Bridging the Gap: Integrating Behavioral Health into Primary Care __________________________________
Mechanism of action: Block the reuptake of serotonin and norepinephrine, but also have effects on other neurotransmitter systems Indications: Depression, anxiety disorders, chronic pain, insomnia
‒
Indications: Bipolar disorder, acute mania Side effects: Tremor, thirst, increased urination, weight gain, cognitive impairment, thyroid problems, kidney problems Considerations: Effective for bipolar disorder but requires careful monitoring due to potential side effects and narrow therapeutic range Examples: Valproic acid (Depakote), lamotrigine (Lamictal), carbamazepine (Tegretol) Mechanism of action: Enhance GABA activity and modulate glutamate activity Indications: Bipolar disorder, epilepsy, neuropathic pain Side effects: Drowsiness, dizziness, nausea, weight gain, liver problems, blood disorders Considerations: It is effective for bipolar disorder and some anxiety disorders but may have significant side effects
‒ ‒
‒
‒
‒ Side effects: Dry mouth, constipation, blurred vision, drowsiness, weight gain, cardiac effects ‒ Considerations: Older class of
antidepressants, practical but with more potential side effects and drug interactions
• Anticonvulsants ‒
• Other antidepressants ‒
Bupropion (Wellbutrin): A norepinephrine- dopamine reuptake inhibitor, effective for depression and smoking cessation Mirtazapine (Remeron): An atypical antidepressant with a unique mechanism of action, effective for depression and insomnia Trazodone (Desyrel): A serotonin antagonist and reuptake inhibitor, primarily used for insomnia but can also be used for depression
‒
‒
‒
‒
‒
‒
Anxiolytics • Benzodiazepines ‒
ANTIPSYCHOTICS • Second-generation antipsychotics (atypical antipsychotics) ‒ Examples: Quetiapine (Seroquel), risperidone (Risperdal), olanzapine (Zyprexa), and aripiprazole (Abilify) ‒ Mechanism of action: Block both dopamine and serotonin receptors ‒ Indications: Schizophrenia, bipolar disorder,
Examples : Alprazolam (Xanax), lorazepam (Ativan), diazepam (Valium), clonazepam (Klonopin)
‒ Mechanism of action: Bind to GABA receptors, enhancing GABA’s inhibitory effects ‒ Indications: Anxiety disorders, panic disorder, insomnia, seizures, muscle spasms ‒ Side effects: Drowsiness, dizziness, impaired coordination, cognitive impairment, dependence, withdrawal ‒ Considerations: Fast-acting for acute anxiety, but with potential for dependence and withdrawal; should be used with caution in older adults and individuals with a history of substance abuse
major depressive disorder (as adjunctive treatment), autism spectrum disorder
‒ Side effects: Weight gain, metabolic syndrome, extrapyramidal symptoms (movement disorders), sedation ‒ Considerations: Generally, it is better tolerated than first-generation antipsychotics but may have metabolic side effects OTHER PSYCHOTROPIC MEDICATIONS • Stimulants: Methylphenidate (Ritalin), amphetamine (Adderall); used for ADHD and narcolepsy • Hypnotics: Zolpidem (Ambien), eszopiclone (Lunesta), zaleplon (Sonata); used for insomnia This is not an exhaustive list; other medications may be appro- priate depending on the specific condition and patient needs. 5.3 PRESCRIBING CONSIDERATIONS Prescribing psychotropic medications requires careful consid- eration of various factors to ensure patient safety and optimize treatment outcomes.
• Nonbenzodiazepine Anxiolytics ‒
Buspirone (BuSpar): Acts as a partial agonist at serotonin receptors, indirectly influencing GABA activity Indications: Generalized anxiety disorder Side effects: Dizziness, nausea, headache Considerations: Non-habit forming but has a slower onset of action than benzodiazepines
‒ ‒ ‒
Mood Stabilizers • Lithium ‒
Mechanism of action: Alters intracellular signaling pathways and influences neurotransmitter release
158
EliteLearning.com/Psychology
Powered by FlippingBook