Antipsychotics

Risperidone: most antidopaminergic atypical therefore the most EPS-prone atypica

l antipsychotic, highest risk of prolactinemia (amenorrhea, galactorrhea)
Most likely to cause metabolic syndrome: olanzepine, clozapine, quetiapine
Ziprasidone: most known for prolonging QTc (others can cause this as well)
Clozapine: last resort because of risk of agranulocytosis, needs monitoring
Depot injections for concern of non-adherance: haloperidol, risperidone
Mood stabilizers
Need levels for narrow therapeutic window: lithium, valproate
Lithium: don t use in kidney disease, can cause renal and thyroid side effects
Valproate: liver toxicity
Oxcarbazepine: can cause hyponatremia
Lamotrigine: good for bipolar depression, not so much mania
The anticonvulsants (carbamezepine, oxcarbazepine, lamotrigine) can cause Steven
s Johnson rash
None are good in pregnancy - use antipsychotics?
Antidepressants
Paroxetine: most serotonergic, worst withdrawal symptoms, 1st trimester cardiac
birth defects
Trazadone: priapism
Venlafaxine: diastolic hypertension
Bupropion: lowers seizure threshold. Contraindicated in bulimia because of the e
lectrolyte abnormalities also lower threshold.
Most sedating: mirtazapine (low doses for sleep, higher doses for depression), t
razadone (pretty much only for insomnia)
Serotonin syndrome: risk with combos of SSRIs
MAOIs: hypertensive crisis when eating wine and cheese (too much norepinephrine)
TCAs: lethal dose is only a few weeks supply so concern for suicide