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Psychiatry

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  • ADHD
  • Antidepressants
  • Somatization Disorder
  • Withdrawl

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    ADHD

    Antidepressants

    atypical antipsychotics

    1. Aripiprazole (Abilify)

    tricyclics

    1. * amitryptiline (Elavil)
    2. imipramine (Tofranil)
    3. desipramine (Norpramin, Pertofrane)
    4. nortriptyline (Pamelor)
    5. *  doxepin (Sinequan)

    SSRI

    (See Serotonin Syndrome)

    Paxil (paroxetine) was found increase congenital heart defects in the 1st trimester of pregnancy, so it's now Category D. Its probably time to abandon use of Paxil since it doesn't seem to add anything to sertraline or fluoxetine.

    SSRI use in pregnancy also increases the risk of persistent pulmonary hypertension (6 fold?) and has a neonatal withdrawl syndrome. On the other hand, it's not like there are always great alternatives. Depression is a very risky condition.

    heterocyclics and other

    trazodone (Desyrel)

    bupropion (Wellbutrin, Zyban)

    mirtazapine (Remeron)

    s/e profiles (bad to better)

    Somatization Disorder

    Part I. Practical Diagnosis - February 15 & Part II. Practical Management - March 1, 2000 AFP

    Withdrawl

    Alcohol withdrawl (benzodiazepine):

    3 stages of withdrawl

    1. autonomic (tachycardia, tachyp, fever, diaphoresis), agitation, tremor,
    2. hallucinations (tactile, visual, auditory) with insight
    3. hallucinations without insight

    can manage as outpatient if

    1. stage 1 withdrawl (some treat very early stage 2)
    2. pt has full-time attendant
    3. pt can meet doc daily
    4. pt and caregiver are committed

    medication management


    Author: John G. Faughnan.  The views and opinions expressed in this page are strictly those of the page author. Pages are updated on an irregular schedule; suggestions/fixes are welcome but they may take weeks to years to be incorporated. Anyone may freely link to anything on this site and print any page; no permission is needed for citing, linking,  printing, or distributing printed copies.