750-1500 50-100 50-500 (2) 1200-2400 (2)

Note: Many antipsychotic medications are used to treat various aspects of bipolar disorder (see page two for a list) 1 LithiumlevelsareexpressedinmEq/l,carbamazepineandvalproicacidlevelsexpressinmcg/ml. 2 Serum monitoring may not necessary 3Not yet established 4Availablein:6/25,6/50,12/25,and12/50mgformulations

PSYCHO-STIMULANTS

PSYCHO-STIMULANTS

NAMES Generic

methylphenidate3 methylphenidate3 methylphenidate3 methylphenidate3 methylphenidate3 methylphenidate3 dexmethylphenidate dextroamphetamine

Brand

Ritalin Concerta2 Metadate Methylin Daytrana (patch) QuillivantXR(liquid)2 Focalin Dexedrine

NAMES Daily Dosage 1

Generic

5-50 mg 18-54 mg 5-40 mg 10-60mg 15-30 mg 10-60mg 5-40mg 5-40mg

lisdexamphetamine d- and l-amphetamine modafinil armodafanil amphetamine salts amphetamine sulfate amphetamine salts

Brand

Vyvanse Adderall Provigil, Sparlon Nuvigil Mydayis Adzenys Evekeo

Note: Adult Doses. 2Sustained release 3Note: Many generic brands have emerged recently. Included here are the most common.

1

© Copyright 2018, John Preston, Psy.D and P.A. Distributors

Daily Dosage

30-70mg 5-40 mg 100-400 mg 150-250 mg 12.5-50 mg 3.1-18.8 mg 5-40 mg

1

ANTIPSYCHOTICS NAMES Brand

Generic

Dosage Range1

Sedation

EPS3

Ortho2

Metabolic Equivalence5 Side Effects

Weight4 Gain

LOW POTENCY chlorpromazine Thorazine 50-800 mg + + +++++ +++++ 100 mg high high clozapine Clozaril 300-900 mg 0 +++++ +++++ 50 mg high high quetiapineSeroquel150-600mg+/0  +++++++ 50mg mid mid HIGH POTENCY perphenazineTrilafon8-60mg+++++ 10mg mid mid 0/+ 0/+ haloperidol Haldol 2-40 mg +++++ 2 mg low low ++ 0/+ pimozide Orap 1-10 mg +++++ 1-2 mg ++ +/0 low low risperidoneRisperdal4-6mg+  ++  1-2mg mid low 0/+ paliperidone Invega 3-12 mg + 1-2 mg low ++ mid 0/+ olanzapineZyprexa5-20mg+/0  +++++ +++++  1-2mg low mid ziprasidoneGeodon60-160mg+/0  0/+  10mg low mid 0/+ iloperidone Fanapt 12-24 mg + 1-2 mg mid mid 0/+ ++ asenapine Saphris 10-20 mg + 1-2 mg low low 0/+ ++ lurasidoneLatuda40-80mg+  0/+  10mg mid mid 0/+ aripiprazole Abilify 15-30 mg ++ 2 mg low low 0/+ 0/+ brexpiprazoleRexulti1-4mg   1mg low low 0/+ + 0/+ cariprazineVraylar1.5-6mg +/01mg low low 0/+ +/0 1

Usual daily oral dosage. Orthostatic Hypotension. Dizziness and falls. Acute:Parkinson’s,dystonias,akathisia.Doesnotreflectriskfortardivedyskinesia.Allneurolepticsmaycausetardivedyskinesia,exceptclozapine. 4 Monitor BMI. 5 Must monitor for blood lipids, fasting glucose, baseline at 12 weeks, and then atleast annually. 6 Doserequiredtoachieveefficacyof100mgchlorpromazine. 7 Inrecenttimesanumberofsecondgenerationantipsychoticshavebeendevelopedininjectableformforacutetreatmentandlongertermprophylaxis.Thesearenotmentioned inthisquickreference. 8 Note: Many antipsychotic medications are approved for the treatment of various phases of bipolar disorder. 2 3

ANTI-ANXIETY Generic

NAMES 

Brand

HYPNOTICS Single Dose DosageRange

BENZODIAZEPINES diazepam Valium 2-10 mg chlordiazepoxide Librium 10-50mg clonazepam Klonopin 0.5-2.0 mg lorazepam Ativan 0.5-2.0 mg alprazolam Xanax 0.25-2.0mg OTHER ANTIANXIETY AGENTS buspirone BuSpar 5-20 mg gabapentin Neurontin 200-600mg hydroxyzine Atarax,Vistaril 10-50mg propranolol Inderal 10-80 mg atenolol Tenormin 25-100 mg guanfacine Tenex,Intuniv0.5-3mg clonidine Catapres, Kapvay 0.1-0.3 mg pregabalin Lyrica 25-450mg prazosin2 Minipress 5-20 mg ANTIOBSESSIONALS Clomipramine Anafranil 150-300 mg All SSRIs

NAMES Equivalence1

5 mg 25mg 0.25 mg 1 mg 0.5mg

1

Dosesrequiredtoachieveefficacyof5mgofdiazepam Fortreatmentofnightmaresanddaytimeanxiety

2

Single Dose Dosage Range

Generic

Brand

temazepam triazolam zolpidem zolpidem zaleplon eszopiclone ramelteon diphenhydramine doxepin suvorexant

Restoril 15-30 mg Halcion 0.25-0.5 mg Ambien 5-10 mg Intermezzo 1.75 mg Sonata 5-10 mg Lunesta1-3mg Rozerem4-16mg Benadryl 25-100 mg Silenor3-6mg Belsomra 15-40 mg

Name

OVER THE COUNTER

St. John’s Wort1, 2 SAM-e3 Omega-34-EPA Folic Acid7 L-methylfolate7, 8 N-acetylcysteine5 Chamomile6 5-HTP7

Daily Dose

 



600-1800mg 400-1600mg 1-2 g 400-800 mcg 7.5-15 mg 1200-2400 mg 200-1500 mg 300-600mg

5 For trichotillomania Treatsdepressionandanxiety 2 Maycausesignificantdrug-druginteractions 6Treatsanxiety 7 3 Treats depression Treats depression 4 Treats depression and bipolar disorder 8 Note: also available as Deplin 1-methylfolate (prescription) 7.5-15 mg 1

REFERENCES and RECOMMENDED BOOKS

Quick Reference & Bipolar Medications • Free Books • Free Downloads Website:www.PsyD-fx.com Handbook of Clinical Clinical Psychopharmacology Made Psychopharmacology For Therapists Ridiculously Simple 8th Edition (2017) Preston, O’Neal and Talaga (2018) Preston and Johnson

Bipolar Medications A Concise Guide (2018) Preston: Free Download

Child and Adolescent Psychopharmacology Made Simple

(2015) Preston, O’Neal, Talaga...