What are some limitations to the use of alprazolam (Xanax) for panic disorder? The rapid onset advantage of alprazolam is offset by its high potency (leading to the development of tolerance) and short duration of action (leading to withdrawal symptoms that mimic panic symptoms and may lead to more frequent use).
Treatment of anxiety disorders in the short term and long term What are the main pharmacotherapy options for treatment of anxiety disorders in the short term and long term? SSRIs, typically starting at a low dose, are the first-line pharmacologic treatments of choice for many anxiety disorders including panic disorder and generalized anxiety disorder. Though …
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Best treatment for acute mania What are the best (most efficacious and well-tolerated) pharmacotherapeutic options for acute mania? Meta analyses have found that the antipsychotics haloperidol, risperidone, and olanzapine (in that order) are more effective than mood stabilizers, and olanzapine and risperidone (in that order) are better tolerated as well. Lithium may be the most …
What are some common psychotropic medications or medication classes listed on the American Geriatric Society 2012 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults? Antipsychotics (all antipsychotics carry an FDA black box warning regarding association with increased mortality when used in the elderly with dementia) TCAs (amitriptyline, clomipramine, doxepin, etc.—due to anticholinergic …
Dose limiting side effects of the second generation antipsychotics What are the main dose limiting side effects of the second-generation (atypical) antipsychotics (SGAs)? Sedation (especially with clozapine, quetiapine, olanzapine, asenapine) and extrapyramidal symptoms (e.g., akathisia, dystonia, parkinsonism; especially for risperidone, asenapine, lurazidone) are common dose-limiting side effects of SGAs. Anticholinergic effects, orthostatic hypotension, and seizures …
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Dosage equivalents of sedative hypnotics What are the dosage equivalents of the commonly used sedative hypnotics? Here is the table which provides approximate equivalencies for commonly used sedative hypnotics. It is important to note that there can be significant differences in metabolism of and sensitivity to these agents for each individual. Sedative Hypnotic Dose Equivalents …
What psychotropics have a relatively high potential for lowering seizure threshold? While epileptic seizures have been reported during treatment with nearly all psychotropics, some, mainly antidepressants and antipsychotics, are associated with a higher risk, and the risk increases in a dose-dependent fashion and depending on other health factors (e.g., electrolyte imbalances in persons with eating …
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