A Warning

Warning:  If any worthwhile concept can found at this blog address, the usefulness is purely accidental.   If you believe that you have received something significant from this blog, please reconsider your opinion. The more you think about the ideas written here, the less meaningful the information will become.  If you have a consequential idea, please send the information promptly. We need all the help we can get. If, however, you have an original thought, Dr. Walker will most likely fail to understand the concept.

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

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

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