Thursday, December 20, 2007

Medications to treat bipolar illness, anxiety, depression, and other psychiatric illnesses

MOOD STABILIZERS

Lamictal

Inhibits glutamate (stimulating neurotransmitter)

Stevens Johnson Syndrome (rare)

100-200 mg daily

Lithium

Alters sodium transport

Tremor, ataxia

300 mg TID

Depakote

Increases GABA (soothing neurotransmitter)

Hepatotoxicity

10 mg x body weight

ANTIPSYCHOTICS

Risperdal

As do all the so-called atypicals, blocks dopamine 2 receptors reducing hallucinations and delusions and blocks serotonin 2A receptors decreasing EPS

Risk of CVA in elderly; dose dependent EPS & hyperprolactinemia

0.5- 6 mg daily

Seroquel

Sedating

Hypotension

100-800 mg divided doses

Geodon

Generally activating

Agitation or sedation; rarely causes EPS

120-240 mg in divided doses

Zyprexa

Good for psychotic depression

Weight gain; diabetes; metabolic syndrome

5-20 mg at bedtime

Abilify

Partial serotonin and dopamine agonist

Nausea

5-30 mg daily

Haldol Decanoate

Decanoate injection increases compliance

EPS; akathisia; tardive dyskinesia

100-200 mg IM monthly

Stelazine

As with other older neuroleptics probably just as effective as newer antipsychotics but with more EPS

EPS; akathisia; tardive dyskinesia

5-20 mg daily

Thorazine

Sedation

Hypotension

50- 800 mg daily

ANTIDEPRESSANTS

Prozac

As with all SSRIs useful in panic; PTSD; OCD

Avoid in agitated insomniacs

20-60 mg daily

Zoloft

Enhances dopamine

GI side effects—diarrhea

50-200 mg daily

Paxil CR

Social anxiety

Cutting tablet destroys controlled release

12.5-50 mg daily

Lexapro

Best tolerated antidepressant; low sexual side effects

Cognitive and affective flattening

10-20 mg daily

Luvox

Rapid antianxiety and insomnia benefits

Can increase tricyclic blood levels

100-300 mg divided

Effexor XR

Boosts norepinephrine and serotonin

Withdrawal side effects if DC quickly

75-300 mg daily

Cymbalta

Useful in chronic pain and stress urinary incontinence

May increase BP

60 mg daily; 40 mg BID for stress incontinence

Wellbutrin XL

May help sexual SE caused by SSRIs

Insomnia; agitation

150-450 mg daily

Vivactil

Activating; energizing; increases dopamine

Anticholinergic SE

10-40 mg divided

Pamelor

Chronic pain

Therapeutic window

50-150 mg daily

Elavil

Sedating; helpful in insomnia; chronic pain

Cardiac precaution

50-300 mg bedtime

Trazodone

Treatment of choice for insomnia

Ataxia; tremor

50-600 mg bedtime

ANTIANXIETY AGENTS

Xanax

Short acting

Breakthrough anxiety

0.25-0.5 mg QID

Ativan

Useful with Risperdal in acute agitation

Confusion

0.5-2 mg TID

Klonopin

Adjunct with SSRIs in panic disorder

Use with caution in liver disease

0.5-1 mg QID

PSYCHOSTIMULANTS

Ritalin

Useful for depression in medically ill elderly patients

Slows growth in children?

2 mg/kg/day

Adderall

Fatigue as residual symptom of depression

Cardiac Caution

5-40 mg divided

Provigil

Sleep apnea; improves attention; useful in fatigue

Headache

200 mg daily

Wednesday, December 19, 2007

Quiz: Do You Have Wisdom in Your Relationships?

 

Yes

No

Do you spread good will, gratitude, and happiness?

 

 

Do you solve problems rather than worrying about them?

 

 

Do you channel anger and frustration into productive work and joyful play?

 

 

Do you have a purpose for living?

 

 

Do you have goals and a plan for the future?

 

 

Do you know when to talk and when to listen?

 

 

When you make a mistake, do you admit it?

 

 

Are you able to develop friends who are free of vices?

 

 

Can you discuss your problems with close friends?

 

 

Do you avoid gossip—both speaking gossip and hearing gossip?

 

 

Can you keep a secret?

 

 

Can you avoid telling your problems to people you don’t know well?

 

 

Are you able to delay pleasure to accomplish worthwhile goals?

 

 

Can you enjoy yourself and take vacations without feeling guilty?

 

 

Can you avoid negative talk?

 

 

Can you control your temper?

 

 

Can you say “no” to other people if the requests they make are unreasonable, amoral, illegal, or detrimental to your self-development and physical health?

 

 

Are you patient with yourself and others?

 

 

Do you feel comfortable being alone?

 

 

Do you feel comfortable in social situations?

 

 

Can you serve others without expecting anything in return?

 

 

Do you feel that the desires and hopes of others are just as important as your desires and hopes?

 

 

Can you follow rules and regulations of society?

 

 

When you feel guilty about your behavior, can you stop or change that behavior?

 

 

Can you drink alcohol in moderation or not at all?

 

 

Can you have sexual intimacy without being promiscuous?

 

 

Do you have a satisfying spiritual life?

 

 

Do you save 10% of your income?

 

 

Score yes answers (Yes = greater than 75% of the time):

0-5                        =            Put on your pampers

6-11                        =            King of kindergarten

12-18                        =            Young and restless

19-24                        =            The wisdom of Solomon

25¬-28                        =            Close to sainthood

Tuesday, December 18, 2007

Are You Healthy?: A Quiz to Improve Relationships

Grade Yourself on a Scale from One to Four. Total the Score in the Four Columns to See How You Rate


 


Almost never

(1 point)


Occasionally

(2 points)


Frequently

(3 points)


Almost

Always

(4 points)

I am able to give and receive love.

 

 

 

 

I am productive and creative at work.

 

 

 

 

I have a purpose and plan for living.

 

 

 

 

I am a problem solver and enjoy change

 

 

 

 

I learn from my mistakes.

 

 

 

 

I accept responsibility for my behavior.

 

 

 

 

I adjust to hardship and pain.

 

 

 

 

total for each column

 

 

 

 

grand total (Adding total from each column) =

Score:

7            =            Buy funeral insurance

8-14            =            Doctor’s best friend           

15-21            =            Very few medical illnesses

22-28            =            May live to be 100

Vacations Improve Relationships: A Quiz to Check the Fun in Your Life

 

 

Yes

No

Do you allow yourself to take scheduled vacations without guilt?

 

 

Do you have a hobby or participate in sporting events?

 

 

Are you fun loving and cheerful?

 

 

Do you surround yourself with people who fill you with joy?

 

 

Do you laugh at yourself, your blunders, and your frailties?

 

 

Do you plan an occasional weekend away from work?

 

 

Is your leisure activity fun and restorative?

 

 

Do sports and games bring more laughs than frowns?

 

 

Does learning something new—acting, painting, playing a musical instrument—stimulate child-like fun and creativity?

 

 

Do you have a good laugh at least once a day?

 

 

Give yourself one point for each yes answer

 

 

 

 

Score:

1-2 points              =            President of Eeyore International

3-5 points              =            Party pooper

6-8 points              =            Fun to be around

9-10 points                =            Life of the party

Search for Jobs by Loving Your Work: A Quiz to Test Your Relationships at Work

 

Yes

No

Do you enjoy your work?

 

 

Do you use your talents and abilities at work?

 

 

Do others respect your work?

 

 

Does your work give you a feeling of satisfaction?

 

 

Does your work help you improve your knowledge and skills?

 

 

Does work make you feel good about yourself?

 

 

Do you have friends at work?

 

 

Do feedback and instruction help you work more efficiently?

 

 

Are you careful to avoid taking advantage of others at work?

 

 

Do you feel appreciated at your workplace?

 

 

Give yourself one point for each yes answer

 

 

Score:

1-2 points              =            Apply for a welfare check

3-5 points              =            Find another job or give yourself an attitude adjustment

6-8 points              =            you would be surprised how few people score this high

9-10 points                =            you find work a tremendous blessing in your life