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Mental Health Nursing I NURS1300 Psychoactive Medications for Clients with Mood Disorder or Schizophrenia CLASSIFICATIONS Typical Neuroleptics Atypical Neuroleptics SSRIs (Antidepressant) Tricyclics (Antidepressant) Tetracyclics (Antidepressant) MAOIs (Antidepressant) Miscellaneous Antidepressants Antimanics MEDICATIONS chlorpromazine (Thorazine) thioridazine (Mellaril) fluphenazine (Prolixin) haloperidol (Haldol) clozapine (Clozaril) risperidone (Risperdal) olanzapine (Zyprexa) ziprasidone (Geodon) citalopram (Celexa) fluoxetine (Prozac) paroxetine (Paxil) sertraline (Zoloft) amitriptyline (Elavil) clomipramine (Anafranil) imipramine (Tofranil) nortriptyline (Pamelor) mirtazapine (Remeron) USES Psychosis ACTIONS Antipsychotic Psychosis Antipsychotic Depression Mood Elevator Depression Mood Elevator Depression phenelzine (Nardil) tranylcypromine (Parnate) Depression Panic Disorder Anxiety Mood Elevator Mood Elevator buproprion (Wellbutrin) nefazodone (Serzone) trazodone (Desyrel) venlafaxine (Effexor) lithium (Lithobid, Eskalith) valproic acid (Depakene) divalproex sodium (Depakote) Depression Mood Elevator Mania Mood Stabilizer SIDE EFFECTS helpful only for positive symptoms of schizophrenia; side effects include extrapyramidal symptoms (refer to assigned readings for list of symptoms); neuroleptic malignant syndrome extrapyramidal symptoms; neuroleptic malignant syndrome (refer to assigned readings for description of this condition); agranulocytosis may occur with use of clozapine; orthostatic hypotension/risk for falls watch patients for cheeking of medications as they may attempt to save them for a suicidal overdose; as energy increases, so does the risk of suicide; SSRIs have been found to increase suicide risk cardiac complications; severe and life-threatening dysrhythmias may result from overdose; side effects may be more problematic in this group of medications than with the SSRIs significant sedation; potentially as dangerous as the tricyclics hypertensive crisis can occur when taken with many foods, beer or wine, and other antidepressants (refer to assigned readings for complete list of foods to avoid, as well as signs and symptoms of hypertensive crisis) headaches, insomnia, nausea and vomiting, appetite changes, dizziness; may experience life-threatening liver failure with Serzone; Effexor may increase suicide risk watch patients for cheeking of medications because they want to experience the high associated with the manic phase; side effects include sedation and hair loss; watch for lithium toxicity (refer to assigned readings for causes and side effects of lithium toxicity)