The Medication FAQ a.k.a. Everything you ever needed to know about psychiatric drugs

[kittyinthedark]

THIS IS A WORK IN PROGRESS. I WILL BE ADDING TO IT DAILY (I HOPE) UNTIL IT IS FINISHED, ALONG WITH CREATING A RESOURCE THREAD FOR FINDING PSYCHIATRIC SERVICES. IF YOU HAVE ANY SUGGESTIONS OR COMMENTS, PLEASE PUT THEM IN THE THREAD I STARTED FOR THAT. IT'S FLOATING AROUND IN TDS SOMEWHERE (NOT STICKIED).


Firstly: I AM NOT A DOCTOR. I am not licensed by any medical board, nor am I rigorously trained in medicine. I am putting this compendium together based upon personal knowledge as a student of biochemistry, drug manufacturers' data, and other reference materials. I would never knowingly put false or even questionable data, and I will always back up what I say with documentation if necessary, but there is a small but non-zero chance that something here may be incorrect or not pertain to your body chemistry/particular medical condition. I hold no responsibility for your lack of it. Double check if you're unsure.

Before you continue reading, know this: EVERY PSYCHIATRIC MEDICATION WORKS DIFFERENTLY FOR EVERY PERSON. We cannot tell you how well you will respond to any given chemical, or what side effects it will cause you. We cannot tell you what to take to cure your problem. We *can* tell you what is likely to happen, and what is unlikely to happen, when you take a certain drug, but we cannot guarantee that anything will work for you or won't make you sick. Many of these drugs do carry a rather elevated risk of some pretty icky side effects, and I will list all common ones with each chemical.

I have heard horror stories and miracle turnarounds both attributed to the same drugs, so it goes without saying that either outcome is possible with any drug listed here. There are also plenty of stories of people with no horror stories or miracle turnarounds in them where the medication maybe helped a little and didn't hurt but didn't do all that much good. For the best results, get evaluated by a psychiatric professional - there is another thread devoted to helping you locate resources if you need help finding them here.

Also, make sure to weigh your options carefully when considering the option of medication. These are very potent chemicals, most of which literally alter your brain chemistry. Now, there is no reason to be frightened of them, I've been on dozens of them over the course of the last four years with very, very few problems, but it is not a decision to be made lightly, and it should only be made with the help of a trained professional (i.e. your doctor or psychiatrist, preferably a psychiatric specialist of some sort).

That being said, I will list some "natural" routes to try before jumping into the world of medication at the end of this FAQ. These health guidelines and the accompanying supplements listed are great for anyone, on medication or not! Staying healthy is even more important for people that have psychiatric issues and/or are on meds, so I suggest reading that part first! I have been able to go off my meds for long periods simply by taking vitamins and exercising, and my clinic has seen similar vast improvements in their patients by simply changing their diet and exercise habits.

The potential drug interaction list for each chemical discussed is not necessarily exhaustive! Always double check with your prescribing physician to make sure you are not taking any medication that is contraindicated for concomitant use! Also, be aware that certain chemicals have only mild interactions while some can go as far as being fatal if mixed with the drug being discussed. Again, always double check with your doctor to make sure it is safe for you to take any of these drugs.

If you are looking for information regarding the interactions between recreational chemicals and antidepressant/psychiatric medication, go to this thread: http://www.bluelight.ru/vb/showthread.php?threadid=27379. It is slightly out of date, so I'm working on contacting someone to see about fixing it up.

Here is another thread about dangerous drug combinations: http://www.bluelight.ru/vb/showthread.php?t=52825



ANTIDEPRESSANTS

Special note to people with bipolar disorder: unless specifically indicated, most of these drugs should not be taken without concomitant use of a mood stabilizer as they can induce severe manic episodes. Check with your prescribing doctor to see what drugs will be best for your treatment.

1. Selective Serotonin Reuptake Inhibitors (SSRI)
2. Norepinephrine-Dopamine Reuptake Inhibitors
3. Norepinephrine Reuptake Inhibitor (NRI/NARI)
4. Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)
5. Tricyclic Antidepressants (TCA)
6. Tetracyclic Antidepressants
7. Dopamine Reuptake Inhibitors (DARI)
8. Selective Serotonin Reuptake Enhancers (SSRE)
9. Reversible Inhibitors of Monoamine Oxidase A (RIMA)
10. Noradrenergic and Specific Serotonergic Antidepressant (NaSSA)
11. Monoamine Oxidase Inhibitors (MAOI)

Selective Serotonin Reuptake Inhibitors (SSRI)

SSRIs are a class of drugs known as Selective Serotonin Reuptake Inhibitors. They work by slowing the reuptake of the neurotransmitter serotonin into the neurons after it has been released into the synapse. This creates an environment of elevated serotonin levels in the synapses, which helps to stabilize mood and lift depression. The specific mechanisms by which SSRIs work are not well-known.

SSRIs are commonly prescribed for unipolar depression, anxiety and panic disorders, obsessive-compulsive disorders, and sometimes for eating disorders and body dysmorphic disorder. They are sometimes used "off-label" to treat Irritable Bowel Syndrome and premature ejaculation.

Care should be used when starting and stopping SSRI treatment, as you must taper on and off of these drugs. There can be mild to severe withdrawal associated with all of them, although some are more likely to cause problems than others.

There is an increased risk of suicidal ideation/behavior and suicide attempts during the first weeks of treatment with an SSRI, particularly in children and young adults. If you experience any increase in suicidal thoughts or behavior (or other unusual behavior/irritability) contact your prescribing doctor immediately - DO NOT quit taking your pills. The side effects listed for each drug are often temporary and will subside within a few weeks of beginning treatment. Some, however, will continue through the course of treatment and must be considered when evaluating the efficacy of the medication for you.

SSRIs SHOULD NEVER BE COMBINED WITH MAOIs (monoamine oxidase inhibitors - isocarboxazid (Marplan), moclobemide (Aurorix, Manerix, Moclodura), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl, Emsam), iproniazid (Marsilid, Iprozid, Ipronid, Rivivol, Propilniazida), iproclozide, nialamide, toloxatone, and harmala (present in Harmal, Banisteriopsis caapi, and tobacco). Certain tryptamines such 5-MeO-DMT or 5-MeO-AMT are weak MAOIs.

You should always be careful to prevent any drug interactions, and a list of potential problem drugs is included for each medication. Be cautious of combining any psychiatric medications (this includes benzodiazepines and antipsychotics in particular), and be particularly aware of the interactions between some of these drugs and antibiotics - clinics don't always double check. Some of these drugs also interact with methadone.

Overdose of SSRIs, or combination of SSRIs, can lead to serotonin syndrome.

There have been very few studies conducted regarding the safety of using SSRIs while pregnant or breastfeeding. Speak with your doctor if you plan to become pregnant while using any of these medications. Your best bet is to stop taking them (by the appropriate tapering method, of course) if you plan to be, or become, pregnant.

Citalopram (Celexa, Cipramil, Emocal, Sepram)

Typical dose: 20-60 mg per day
Treats: depression, anxiety (less common), body dysmorphic disorder (less common)
Common side effects: fatigue, drowsiness, dry mouth, hyperhidrosis (increased sweating), trembling, headache, dizziness, sleep disturbances, arrythmia (heart palpitations), increased blood pressure, indigestion/other digestive issues, loss of libido, and ejaculatory problems.
Potential drug interactions: cisapride*, carbamazepine (Tegretol), cimetidine (Tagamet), erythromycin (Eryc, Ery-Tab), fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), lithium (Lithobid, Lithonate), metoprolol (Lopressor), omeprazole (Prilosec), warfarin (Coumadin), alosetron, amphetamines, aspirin, benzodiazepines, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve), buspirone, certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine), clarithromycin, cyproheptadine, dexamethasone, dextromethorphan, diltiazem, ethosuximide, furazolidone, grapefruit juice, kava kava, linezolid, medicines that treat HIV infection or AIDS, methadone, migraine medications (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan), modafinil (Provigil), nefazodone, nicardipine, phenobarbital, phenytoin, prescription pain relievers (codeine, hydrocodone, meperidine, morphine, tramadol, oxycodone), primidone, procarbazine, quinine, rifabutin, rifampin, St. John's Wort, troglitazone, tryptophan, valerian, verapamil
*DO NOT COMBINE WITH THIS MEDICATION
Other info: DO NOT combine with escitalopram.

More information on citalopram

Escitalopram oxalate (Lexapro, Cipralex, Esertia)

Typical dose: 10-20 mg per day
Treats: depression, anxiety disorders, obsessive-compulsive disorder, body dysmorphic disorder
Common side effects: nausea, insomnia, problems with ejaculation, somnolence (sleepiness), hyperhidrosis (increased sweating), fatigue, decreased libido, and anorgasmia (inability to achieve orgasm)
Potential drug interactions: cisapride*, aspirin, carbamazepine (Tegretol), cimetidine (Tagamet), desipramine (Norpramin), ketoconazole (Nizoral), linezolid (Zyvox), lithium (Eskalith), metoprolol (Lopressor), sumatriptan (Imitrex), warfarin (Coumadin), nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil) or naproxen (Aleve), alosetron, amphetamines, benzodiazepines, buspirone, certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine), clarithromycin, cyproheptadine, dexamethasone, dextromethorphan, diltiazem, erythromycin, ethosuximide, furazolidone, grapefruit juice, itraconazole, kava kava, medicines that treat HIV infection or AIDS, migraine medications (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan), methadone, modafinil (Provigil), nefazodone, phenobarbital, phenytoin, prescription pain relievers (codeine, hydrocodone, meperidine, morphine, tramadol, oxycodone), primidone, procarbazine, quinine, rifabutin, rifampin, St. John's Wort, troglitazone, tryptophan, valerian, verapamil, voriconazole
*DO NOT COMBINE WITH THIS MEDICATION
Other info: DO NOT combine with citalopram.

More information on escitalopram oxalate

Fluoxetine (Prozac, Symbyax*, Fontex, Lovan, Seromex, Seronil, Sarafem, Fluctin, FLUX, Fluxil, Fluxine, Modipran, Prolert, Prozyn, Rize, Ufrex, Vonder, Zauxit, Foxetin, Ladose, Fludac, Oxetin) *in combination with olanzapine

Typical dose: 20-60 mg per day (80 mg max)
Treats: depression, anxiety and panic disorders, obsessive-compulsive disorder, bulimia nervosa, anorexia nervosa (questionable results), premenstrual dysphoric disorder, slow-channel congenital myasthenic syndrome (off-label)
Common side effects: anxiety, headache, restlessness, insomnia, nausea, diarrhea, weight loss, trembling, weakness, skin rash, decreased libido, anorgasmia (inability to reach orgasm), weight gain.
Potential drug interactions: astemizole* (Hismanal), cisapride* (Propulsid), pimozide* (Orap), terfenadine* (Seldane), thoridazine* (Mellaril), amphetamines, aspirin, benzodiazepines, buspirone, carbamazepine, diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine), migraine medications (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, dihydroergotamine, ergotamine, methysergide), cimetidine (Tagamet), cyproheptadine, dextromethorphan, dofetilide, ergonovine, furazolidone, linezolid, lithium, metoprolol, methylergonovine, ibuprofen (Advil), phenytoin, propafenone, propranolol, St. John's wort, warfarin (Coumadin)
*DO NOT COMBINE THIS DRUG WITH ANY OF THESE
Other info: fluoxetine is considered an atypical SSRI because of its pronounced effects on dopamine and norepinephrine concentration in the synapse. Fluoxetine is considered to be one of the least withdrawal-inducing drugs because of its long half-life. Fluoxetine can cause manic episodes, rapid cycling, and other problems in bipolar patients, especially if they are not on a mood stabilizer.

More information on fluoxetine

fluvoxamine maleate (Luvox, Faverin, Fevarin, Dumyrox)

Typical dose: 50-300 mg per day (dependent on condition being treated)
Treats: depression, anxiety and panic disorders, obsessive-compulsive disorder,
Common side effects: anorexia, constipation, dry mouth, headache, nausea, nervousness, skin rash, manic episodes, insomnia, somnolence, liver toxicity, increased urination, seizures, hyperhidrosis (increased sweating), tremors, and Tourette's syndrome.
Potential drug interactions: astemizole* (Hismanal), cisapride* (Propulsid), pimozide (Orap*), ramelteon* (Rozerem), terfenadine* (Seldane), thioridazine* (Mellaril), alcohol, amphetamines, benzodiazepines, caffeine, carbamazepine, diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine), cimetidine (Tagamet), dextromethorphan, diltiazem, dofetilide, doxercalciferol, ergonovine, grapefruit juice, kava kava, linezolid, medications for the treatment of HIV infection or AIDS, melatonin, migraine medications (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, dihydroergotamine, ergotamine, methysergide), methylergonovine, metoprolol, paricalcitol, propranolol, sildenafil, St. John's wort, Hypericum perforatum, theophylline, tizanidine, valerian, verapamil, voriconazole, warfarin (Coumadin)
*DO NOT MIX THIS DRUG WITH ANY OF THESE
Other info: Fluvoxamine seems to have fewer side effects than other SSRIs, particularly with respect to loss of libido/inability to reach orgasm.

More information on fluvoxamine maleate.

Paroxetine (Paxil, Seroxat, Aropax, Deroxat, Pondera, Cebrilin)

Typical dose 20-50mg per day
Treats: depression, anxiety and panic disorders, obsessive-compulsive disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, chronic headache (off-label), bipolar disorder (off-label), compulsive gambling (off-label), hot flashes (off-label), diabetic neuropathy (off-label)
Common side effects: somnolence, headache, loss of appetite, weight gain, nausea, decreased libido, anorgasmia (inability to reach orgasm), dry mouth, constipation, diarrhea, rash, restlessness, itchiness, hyponatremia, hyperhidrosis (increased sweating)
Potential drug interactions: astemizole* (Hismanal), cisapride* (Propulsid), pimozide* (Orap), terfenadine* (Seldane), thioridazine* (Mellaril), antacids (only interacts with Paxil CR), alcohol, amphetamines, certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine), certain migraine medications (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan), cimetidine (Tagamet), dextromethorphan, digoxin, doxercalciferol, fosphenytoin, furazolidone, linezolid, lithium, antipsychotics, medications for regulating heart rhythm or blood pressure, phenobarbital, phenytoin, prescription pain medications, primidone, procarbazine, St. John's wort, Hypericum perforatum, theophylline, tramadol, warfarin (Coumadin)
*DO NOT COMBINE THIS MEDICATION WITH ANY OF THESE
Other info: Paroxetine seems to have an increased rate and severity of withdrawal issues with some people reporting electric shock sensations (paraesthesia), auditory hallucination, severe flu-like symptoms, dizziness, and other withdrawal symptoms.

More information on paroxetine.

Sertraline (Zoloft, Lustral, Serlain, Sertralin, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Concorz)

Typical dose: 50-200 mg per day
Treats: depression, anxiety and panic disorders, obsessive-compulsive disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, binge eating disorders (off-label), refractory neurocardiogenic syncope (off-label), impulsive aggressive behavior (off-label)
Common side effects: insomnia, feeling of weakness (asthenia), nausea, loss of appetite, tremors, confusion, dizziness, anorgasmia (inability to reach orgasm), and decreased libido
Potential drug interactions: astemizole* (Hismanal), cisapride* (Propulsid), pimozide* (Orap), terfenadine* (Seldane), thioridazine* (Mellaril), amphetamines, bosentan, carbamazepine, certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine), certain migraine medications (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan), cimetidine (Tagamet), cyclosporine, dextromethorphan, diazepam, doxercalciferol, furazolidone, linezolid, phenobarbital, prescription pain medications, procarbazine, rifabutin, rifampin, rifapentine, St. John's wort, sleep medications, tolbutamide, tramadol, warfarin (Coumadin)
*DO NOT COMBINE THIS MEDICATION WITH ANY OF THESE
Other info: This medication should not be administered while electroconvulsive therapy is being used.

More information on sertraline.

 

[kittyinthedark]

Norepinephrine-Dopamine Reuptake Inhibitors

Bupropion (a.k.a. amfebutemone)(Wellbutrin, Zyban)

Typical dose: 150-300 mg daily (sometimes slightly higher)
Treats: depression, smoking addiction, bipolar disorder (off-label), schizoaffective disorder (off-label)
Common side effects: dry mouth, tremors, anxiety, loss of appetite, agitation, dizziness, headache, hyperhidrosis (increased sweating), increased risk of seizure, aggressiveness, and both initial and terminal insomnia
Potential drug interactions: alcohol, amphetamines, carbamazepine, cimetidine (Tagamet), cocaine, corticosteroids, disulfiram*, doxercalciferol, kava kava (Piper methysticum), levodopa, linezolid, medications or herbal products for weight control or appetite, sleep medications, nicotine, orphenadrine, phenobarbital, phenytoin, rifampin, ritonavir, some medicines for heart rhythm or blood pressure, migraine medication, prescription painkillers, St. John's wort (Hypericum perforatum), theophylline, tramadol, valerian (Valeriana officinalis), valproic acid (Depakote), warfarin (Coumadin)
Other info: Bupropion can raise the risk of seizure in some patients. People with a high risk for or past history of epilepsy should exercise caution when using this medication. People also taking insulin, sympathomimetic anorectical drugs, or antimalaria agents should not take more than 150 mg daily.

*DO NOT combine these drugs.

More information on bupropion

Norepinephrine/Noradrenaline Reuptake Inhibitors (NRI/NARI)

Atomoxetine (Strattera)

Typical dose: up to 60 mg per day
Treats: ADHD, depression (somewhat less common)
Common side effects: insomnia, somnolence (sleepiness), dry mouth, decreased appetite, weight loss, nausea, dizziness, tiredness, mood swings, irritability, ear infection, influenza
Potential drug interactions: alcohol, amphetamines, atropine, breathing treatments (albuterol, formoterol, salmeterol), cimetidine (Tagamet), certain heart medications such as amiodarone or quinidine, decongestant or cold medications, ephedra (Ma huang, ephedrine), furazolidone, linezolid,vmedications for HIV infection or AIDS such as ritonavir, medications for weight loss, procarbazine, scopolamine, thioridazine (Mellaril)
Other info: Atomoxetine is one of very few non-stimulant treatments for ADHD. The manufacturer of atomoxetine saw no statistically significant antidepressant properties in its studies, but there are some patients, particularly with treatment-resistant depression, that respond to it very well as a treatment for depression.

More information on atomoxetine.

Reboxetine (Edronax, Norebox, Prolift, Solvex, Vestra)

Typical dose: 8-12 mg per day
Treats: ADHD, depression
Common side effects: constipation, dizziness, dry mouth, headache, decreased libido, hyperhidrosis (increased sweating), tremor, insomnia, trouble urinating
Potential drug interactions: bosentan, certain antibiotics (clarithromycin, erythromycin, troleandomycin, and others), SSRIs, certain heart medicines (amiodarone, diltiazem, verapamil, and others), imatinib (STI-571), medicines used to treat fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole, and others), medicines used for treating seizures (carbamazepine, oxcarbazepine, phenobarbital, phenytoin, primidone, and others), medicines used for treating HIV or AIDS infection (nelfinavir, ritonavir, saquinavir, efavirenz, delavirdine, nevirapine, and others), rifampin, rifabutin, St. John's wort, zafirlukast, lorazepam

More information on reboxetine.

Viloxazine (Emovit, Vivalan, Vivarint, Vicilan) (discontinued in UK)

Typical dose: 500 mg per day (unsure)
Treats: depression, nocturnal enuresis (bedwetting), narcolepsy (uncommon), alcoholism
Common side effects: nausea, vomiting, insomnia, loss of appetite, increased erythrocyte sedimentation, EKG and EEG anomalies, epigastric pain, diarrhea, constipation, vertigo, orthostatic hypotension, edema of the lower extremities, dysarthria, tremor, psychomotor agitation, mental confusion, inappropriate secretion of antidiuretic hormone, increased transaminases, and increased libido.
Potential drug interactions: alcohol, phenytoin, theophylline, carbamazepine
Other info: Viloxazine is known to increase plasma levels of phenytoin by an average of 37%. It is also known to significantly increase plasma levels of theophylline and decrease its clearance from the body, sometimes resulting in accidental overdose of theophylline. Viloxazine did cause seizures in a few trials, but it is also shown to have anticonvulsant properties, so it may be used with caution in epileptic patients.

More information on viloxazine.


Serotonin-Norepinephrine Reuptake Inhibitor (SNRI)

Duloxetine (Cymbalta, Yentreve)

Typical dose: 40-60 mg per day for depression, up to 120 mg for peripheral neuropathy
Treats: depression, bipolar disorder, diabetic peripheral neuropathy, stress urinary incontinence
Common side effects: nausea, vomiting, abdominal pain, somnolence, insomnia, restlessness, dry mouth, dark urine, difficulty breathing, chest pains, fainting spells, itching, rash, mania, unexplained flu-like symptoms, mild jaundice
Potential drug interactions: alcohol, amphetamines, certain migraine headache medicines (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan), dextroamphetamine, doxercalciferol, furazolidone, linezolid, lithium, medicines for heart rhythm or blood pressure, medications for weight control or appetite, MAO inhibitors, procarbazine, St. John's wort (Hypericum perforatum)
Other info: Based upon personal experience, combining duloxetine with alcohol or marijuana can cause very severe insomnia.

More information on duloxetine.

Milnacipran (Ixel)

Typical dose: 100 mg per day
Treats: depression, chronic pain, fibromyalgia, lupus
Common side effects: itching, nausea, vertigo, increased anxiety, sweats, shivering, dysuria and testicle pain
Potential drug interactions: MAO inhibitors, lithium, 5-HT1AD agonists, epinephrine, norepinephrine, clonidine, digitalis-glycosids
Other info: Dosage should be decreased in patients with advanced renal disease. Milnacipran should be used with caution in patients with hypertrophy of the prostate gland, hypertension, heart disease, or open angle glaucoma.

More information on milnacipran.

Venlafaxine (Effexor, Efexor, Efectin)

Typical dose: 75-225 mg per day (sometimes higher)
Treats: depression, anxiety disorders
Common side effects: nausea, dizziness, somnolence (sleepiness), insomnia, vertigo, dry mouth, sexual dysfunction, hyperhidrosis (increased sweating), vivid dreams, increased blood pressure, electric shock-like sensations, difficulty breathing, fainting spells, dysuria, mania, anxiety, blurred vision
Potential drug interactions: Salvia divinorum (salvia, Sally D, Ska Pastora, yerba de Maria, Shepherdess's Herb), alcohol, amphetamines, migraine headache medicines (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan), cimetidine (Tagamet), furazolidone, linezolid, lithium, medicines for heart rhythm or blood pressure, medications for weight control or appetite, MAO inhibitors, procarbazine, St. John's wort (Hypericum perforatum), metoclopramide, propafenone, tranylcypromine, trimipramine
Other info: Venlafaxine often causes very severe withdrawal if suddenly discontinued, or even if tapering is done too quickly. You should taper no faster than 37.5 mg per week. Studies conducted by Wyeth-Ayerst found cases of withdrawal so severe that they required permanent maintenance on venlafaxine. Some of these cases were successfully managed by concomitant administration of fluoxetine, reduction and discontinuation of venlafaxine dose, then subsequent discontinuation of fluoxetine.

More information on venlafaxine.

 

[kittyinthedark]

Tricyclic Antidepressants (TCA's)

TCAs are used to treat depression, neuropathic pain, nocturnal enuresis (bedwetting), and a number of other off-label conditions.

The method of action of TCAs is not well-understood, but it is believed to work by inhibiting reuptake of norepinephrine, noradrenaline, serotonin, and/or dopamine in the brain. Some drugs are more well-researched and the chemical effects are more well-known (for example, it is known that amitryptyline affects both serotonin and noradrenaline).

TCAs may make your skin more sensitive to the sun. Make sure to wear protective clothing and use sunscreen if you will be out in the sun, and do not use tanning beds or heat lamps while you are on any of these medications.

From Wikipedia: TCAs are highly metabolized by the cytochrome P450 hepatic enzymes. Drugs that inhibit cytochrome P450 (for example cimetidine, methylphenidate, antipsychotics, and calcium channel blockers) may produce decreases in the tricyclics metabolism leading to increases in tricyclic blood concentrations and accompanying toxicity. Drugs which prolong the QT interval including antiarrhythmics such as quinidine, the antihistamines astemizole and terfenadine, and some antipsychotics may increase the chance of ventricular dysrhythmias. TCAs may enhance the response to alcohol and the effects of barbiturates and other CNS depressants. Side effects may also be enhanced by other drugs which have antimuscarinic properties.

Amitryptyline (Elavil, Endep, Tryptanol, Elatrol, Tryptizol)

Typical dose: 75 to 200 mg per day
Treats: depression, involutional melancholia, secondary depression due to alcoholism
or schizophrenia, noctural enuresis in children over the age of 7, insomnia (off-label), chronic pain (off-label), postherpetic neuralgia (off-label), fibromyalgia (off-label), vulvodynia (off-label), interstitial cystitis (off-label), irritable bowel syndrome (off-label), migraines (off-label, as prophylaxis)
Potential side effects: abnormal production of milk in females, anxiety, agitation, panic attacks, inability to sleep, irritability, hostility or extreme anger, aggressiveness, engaging in unusual or dangerous activities, restlessness or inability to sit still, acute manic and depressed spikes (often cycling), blurred vision or eye pain, breast enlargement in both males and females, confusion, hallucinations, difficulty breathing, fainting spells, fever with increased sweating, irregular heartbeat, muscle stiffness/spasms, pain or difficulty passing urine, loss of bladder control, seizures, sexual difficulties, stomach pain, swelling of the testicles, tingling/pain/numbness in the feet or hands, unusual weakness or tiredness, yellowing of the eyes or skin, anxiety, constipation, diarrhea, drowsiness or dizziness, dry mouth, increased sensitivity of the skin to sun or ultraviolet light, loss of appetite, nausea, vomiting, skin rash or itching, weight gain or loss
Potential drug interactions: astemizole* (Hismanal), cisapride* (Propulsid), probucol*, terfenadine* (Seldane), thioridazine* (Mellaril), MAO inhibitors*, alcohol, antacids, atropine and related drugs (hyoscyamine, scopolamine, tolterodine and others), barbiturate medicines for inducing sleep or treating seizures (such as phenobarbital), blood thinners (such as warfarin), bromocriptine, bupropion (Wellbutrin, Zyban), cimetidine (Tagamet), clonidine, cocaine, delavirdine, diphenoxylate, disulfiram, donepezil, drugs for treating HIV infection, female hormones (including contraceptive or birth control pills and estrogen), galantamine, herbs and dietary supplements like (ephedra/Ma huang, kava kava, SAM-e, St. John's wort, valerian, etc), imatinib (STI-571), kaolin/pectin, labetalol, levodopa and other medicines for movement problems like Parkinson's disease, lithium, medicines for anxiety or sleeping problems, medicines for cold/flu/breathing difficulties (like pseudoephedrine), medicines for hay fever or allergies (antihistamines), medicines for weight loss or appetite control, medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others), metoclopramide, muscle relaxants (like cyclobenzaprine, etc.), prescription pain medications (like morphine, codeine, tramadol and others), procarbazine, seizure (convulsion) or epilepsy medicine such as carbamazepine or phenytoin, stimulants like dexmethylphenidate or methylphenidate, some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin), tacrine, thyroid hormones like levothyroxine
*DO NOT COMBINE THIS MEDICATION WITH ANY OF THESE
Other info: If you are diabetic, check your blood sugar more often than usual,
especially during the first few weeks of treatment with amitriptyline. Amitriptyline can affect blood glucose (sugar) levels. Call your prescriber or health care professional for advice if you notice a change in the results of blood or urine glucose tests. If you are going to have surgery or will need an x-ray procedure that uses contrast agents, tell your prescriber or health care professional that you are taking this medicine.


Clomipramine (Anafranil)

Typical dose: 100-225 mg per day (up to 300)
Treats: depression, obsessive-compulsive disorders, panic attacks, narcolepsy, chronic pain,
nocturnal enuresis, cocaine addiction relapse (off-label)
Potential side effects: abnormal production of milk in females, blurred vision or eye pain, breast enlargement in both males and females, confusion, hallucinations, difficulty breathing, fainting spells, fever, irregular heartbeat, muscle stiffness/spasms, pain or difficulty passing urine, loss of bladder control, seizures, sexual difficulties, stomach pain, swelling of the testicles, tingling/pain/numbness in the feet or hands, tremor, unusual weakness or tiredness, yellowing of the eyes or skin, anxiety, constipation, or diarrhea, drowsiness or dizziness, dry mouth, headache, increased sensitivity of the skin to sun or ultraviolet light, loss of appetite, nausea, vomiting, skin rash or itching, weight gain or loss
Potential drug interactions: astemizole* (Hismanal), cisapride* (Propulsid),
probucol*, terfenadine* (Seldane), thioridazine* (Mellaril), MAO inhibitors*, alcohol, antacids, atropine and related drugs (like hyoscyamine, scopolamine, tolterodine and others), barbiturate medicines for inducing sleep or treating seizures such as phenobarbital, blood thinners such as warfarin, bromocriptine, bupropion (Wellbutrin, Zyban), cimetidine (Tagamet), clonidine, cocaine, delavirdine, diphenoxylate, disulfiram, donepezil, drugs for treating HIV infection, female hormones (including contraceptive or birth control pills and estrogen), galantamine, herbs and dietary supplements (like ephedra/Ma huang, kava kava, SAM-e, St. John's wort, valerian, or others), imatinib (STI-571), kaolin/pectin, labetalol, levodopa and other medicines for movement problems like Parkinson's disease, lithium, medicines for anxiety or sleeping problems, medicines for cold/flu/breathing difficulties (like pseudoephedrine), medicines for hay fever or allergies (antihistamines), medicines for weight loss or appetite control, medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others), metoclopramide, muscle relaxants like cyclobenzaprine, prescription pain medications (morphine, codeine, tramadol, and others), procarbazine, seizure (convulsion) or epilepsy medicine such as carbamazepine or phenytoin, stimulants like dexmethylphenidate or methylphenidate, some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin), tacrine, thyroid hormones such as levothyroxine
*DO NOT COMBINE THIS MEDICATION WITH ANY OF THESE
Other info: Clomipramine should not be used in patients with delirium tremens or coma, hypertrophy of the prostate with urine retention, closed-angle glaucoma, epilepsy or other conditions that lower the seizure threshold, serious liver or kidney disease, severe hypotension, shock, serious cardiovascular dysfunction, or bone marow depression or any form. Patients with hyperfunction of the thyroid gland should use caution when taking this medication.


Desipramine (Norpramin, Pertofrane)

Typical dose: 75-225 mg per day (??)
Treats: depression, neuropathic pain, nocturnal enuresis
Potential side effects: abnormal production of milk in females, blurred vision or eye pain, breast enlargement in both males and females, confusion, hallucinations, difficulty breathing, fainting spells, fever, irregular heartbeat, muscle stiffness/spasms, pain or difficulty passing urine, loss of bladder control, seizures, sexual difficulties, stomach pain, swelling of the testicles, tingling/pain/numbness in the feet or hands, tremor, unusual weakness or tiredness, yellowing of the eyes or skin, anxiety, constipation, diarrhea, drowsiness or dizziness, dry mouth, headache, increased sensitivity of the skin to sun or ultraviolet light, loss of appetite, nausea, vomiting, skin rash or itching, weight gain or loss
Potential drug interactions: astemizole* (Hismanal), cisapride* (Propulsid), probucol*, terfenadine* (Seldane), thioridazine* (Mellaril), MAO inhibitors*, alcohol, antacids, atropine and related drugs (like hyoscyamine, scopolamine, tolterodine and others), barbiturate medicines for inducing sleep or treating seizures such as phenobarbital, blood thinners such as warfarin, bromocriptine, bupropion (Wellbutrin, Zyban), cimetidine (Tagamet), clonidine, cocaine, delavirdine, diphenoxylate, disulfiram, donepezil, drugs for treating HIV infection, female hormones (including contraceptive or birth control pills and estrogen), galantamine, herbs and dietary supplements (like ephedra/Ma huang, kava kava, SAM-e, St. John's wort, valerian, or others), imatinib (STI-571), kaolin/pectin, labetalol, levodopa and other medicines for movement problems like Parkinson's disease, lithium, medicines for anxiety or sleeping problems, medicines for colds/flu/breathing difficulties like pseudoephedrine, medicines for hay fever or allergies (antihistamines), medicines for weight loss or appetite control, medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others), metoclopramide, muscle relaxants like cyclobenzaprine, prescription pain medications (like morphine, codeine, tramadol and others),procarbazine, seizure or epilepsy medicine such as carbamazepine or phenytoin, stimulants like dexmethylphenidate or methylphenidate, some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin), tacrine, thyroid hormones such as levothyroxine
*DO NOT COMBINE THIS MEDICATION WITH ANY OF THESE
Other info: Desipramine is especially useful in treating neuropathic pain among the TCAs.


Dosulepin/Dothiepin (Prothiaden, Thaden, Dothapax, Prepadine)

Typical dose: 50-150 mg per day up to 225 mg
Treats: low-level anxiety, depression, and similar disorders, particularly when insomnia and anorexia are present
Common side effects: blurred vision, dry mouth, dilated pupils, hypothermia, constipation, tachycardia, arrhythmias, confusion, urinary retention, tremors, blood disorders, hypotension, sexual dysfunction, hyperhidrosis, increased sensitivity to sunlight, sedation, rashes, hypomania, weight gain
Potential drug interactions: adrenaline, alcohol, cimetidine (Tagamet), MAOIs, phenylephrine, SSRIs, any vasoconstrictors, any medication that affects electrical impulses to the heart (e.g. astemizole, halofantrine, terfenadine), herbal remedies for depression
Other info: This drug is not recommended for use in children. It should not be taken by people with heart conditions related to eletrical impulses to the heart (particularly arrhythmia or recent heart attack), mania, liver disease, thyroid disease, epilepsy, phaeochromocytoma glaucoma, diabetes, hypotension, urinary retention, porphyria, or vulnerability to dizziness or fainting.

More info on Dosulepin/Dothiepin


Doxepin (Adapin, Adapine, Sinequan, Sinquan, Aponal, Zonalon [topical], Xepin [topical])

Typical dose: 5-150 mg per day (up to 300 mg in clinical treatment)
Treats: depression, anxiety disorders, insomnia, alcohol withdrawal symptoms (not including seizure activity), gastrointestinal uleceration, Irritable Bowel Syndrome, tension headaches, dermatological itch (topical cream)
Common side effects: fatigue, dizziness, drowsiness, lightheadedness, confusion, nightmares, agitation, anxiety, insomnia, delirium, dry mouth, obstipation, difficulty urinating, hyperhidrosis, hypotension, arrhythmias, skin rash, sensitivity to sunlight, increased appetite, weight gain, sexual dysfunction
Potential drug interactions: astemizole* (Hismanal), cisapride* (Propulsid), probucol*, terfenadine* (Seldane), thioridazine* (Mellaril), MAOIs*, alcohol, antacids, atropine and related drugs (like hyoscyamine, scopolamine, tolterodine and others), barbiturate medicines for inducing sleep or treating seizures, blood thinners such as warfarin (Coumadin), bromocriptine, bupropion, cimetidine (Tagamet), clonidine, cocaine, delavirdine, diphenoxylate, disulfiram, donepezil, drugs for treating HIV infection, female hormones (including contraceptive or birth control pills and estrogen), galantamine, guanethidin, guanfacin, herbs and dietary supplements (like ephedra (Ma huang), kava kava, SAM-e, St. John's wort, valerian, or others), imatinib/STI-571, kaolin/pectin, labetalol, levodopa and other medicines for movement problems like Parkinson's disease, lithium, medicines for anxiety or sleeping problems, medicines for colds/flu/breathing difficulties like pseudoephedrine, medicines for hay fever or allergies (antihistamines), medicines for weight loss or appetite control, medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others), metoclopramide, muscle relaxants like cyclobenzaprine, prescription pain medications (like morphine, codeine, tramadol and others), procarbazine, seizure (convulsion) or epilepsy medicine such as carbamazepine or phenytoin, reserpin, stimulants like dexmethylphenidate or methylphenidate, some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin), tacrine, thyroid hormones such as levothyroxine
*DO NOT COMBINE THIS MEDICATION WITH ANY OF THESE
Other info: This medication should not be taken if you are hypersensitive to doxepin or other dibenzoxepines, are experiencing acute delirium tremens, have untreated closed angle glaucoma, have hypertropy of the prostate with urine retention, or have paralytic ileus. Caution should be used in patients with hypertrophy of the prostate without urine retention, reduced function of the bone marrow, organic brain disorders, preexisting epilepsy or high seizure risk, preexisting cardial damage (particularly arrhythmias like sinoatrial blockage). This medication is not indicated for use in children.

More info on Doxepin

Imipramine (Tofranil, Berkomine, Praminil)

Typical dose: 150-300 mg per day (only up to 100 mg in the elderly and less in children)
Treats: depression, nocturnal enuresis in children
Common side effects: increased sensitivity to sunlight, tremors, dry mouth, blurred vision, constipation, diarrhea, insomnia, drowsiness, dizziness, headache, hyperhidrosis, flushing, loss of appetite, skin rash or itching, weight gain, agitation, irritability, confusion, and delirium
Potential drug interactions: astemizole* (Hismanal), cisapride* (Propulsid), probucol*, terfenadine* (Seldane), thioridazine* (Mellaril), MAOIs*, alcohol, antacids, atropine and related drugs (like hyoscyamine, scopolamine, tolterodine and others), barbiturate medicines for inducing sleep or treating seizures such as phenobarbital, blood thinners such as warfarin (Coumadin), bromocriptine, bupropion, cimetidine (Tagamet), clonidine, cocaine, delavirdine, diphenoxylate, disulfiram, donepezil, drugs for treating HIV infection, female hormones (including contraceptive or birth control pills and estrogen), galantamine, herbs and dietary supplements (like ephedra (Ma huang), kava kava, SAM-e, St. John's wort, valerian, or others), imatinib/STI-571, kaolin/pectin, labetalol, levodopa and other medicines for movement problems like Parkinson's disease, lithium, medicines for anxiety or sleeping problems, medicines for colds/flu/breathing difficulties like pseudoephedrine, medicines for hay fever or allergies (antihistamines), medicines for weight loss or appetite control, medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others), metoclopramide, muscle relaxants like cyclobenzaprine, prescription pain medications (like morphine, codeine, tramadol and others), procarbazine, seizure or epilepsy medicine such as carbamazepine or phenytoin, stimulants like dexmethylphenidate or methylphenidate, some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin), tacrine, thyroid hormones such as levothyroxine
Other info: Imipramine should not be taken by patients with epilepsy, organic brain damage, urine retention, heart diseases, or acute glaucoma and should be used with caution in patients with hyperthyroidism or liver diseases.

More info on Imipramine.

Lofepramine (Gamanil, Lomont, Ferprapax)

Typical dose: 140-210 mg daily (in divided doses)
Treats: depression, anxiety, reflex sympathetic dystrophy
Common side effects: drowsiness, blurred vision, dry mouth, constipation, nausea, low blood pressure, urinary retention, hyperhidrosis (increased sweating, heartbeat irregularities, weight changes, muscle stiffness or spasms, confusion, difficulty breathing, unusual weakness or tremor, fever, yellowing of the eyes or skin, fainting spells
Potential drug interactions: ??? I was unable to find any comprehensive information on drug interactions. Do not combine with MAOIs. See your prescribing doctor for more information.
Other info: Lofepramine should not be used in patients with liver failure or heart disease. Use with caution in epileptic patients or those with glaucoma or psychosis.

More information on Lofepramine


Nortriptyline (Pamelor, Aventyl)

Typical dose: 70-100 mg per day (maximum of 150 mg)
Treats: depression, childhood nocturnal enuresis (bewetting), chronic pain modification, migraine treatment/prevention
Common side effects: dry mouth, drowsiness, orthostatic hypotension (head rushes upon standing), urinary retention, constipation, rapid or irregular heartbeat.
Potential drug interactions: •astemizole (Hismanal)*, cisapride (Propulsid)*, probucol*, terfenadine (Seldane)*, thioridazine (Mellaril)*, MAOIs*, alcohol, antacids, atropine and related drugs (like hyoscyamine, scopolamine, tolterodine and others), barbiturate medicines for inducing sleep or treating seizures (convulsions) such as phenobarbital, blood thinners such as warfarin (Coumadin), bromocriptine, bupropion (Wellbutrin, Zyban), cimetidine (Tagamet), clonidine, cocaine, delavirdine, diphenoxylate, disulfiram, donepezil, drugs for treating HIV infection, female hormones (including contraceptive or birth control pills and estrogen), galantamine, herbs and dietary supplements (like ephedra (Ma huang), kava kava, SAM-e, St. John's wort, valerian, or others), imatinib (STI-571), kaolin/pectin, labetalol, levodopa and other medicines for movement problems like Parkinson's disease, lithium, medicines for anxiety or sleeping problems, medicines for colds/flu/breathing difficulties (like pseudoephedrine), medicines for hay fever or allergies (antihistamines), medicines for weight loss or appetite control, medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others), metoclopramide, muscle relaxants like cyclobenzaprine, prescription pain medications (like morphine, codeine, tramadol and others), procarbazine, seizure (convulsion) or epilepsy medicine such as carbamazepine or phenytoin, stimulants like dexmethylphenidate or methylphenidate, some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin), tacrine, thyroid hormones such as levothyroxine
* DO NOT combine these medications
Other info: Patients with a history of cardiovascular disease, stroke, glaucoma, epilepsy, or hyperthyroidism should be carefully monitored while on nortriptyline. Nortriptyline should not be used in patients in the acute recovery phase after myocardial infarction (heart attack)

More information on Nortriptyline


Protriptyline (Vivactil)

Typical dose: 15-40 mg per day
Treats: depression, ADHD
Common side effects: abnormal production of milk in females, blurred vision or eye pain, breast enlargement in both males and females, confusion, hallucinations (seeing or hearing things that are not really there), difficulty breathing, fainting spells, fever, irregular or fast, pounding heartbeat, palpitations, muscle stiffness, or spasms, pain or difficulty passing urine, loss of bladder control, seizures (convulsions), sexual difficulties (decreased sexual ability or desire), stomach pain, swelling of the testicles, tingling, pain, or numbness in the feet or hands, tremor (shaking), unusual weakness or tiredness, yellowing of the eyes or skin
Potential drug interactions: astemizole (Hismanal)*, cisapride (Propulsid)*, probucol*, terfenadine (Seldane)*, thioridazine (Mellaril)*, MAOIs*, alcohol, antacids, atropine and related drugs (like hyoscyamine, scopolamine, tolterodine and others), barbiturate medicines for inducing sleep or treating seizures (convulsions) such as phenobarbital, blood thinners such as warfarin (Coumadin), bromocriptine, bupropion (Wellbutrin, Zyban), cimetidine (Tagamet), clonidine, cocaine, delavirdine, diphenoxylate, disulfiram, donepezil, drugs for treating HIV infection, female hormones (including contraceptive or birth control pills and estrogen), galantamine, guanethidine (Ismelin), herbs and dietary supplements (like ephedra (Ma huang), kava kava, SAM-e, St. John's wort, valerian, or others), imatinib/STI-571, kaolin/pectin, labetalol, levodopa and other medicines for movement problems like Parkinson's disease, lithium. medicines for anxiety or sleeping problems, medicines for colds/flu/breathing difficulties (like pseudoephedrine), medicines for hay fever or allergies (antihistamines), medicines for weight loss or appetite control, medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others), metoclopramide, muscle relaxants like cyclobenzaprine, prescription pain medications (like morphine, codeine, tramadol and others), procarbazine, seizure (convulsion) or epilepsy medicine such as carbamazepine or phenytoin, stimulants (like dexmethylphenidate or methylphenidate), some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin), tacrine, thyroid hormones such as levothyroxine
*DO NOT combine these medications
Other info: Do not use protriptyline in patients with glaucoma or predisposition to urinary retnetion. Use with caution in patients with a history of epilepsy/seizures or hyperthyroidism.

More information on Protriptyline


Trimipramine (Surmontil)

Typical dose: 75-200 mg per day (up to 300 or 400 mg in severely depressed patients - usually requires hospitalization)
Treats: depression, anxiety
Common side effects: anxiety, constipation, diarrhea, drowsiness or dizziness, dry mouth, increased sensitivity of the skin to sun or ultraviolet light, loss of appetite, nausea/vomiting, ringing in the ears, skin rash/itching, unpleasant taste, weight gain or loss, blood pressure changes, blurred vision or eye pain, unusual bruising, confusion, difficulty breathing, fainting spells, fever, hyperhidrosis (increased sweating), irregular heartbeat, muscle stiffness or spasms, stomach pain, tingling/pain/numbness in the feet or hands, unusual weakness or tiredness, yellowing of the skin or eyes
Potential drug interactions: astemizole (Hismanal)*, cisapride (Propulsid)*, probucal*, terfenadine (Seldane(, thioridazine (Mellaril)*, MAOIs*, alcohol, antacids, aprepitant, atropine and related drugs (like hyoscyamine, scopolamine, tolterodine and others), barbiturate medicines for inducing sleep or treating seizures (convulsions) such as phenobarbital, blood thinners such as warfarin (Coumadin), bromocriptine, bupropion (Wellbutrin, Zyban), cimetidine (Tagamet), clonidine, cocaine, delavirdine, diphenoxylate, disulfiram, donepezil, drugs for treating HIV infection, female hormones (including contraceptive or birth control pills and estrogen), galantamine, herbs and dietary supplements (like ephedra (Ma huang), kava kava, SAM-e, St. John's wort, valerian, or others), imatinib/STI-571, kaolin/pectin, labetalol, levodopa and other medicines for movement problems like Parkinson's disease, lithium, medicines for anxiety or sleeping problems, medicines for hay fever or allergies (antihistamines), medicines for colds/flu/breathing difficulties (like pseudoephedrine), medicines for fungus infections (examples: fluconazole, voriconazole), medicines for thyroid disease (examples: levothyroxine, methimazole, potassium iodide, sodium iodide, propylthiouracil), medicines for weight loss or appetite control, medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others), modafinil (Provigil), muscle relaxants like cyclobenzaprine, naphazoline, oxymetazoline, phenylephrine (often found in over the counter cold medicine), prescription pain medications (like morphine, codeine, tramadol and others), procarbazine, seizure (convulsion) or epilepsy medicine such as carbamazepine or phenytoin, stimulants like dexmethylphenidate or methylphenidate, some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin), tacrine, xylometazoline
*DO NOT combine these medications
Other info: Trimipramine should not be used in patients with acute delirium tremens, acute closed angle galucoma, hypertrophy or the prostate with urine retention, or paralytic ileus. Caution should be used in patients with hypertrophy of the prostate without urine retention, reduced function of the bone marrow, organic brain disorders, history of epilepsy, or preexisting cardial damage (particularly impulse conductive disorders)

More information on Trimipramine

 

[kittyinthedark]

Tetracyclic Antidepressants

(From www.mayoclinic.com with minor editing) Instead of inhibiting the reabsorption of certain neurotransmitters as other antidepressants do, tetracyclic antidepressants prevent neurotransmitters from binding with nerve cell receptors called alpha-2 receptors. This indirectly increases the levels of norepinephrine and serotonin in the brain. In turn, that may improve and elevate mood.

The only tetracyclic antidepressants approved by the FDA to treat depression is mirtazapine, which I have not classified as a tetracyclic, but a NaSSA (see below).

Side effects of tetracyclic antidepressants include:

* Drowsiness
* Weight gain
* Dry mouth
* Dizziness
* Lightheadedness
* Thirst
* Muscle or joint aches
* Constipation
* Increased appetite
* Increased cholesterol

Safety concerns with tetracyclic antidepressants

Because of a potential drug interaction, don't take tetracylics with another type of antidepressant called a monoamine oxidase inhibitor (MAOI). You may have increased drowsiness if you take tetracyclics with other medications or substances that also cause drowsiness, such as antihistamines, sedatives or alcohol.

In addition, in rare circumstances, some tetracyclics can cause a potentially dangerous drop in white blood cell counts (agranulocytosis). This condition can make you vulnerable to infection. Talk to your doctor if you develop a sore throat, fever, inflammation of the mouth, flu-like symptoms or other signs of infection.


Amoxapine (Asendin, Asendis, Defanyl, Demolox, Moxadil)

Typical dose: 200-400 mg per day (600 mg per day for inpatient treatment)
Treats: depression, panic disorders, bipolar disorder, obsessive-compulsive disorder, ADHD, enuresis, bulimia nervosa, cocaince dependency, tobacco addiction
Common side effects: blurred vision, confusion or nervousness, constipation or diarrhea, drowsiness or dizziness, dry mouth, headache, increased appetite and weight gain, increased sensitivity to sunlight, nausea, vomiting, sexual difficulties, insomnia, unusual tiredness or weakness, difficulty breathing, eye pain, fainting spells, fast or irregular heartbeat (palpitations), fever with increased sweating, loss of bladder control or problems passing urine, muscle stiffness or problems with movement, pale skin, seizures (convulsions), skin rash or itching (hives), swelling or tenderness of breasts or testicles, unusual and uncontrollable tongue and chewing movements, smacking lips or puffing cheeks, uncontrollable muscle spasms in the face/hands/arms/legs, yellowing of the eyes or skin
Potential drug interactions: MAOIs*, alcohol, barbiturate medicines for inducing sleep or treating seizures (convulsions), blood thinners, cimetidine (Tagamet) or ranitidine, clonidine, disulfiram, erythromycin, female hormones (including contraceptive or birth control pills), labetalol, linezolid, medicines for anxiety or sleeping problems such as benzodiazepines, medicines for colds and breathing difficulties, medicines for hay fever and other allergies, medicines for high blood pressure, medicines for movement abnormalities as in Parkinson's disease, medicines for gastrointestinal problems, medicines for over- or under-active thyroid, seizure (convulsion) or epilepsy medicine, levodopa (Sinemet, Larodopa), lithium, methylphenidate, medication for asthma
*DO NOT COMBINE THIS DRUG WITH ANY OF THESE
Other info: Cigarette smoking may decrease the efficacy of amoxapine.

More info on Amoxapine


Maprotiline (Ludiomil, Deprilep, Psymion)

Typical dose: 150-225 mg per day (higher incidence of seizure at higher doses)
Treats: depression, anxiety
Common side effects: dizziness, drowsiness, fatigue, dry mouth, obstipation, increased appetite/weight gain, hypotension, tachycardia and other arrhythmias, impaired sexual function in men, allergic skin reactions, agitation, confusion, hypomania, seizures (more often at high doses), prolonged and painful erections, leukopenia/agranulocytosis (dangerous fall in white blood cells), blurred vision, constipation, diarrhea, headache, increased sensitivity to sunlight, insomnia, difficulty breathing, eye pain, fainting spells, fever with hyperhidrosis (increased sweating), hallucinations, loss of bladder control, muscle stiffness, pale skin, uncontrollable muscle twitches of the mouth, yellowing of the eyes/skin
Potential drug interactions: alcohol, barbiturate medicines for inducing sleep or treating seizures (convulsions), blood thinners, cimetidine (Tagamet) or ranitidine, clonidine, disulfiram, erythromycin, female hormones (including contraceptive or birth control pills), labetalol, linezolid, medicines for anxiety or sleeping problems (such as benzodiazepines), medicines for colds and breathing difficulties, medicines for hay fever and other allergies, medicines for high blood pressure, medicines for movement abnormalities as in Parkinson's disease, medicines for gastrointestinal problems, medicines for over- or under-active thyroid, seizure (convulsion) or epilepsy medicine
Other info: Maprotiline should not be used in patients with hypertrophy of the prostate gland with urine hesitancy or closed angle glaucoma. Caution should be used in patients with concomitant use of an MAOI, serious impairment of theliver or kidneys, epilepsy or other conditions that lower the seizure threshold, serious cardiovascular conditions, or those under the age of 18.

More info on Maprotiline


Mianserin (Bolvidon, Norval, Tolvon)

Typical dose: 15-75 mg per day (???)
Treats: depression
Common side effects: liver impairment, hyponatremia (low blood sodium), athralgia (joint pain), seizures, dizziness, edema (excessive fluid retention), orthostatic hypotension (headrushes upon standing from a drop in blood pressure), hypomania, mild jaundice, breast pain/tenderness (male breast enlargement), drowsiness, dry mouth, blurred vision, constipation, difficulty urinating, shakiness, skin rashes, confusion
Potential drug interactions: MAOIs*, alcohol, blood thinners such as warfarin (Coumadin)
Other info: Use mianserin with caution in patients with closed angle glaucoma, decreased kidney or liver function, defect of the heart's electrical pathways, diabetes, enlarged prostate, or those who have suffered a recent heart attack. Do not use in patients with epilepsy, mania, or severe liver disease.
*DO NOT COMBINE THIS MEDICATION WITH ANY OF THESE

More info on Amoxapine


Nefazodone (Serzone)

Typical dose: 100-600 mg per day
Treats: depression
Common side effects: constipation, dry mouth, dizziness, drowsiness, nausea, confusion/agitation, blurred vision, irregular heartbeat, fainting spells, loss of balance, flu-like symptoms, difficulty passing urine, skin rash, seizures
Potential drug interactions: MAOIs*, astemizole*, carbamazepine*, cerivastatin*, cisapride*, lovastatin*, pimozide*, red yeast rice*, simvastatin*, terfenadine*, triazolam*, atorvastatin, buspirone, cilostazol, cyclosporine, dextroamphetamine, digoxin, dofetilide, entacapone, furazolidone, haloperidol, herbal dietary supplements (like kava kava, St. John's wort, and valerian), linezolid, loratadine, medications used for HIV infection (examples: indinavir, nelfinavir, ritonavir), melatonin, modafinil (Provigil), paricalcitol, phenytoin, sibutramine, sildenafil, tacrolimus, tolcapone, tolterodine, warfarin (Coumadin)
Other info: The sale of nefazodone was discontinued in 2003 in some countries because of the possibility of liver damage.

More info on Nefazodone


Setiptiline (Tecipul)

Typical dose: Less than 50 mg
Treats: depression, schizophrenia, sleep-related breathing disorders
Common side effects: ???
Potential drug interactions: ???
Other info: I was unable to find any extensive information on setiptiline. It is only used in research trials at this point.

More info on Setiptiline


Trazodone (Desyrel, Trittico, Thombran, Trialodine)

Typical dose: 50-300 mg per day (up to 600 mg per day during inpatient care)
Treats: depression, anxiety, insomnia, nightmares/disturbed sleep, fibromyalgia (to control sleeping)
Common side effects: blurred vision, constipation, drowsiness, dizziness, dry mouth, headache, muscle aches, nausea, vomiting, unusual tiredness or weakness, fainting spells, irregular heartbeat, skin rash, trembling, edema (fluid retention)
Potential drug interactions: herbal medicines (kava kava, St John's wort, valerian, etc.), linezolid, medicines for high blood pressure, medicines for seizures, barbiturates such as phenobarbital, certain antidepressants or tranquilizers, certain medications used for Parkinson's disease (such as entacapone or tolcapone), muscle relaxants, certain antihistamines used in cold medicines
Other info: Trazodone has been connected with cases of priapism. Male patients experiencing prolonged or painful erections should seek medical attention immediately. (From Wikipedia) Recent clinical studies in patients with pre-existing cardiac disease indicate that trazodone may be arrhythmogenic in some patients in that population. Arrhythmias identified include isolated PVC's, ventricular couplets, and in 2 patients short episodes (3 to 4 beats) of ventricular tachycardia. There have also been several post-marketing reports of arrhythmias in trazodone-treated patients who have pre-existing cardiac disease and in some patients who did not have pre-existing cardiac disease. Until the results of prospective studies are available, patients with pre-existing cardiac disease should be closely monitored, particularly for cardiac arrhythmias. Trazodone is not recommended for use during the initial recovery phase of myocardial infarction.

More info on Trazodone

 

[kittyinthedark]

Dopamine Reuptake Inhibitors (DARI)
Amineptine
Methylphenidate
Phenmetrazine
Vanoxerine
Nomifensine

 

[kittyinthedark]

Selective Serotonin Reuptake Enhancers (SSRE)
Tianeptine

Reversible Inhibitors of Monoamine Oxidase A (RIMA)
Brofaromine
Moclobemide

Noradrenergic and Specific Serotonergic Antidepressant (NaSSA)
Mirtazapine

NK1 receptor antagonists
Aprepitant

 

[kittyinthedark]

Monoamine Oxidase Inhibitors (MAOI)

Harmaline (Telepathine, Banisterine)
Nialamide
Selegiline (Carbex, Eldepryl, l-deprenyl, Anipryl [veterinary])
Isocarboxazid
Iproniazid (Marsilid, Iprozid, Ipronid, Rivivol, Propilniazida)
Iproclozide
Phenelzine (Nardil)
Toloxatone
Tranylcypromine (Parnate)

(from Wikipedia with minor editing) Monoamine oxidase inhibitors (MAOIs) are a class of antidepressant drugs prescribed for the treatment of depression as well as a number of off-label uses. They are particularly effective in treating atypical depression, and have also shown efficacy in helping smokers to quit.

Due to potentially lethal dietary and drug interactions they had been reserved as a last line of defense, used only when other classes of antidepressant drugs (for example tricyclic antidepressants and selective serotonin reuptake inhibitors) have been tried unsuccessfully. Recently, however, a patch form of the drug Emsam, which was approved for use by the FDA on February 28, 2006, was developed. When applied transdermally the drug does not enter the gastro-intestinal system as it does when taken orally, thereby decreasing the dangers of dietary interactions associated with MAOI pills.

In the past they were prescribed for those resistant to tricyclic antidepressant therapy, but newer MAOIs are now sometimes used as first-line therapy. They are also used for treating agoraphobia and social anxiety. Currently, the availability of Selegiline and moclobemide provides a safer alternative, although not always as effective as the old types.

Monoamine oxidase inhibitors can be used to potentiate the effect of a number of hallucinogenic drugs, notably phenethylamines, tryptamines and several others.

MAOIs act by inhibiting the activity of monoamine oxidase preventing the breakdown of monoamine neurotransmitters and so increasing the available stores. There are two isoforms of monoamine oxidase, MAO-A and MAO-B. MAO-A preferentially deaminates serotonin, melatonin, adrenaline and noradrenaline. MAO-B preferentially deaminates phenylethylamine and trace amines. Dopamine is equally deaminated by both types. Many formulations use forms of fluoride attached to assist getting past the blood-brain barrier and is suspected as a factor in pineal gland effects. The early MAOIs inhibited monoamine oxidase irreversibly. When they react with monoamine oxidase, they permanently deactivate it, and the enzyme cannot function until it has been replaced by the body, which can take about two weeks. A few newer MAOIs, notably moclobemide, are reversible, meaning that they can inhibit the enzyme for a time, but eventually detach, allowing the enzyme to function once more.

When ingested orally, MAOIs inhibit the catabolism of dietary amines. Sufficient intestinal MAO-A inhibition can lead to hypertensive crisis, when foods containing tyramine are consumed (so-called "cheese reaction"), or hyperserotonemia if foods containing tryptophan are consumed. The amount required to cause a reaction exhibits great individual variation and depends on the degree of inhibition, which in turn depends on dosage and selectivity. Examples of foods and drinks with potentially high levels of tyramine include fermented substances, such as Chianti and other aged wines, and aged cheeses. Liver is also a well-known source. (See a list of foods containing tyramine). Examples of levodopa-containing foods include broad beans. These diet restrictions are not necessary for those taking selective MAO-B inhibitors.

It deserves separate mention that some meat extracts and yeast extracts (Bovril, Marmite, Vegemite) contain extremely high levels of tyramine, and should not be used with these medications.

The most significant risk associated with the use of MAOIs, is the potential for interactions with over-the-counter and prescription medicines, illicit drugs and certain supplements (e.g. St Johns Wort). It is vital that a doctor supervise such combinations to avoid adverse reactions. For this reason, many users carry an MAOI-card, which lets emergency medical personnel know what drugs to avoid. (E.g. adrenaline dosage should be reduced by 75%, and duration is extended)

MAOIs should not be combined with other psychoactive substances (antidepressants, illicit drugs, painkillers, stimulants, etc.) except under expert care. Certain combinations can cause lethal reactions, common examples including SSRIs, tricyclics, meperidine and tramadol. Agents with actions on epinephrine, norepinephrine or dopamine must be administered at much lower doses due to potentiation and prolonged effect. Purely opiate-acting analgesics, such as morphine and buprenorphine may be used safely with MAOIs, but may require a dosage adjustment.

FOODS TO AVOID WHILE ON AN MAOI:
aged cheeses; meats and fish (especially aged, smoked, pickled, or processed such as bologna, pepperoni, salami, summer sausage); beer and ale; alcohol-free beer; wine (especially red); sherry; hard liquor; liqueurs; avocados; bananas; figs; raisins; soy sauce; miso soup; yeast/protein extracts; bean curd; fava or broad bean pods; or any over-ripe fruit; caffeinated products (soda, coffee, tea, chocolate, energy drinks); any other products high in tyramine

There are very high risks of drug interactions while taking an MAOI. Check with your prescribing physician about any other medications, vitamins, supplements, herbs, or health products you take. This includes ALL over-the-counter drugs. Potential drug interactions:
alcohol, barbiturates such as phenobarbital, bupropion (Wellbutrin, Zyban), buspirone, caffeine, carbamazepine, certain medicines for blood pressure (especially beta-blockers, methyldopa, reserpine, guanadrel, and guanethidine), cocaine, dextromethorphan (found in most cough syrups), diet pills or stimulants (like amphetamines or ephedra), furazolidone, ginseng, guarana, kava kava, levodopa, linezolid, local anesthetics, medicines for allergies/colds/flu symptoms/sinus congestion/breathing difficulties, medicines for diabetes, medicines for migraine headaches, medicines for movement abnormalities as in Parkinson's disease (examples: entacapone, levodopa, selegiline, tolcapone), muscle relaxants, other medicines for depression/anxiety/mood/mental problems, meperidine, procarbazine, SAM-e, seizure (convulsion) or epilepsy medicine, St. John's wort, tramadol, tryptophan, tyramine (many foods contain tyramine), valerian, water pills (diuretics), yohimbine

If you experience any of the follow symptoms, contact your prescribing physician immediately:
agitation/excitability/restlessness/nervousness, chest pain, confusion or changes in mental state, convulsions or seizures (uncommon), difficulty breathing, difficulty passing urine, enlarged pupils, sensitivity of the eyes to light, fever, clammy skin, increased sweating, headache or increased blood pressure, lightheadedness or fainting spells, muscle or neck stiffness or spasm, sexual dysfunction, slow, fast, or irregular heartbeat (palpitations), sore throat with fever, yellowing of the skin or eyes

Side effects that usually do not require medical attention:
blurred vision or change in vision, constipation or diarrhea, difficulty sleeping, drowsiness or dizziness, dry mouth, increased appetite; weight increase, increased sensitivity to sunlight, muscle aches or pains, trembling, nausea or vomiting, swelling of the feet or legs, unusual tiredness or weakness

 

[kittyinthedark]

ANTIPSYCHOTICS

1. Typical Antipsychotics
2. Atypical Antipsychotics
3. Dopamine Partial Agonists
4. Others

Typical Antipsychotics

Phenothiazines
Chlorpromazine (Thorazine)
Fluphenazine (Prolixin)
Perphenazine (Trilafon)
Prochlorperazine (Compazine)
Thioridazine (Mellaril)
Trifluoperazine (Stelazine)

Buterophenone derivatives
Haloperidol (Haldol)
Droperidole
Pimozide (Orap)

 

[kittyinthedark]

Atypical Antipsychotics
Clozapine (Clozaril)
Olanzapine (Zyprexa)
Risperidone (Risperdal)
Quetiapine (Seroquel)
Ziprasidone (Geodon)
Aripiprazole (Abilify)
Brexpiprazole (Rexulti)
Cariprazine (Vraylar, Reagila)
Paliperidone (Invega)
Lurasidone (Latuda)

 

[kittyinthedark]

Others
Symbyax
Tetrabenazine (Nitoman in Canada and Xenazine in New Zealand and some parts of Europe)

 

[kittyinthedark]

MOOD STABILIZERS

Lithium carbonate
Valproic acid (Depakote)
Lamotrigine (Lamictal)
Carbamazepine (Tegretol)
tiagabine (Gabitril)
Oxcarbazepine (Trileptal)
Topiramate (Topamax)

 

[kittyinthedark]

BENZODIAZEPINES (USED FOR ANXIETY/INSOMNIA)

This list may be expanded at request. Currently includes most commonly prescribed.

Benzodiazepines have a high risk for tolerance, dependency, and abuse. There is also a risk of moderate to severe withdrawal upon cessation, particularly for those with shorter half-lives. DO NOT stop taking benzodiazepines suddenly, as there is a risk of seizure, especially at high doses. Use them appropriately and under the care of a physician.

(from Wikipedia with minor editing) The benzodiazepines, or "benzos" for short, are considered minor tranquilizers that are a class of drugs with sedative, hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. Benzodiazepines are often used for short-term relief of severe, disabling anxiety or insomnia. Long-term use can be problematic due to the development of tolerance and physiological and psychological dependency. They are believed to act on the GABA receptor GABAA, the activation of which dampens higher neuronal activity. They began to be widely prescribed for stress-related ailments in the 1960s and 1970s. Their chemical structure is based upon diazepine and phenyl groups.

Benzodiazepines are commonly divided into three groups: Short-acting compounds act for less than six hours and have few residual effects if taken before bedtime, but rebound insomnia may occur and they might cause wake-time anxiety. Intermediate-acting compounds have an effect for 6-10 hours, may have mild residual effects but rebound insomnia is not common. Long-acting compounds have strong sedative effects that persist. Accumulation of the compounds in the body may occur. The elimination half-life may greatly vary between individuals, especially the elderly.


Do not take Alprazolam with any of the following:
alcohol, grapefruit juice, ketoconazole, itraconazole, some medicines for HIV infection or AIDS

Grapefruit juice may potentiate any or all benzos depending on your body chemistry.

Exercise EXTREME caution when combining benzos and alcohol. It will severely impair your judgment, and it carries a HEAVY risk of severe respiratory depression, which can lead to brain damage and death. I know someone who is spending the rest of his life in a wheelchair with brain damage after being resuscitated the day after what he thought was a great night of partying.

Flumazenil (Annexate) is a universal antidote to benzodiazepines, and it should be administered in many, if not most, cases of acute overdose.

Benzos may also interact with the following medications:
alcohol, barbiturates, bosentan, caffeine, chloroquine, cimetidine (Tagamet), cyclosporine, disulfiram, ergotamine, female hormones (including contraceptive or birth control pills), herbal or dietary supplements (such as kava kava, melatonin, dehydroepiandrosterone, DHEA, St. John's Wort or valerian), imatinib/STI-571, isoniazid, levodopa, medicines for depression/mental problems/psychiatric disturbances, medicines for fungal infections (fluconazole, voriconazole, etc.), mifepristone, RU-486, phenytoin, prescription pain medicines, probenecid, rabeprazole, rifampin/rifapentine/rifabutin/etc., some antibiotics (clarithromycin, erythromycin, troleandomycin, etc.), some medicines for colds/hay fever/allergies, some medicines for high blood pressure or heart problems (amiodarone, digoxin, diltiazem, nicardipine, verapamil, etc.), some medicines for seizures (carbamazepine, oxcarbazepine, phenobarbital, phenytoin, primidone, valproic acid, etc.), theophylline, troglitazone, zafirlukast, zileuton

If you experience any of the following symptoms, contact your prescribing physician immediately:
confusion, forgetfulness, depression, difficulty passing urine, difficulty sleeping, difficulty speaking, lightheadedness or fainting spells, mood changes, excitability, aggressive behavior, muscle cramps, staggering or jerky movements, tremors, weakness or tiredness, restlessness, tremors

Side effects that usually do not require medical attention:
blurred or double vision, constipation or diarrhea, drowsiness, dizziness, dry mouth, decrease or increase in amount of saliva, increase or decrease in appetite, menstrual changes, nausea, sexual dysfunction, weight changes

Alprazolam (Xanax, Xanor, Tafil, Alprox)
Half life: 6-12 hours
Effects: anxiolytic

Bromazepam (Lexotan, Lexomil, Somalium, Bromam)
Half life: 10-20 hours
Effects: anxiolytic

Chlordiazepoxide (Librium, Tropium, Risolid, Klopoxid)
Half life: 36-200 hours (active metabolite)
Effects: anxiolytic

Cinolazepam (Gerodorm)
Half life: 9 hours
Effects: sedative

Clobazam (Frisium, Urbanol)
Half life: 12-60 hours
Effects: anxiolytic, anticonvulsant

Clonazepam (Klonopin, Klonapin, Rivotril)
Half life: 18-50 hours
Effects: anxiolytic, anticonvulsant

Clorazepate (Tranxene)
Half life: 36-100 hours (active metabolite)
Effects: anxiolytic, anticonvulsant

Diazepam (Valium, Apzepam, Stesolid, Apozepam, Hexalid, Valaxona)
Half life: 36-200 hours (active metabolite)
Effects: anxiolytic, hypnotic, anticonvulsant, muscle relaxant

Estazolam (ProSom)
Half life: 10-24 hours
Effects: hypnotic

Flunitrazepam (Rohypnol, Fluscand, Flunipam, Ronal)
Half life: 36-200 hours (active metabolite)
Effects: hypnotic

Flurazepam (Dalmane)
Half life: 40-250 hours (active metabolite)
Effects: hypnotic

Halazepam (Paxipam)
Half life: 30-100 hours (active metabolite)
Effects: anxiolytic

Ketazolam (Anxon)
Half life: 2 hours
Effects: anxiolytic

Loprazolam (Dormonoct)
Half life: 6-12 hours
Effects: hypnotic

Lorazepam (Ativan, Temesta, Lorabenz)
Half life: 10-20 hours
Effects: anxiolytic

Lormetazepam (Noctamid, Pronoctan)
Half life: 10-12 hours
Effects: hypnotic

Medazepam (Nobrium)
Half life: 36-200 hours
Effects: anxiolytic

Midazolam (Dormicum, Versed, Hypnovel)
Half life: 3 hours
Effects: hypnotic

Nitrazepam (Mogadon, Apodorm, Pacisyn, Dumolid)
Half life: 15-38 hours
Effects: hypnotic

Nordazepam (Madar, Stilny)
Half life: 50-120 hours
Effects: anxiolytic

Oxazepam (Serax, Serenid, Serepax, Sobril, Oxascand, Alopam, Oxabenz, Oxapax)
Half life: 4-15 hours
Effects: anxiolytic

Pinazepam (Domar)
Half life: 40-100 hours (active metabolite)
Effects: sedative

Prazepam (Centrax)
Half life: 36-200 hours (active metabolite)
Effects: anxiolytic

Quazepam (Doral)
Half life: 25-100 hours
Effects: hypnotic

Temazepam (Restoril, Normison, Euhypnos)
Half life: 8-22 hours
Effects: hypnotic

Tetrazepam (Mylostan)
Half life: 3-26 hours
Effects: skeletal muscle relaxant

Triazolam (Halcion, Rilamir)
Half life: 2 hours
Effects: hypnotic

 

[kittyinthedark]

ATTENTION DEFICIT DRUGS

Methylphenidate (Methylin, Ritalin, Metadate, Concerta, Focalin, Attenta, Equasym, Rubifen, Daytrana)
Dextroamphetamine (Dexedrine)
Amphetamine salts (Adderall)
Methamphetamine (Desoxyn)
Bupropion (Wellbutrin)
Atomoxetine (Strattera)
Benzphetamine (Didrex)
Modafinil (Alertec, Provigil)
Pemoline (Cylert)
Clonidine

 

[kittyinthedark]

ADDICTION TREATMENT DRUGS

Disulfiram
Naltrexone
Naloxone
Buproprion
Methadone
Suboxone
Buprenorphine

 

[kittyinthedark]

THE "NATURAL" ROUTE

Keeping your body healthy is one of the most important things you can do if you are struggling with a psychiatric illness (or even if you're not!). It is well-documented, if not naturally obvious, that if you are healthier, you will feel better, and you can even turn some of your symptoms around. I can certainly say from personal experience that I feel immeasurably better when I work out several days a week and eat right, not to mention that I look a lot better too, which never hurts the psyche. So here are some key things you can do to keep your body and mind in great condition:

EXERCISE, EXERCISE, EXERCISE!

No, that doesn't mean you have to go get an expensive gym membership or turn into a meathead. In fact, I prefer to never go to the gym to get my exercise. Something as simple as taking a walk around the block every day is plenty. Play a sport, go swimming, play with the kids, take a walk through the park, use the stairs instead of the elevator, have crazy hot sex, ANYTHING that will get you up and around for 20-30 minutes a day. My anti-poison of choice: DDR! (That's the video game Dance Dance Revolution for those not quite so dorky as I.) I know several people that have lost over 20 pounds playing DDR, and I myself have lost 10. There is an unlimited list of things you can do - as long as you're moving, you're doing it right.

It's not a myth that exercise makes you feel great. When you exercise, your body releases endorphines, the chemicals that help create pleasurable feelings in our brains. And like I'll keep repeating, a healthy body is a happy body, and although we might not be readily aware of it, our heads know when things downstairs are amiss, and I guarantee you will notice a change in your overall attitude within a few weeks of starting up a regular exercise regimen. You'll have more energy, more stamina, and chances are, a better attitude about your body.

There are also a number of dietary supplements that can greatly improve your health.

Omega-3 and Omega-6 Fatty Acids

These polyunsaturated fatty acids are an essential nutrient for humans, which means that we must get it from food because we can't produce it in our bodies on our own. Yes, you heard me right: fat is GOOD for you. No, that doesn't mean you can go gorge yourself on junk food. (Sorry!)

However, these fats have been shown to have some amazing health benefits, such as improving cardiovascular health and reducing blood pressure; improving brain function and reducing depression, anxiety, ADHD, and aggression; preventing several types of cancer; reducing blood triglycerides and other harmful lipids; improving rheumatoid arthritis; preventing low birth weight babies; and I'm sure you get the picture by now!

You can find these fatty acids in:
- Fish
- Nuts
- Most vegetable oils
- Borage seed and flaxseed oils
- Poultry
- Baked goods
- Eggs

These fats do not have a daily recommended value (the amount listed on the nutrition chart on all food packaging, but the generally suggested amount is roughly 1.5 grams a day for men and 1 gram a day for women. The FDA suggests that no more than 3 grams per day of these fatty acids should be eaten from fish, of which no more than 2 grams per day should be from over the counter supplements made from fish. The NIH recommends 650 mg per day of EPA and DHA, 2.2 grams per day of alpha-linolenic acid, and 4.4 grams per day of linoleic acid (all particular kinds of omega-3 and omega-6 fatty acids). If you are unsure of what will be best for you, contact your physician or a licensed nutritionist.

Note that research shows that the ratio of these fats is very important, and the healthiest ratio is from1:1 to a 4:1 maximum of omega-6 to omega-3. Many Western diets are 10 to 1, or even up to 30 to 1, largely due to poor, overly-fatty eating habits with too many bad-ratio vegetable oils. (The best oils are canola, flaxseed, and some olive oils.)

WARNING: you should consult with your doctor before adding these supplements to your diet if:
- you take aspirin or coumadin (warfarin) regularly
- you are prone to particularly low blood pressure or have any bleeding or hemorrhaging disorders
- you have diabetes
- your immune/inflammatory response is suppressed or impaired
- you have unusually high LDL cholesterol


B-Vitamins

The B-vitamins are a class of water-soluble vitamins that play an integral role in metabolism and other cell functions. Because they are water-soluble, it means we need to ingest them on a regular basis in order to maintain a healthy level. (Fun fact: the exception to this rule is cobalamin - for some reason, the liver can store as much as a six-year supply).

The B-vitamins are also important in maintaining skin and muscle tone, enhancing the immune system, aiding nervous system function, promoting cell growth, and reducing the risk of certain cancers (although the cancer benefit is usually only when consumed in food, not as a supplement/pill). They are also well-known to help alleviate stress, depression, and anxiety, and they can aid in weight loss.

B-vitamin deficiencies can lead to a wide range of impairments and diseases, so it is important to maintain a healthy level at all times, whether through diet or supplements. Vegans should be extra cautious to supplement their B-12 intake, as B-12 is not found in plant materials. And on that note, beware nutritional packaging that says vegan foods do contain B-12, as this is unfortunately a blatant lie. The assay used to measure B-12 in food is actually a bacterial response to the food product, not an actual measurement of B-12 itself, and it can produce false positives, as the bacteria will react to B-12 variants that cannot be used by the human body. It is also important for pregnant women to ensure adequate B-vitamin intake. If you are pregnant, you should consult with your doctor about an appropriate supplement regimen.

Good sources of B-Vitamins:
- potatoes
- bananas
- lentils
- chili peppers
- liver/liver oil
- tuna
- turkey
- molasses
- yeast (so yes, Vegemite and Marmite are good for you, even though they are gross! Sorry Aussies. )

Vitamin D

The D vitamins are fat-soluble prohormones that play an incredibly important role in our health. They help keep bones healthy, mediate parathyroid secretions, and bolster the immune system. Most of our vitamin D is produced in our skin by exposure to ultraviolet-B light from the sun, so this means that people living in non-tropical latitudes must take extra care to consume extra vitamin D during the winter, when our bodies are incapable of producing enough on their own. Most people outside of the tropics are deficient in vitamin D, many severely so.

Vitamin D promotes anti-tumor immune responses and, according to current research, can help prevent 85% of cancers! It has been documented to reduce colon cancer risk by 50%, and breast and ovarian cancer risks by over 30%. It has also recently been implicated in some amazing heart health benefits in the way of helping the body prevent and even reverse the development of atherosclerotic plaques, the artery blockages that cause heart attacks and other damage associated with heart disease. So needless to say, this is a very important vitamin!

Based on my current research, the optimal amount to take is 2000-3000 IU (50-75 mcg) per day. Keep in mind that vitamin D must be enveloped in fats in order to enter the bloodstream through the intestines, so your best bet is to take the supplements that come in gelcap form rather than pressed pills. If you do take pressed pills, make sure to eat something fatty along with the pills (for instance, I take them along with all my other pills each day, which includes several grams of fish and flaxseed oils). Preliminary studies indicate that the gelcap form is significantly more effective.

Good sources of D-vitamins:
- fatty fish/fish liver oils
- mushrooms
- eggs
- fortified foods (commonly milk, yogurt, bread, margarine, and cereals)


to be continued...

 

[Jabberwocky]

Was going to archive this but instead thought I'd give it a few days on the front page and see if the current group of TDS regulars want to carry on with this project.

 

[madmick19]

Psychiatric Medication guide for patients and Carers by St Vincents Hospital staff

 

[ocean]

Bump

 

[Draigan]

Thanks I think this is good tds material personally.