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Home , Biperiden, Mesoridazine, Oxcarbazepine, Trihexyphenidyl, Ziprasidone

PRESCRIPTION FOR MENTAL ILLNESS

This pamphlet should be used only as a general guideline to inform you about the (s) which you are taking including: • What these medications are used for • How the medication works • Possible side effects • Precautions you should be aware of

You may experience all, some, or none of the side effects listed because individuals react differently to each medication. If you MEDICATIONS FOR MENTAL HEALTH have additional questions after reading the material, ask your A guide for families, friends, board and care homes, doctor or pharmacist. caregivers, and patients WHY USE YOUR MEDICATIONS? Prescription medications can help you with the following: • reduce symptoms • prevent relapse

• improve your quality of life You must monitor your response to the medication carefully in order to maximize the benefits of medications and detect side effects. DO NOT use and illicit drugs while taking the medications.

HOW DO YOU TAKE YOUR MEDICATION? • To get the most benefit, use the medication as prescribed. o If 1 time a day, take in the morning or evening. o If 2 times a day, take in the morning and late afternoon/early evening. o Or as directed by your doctor. • Take your medication at the same time(s) each day. • DO NOT change your dose or take it more often than prescribed. • The medication may be taken with or without food, if you do not know, ask your doctor or pharmacist. This brochure provides information about medications • DO NOT stop taking the medication(s) or reduce the in the following categories: dose without first discussing it with your doctor. • Stopping the medication(s) may worsen the illness. • WHAT IF YOU MISSED A DOSE? • Anti- & Sleeping Agents If you missed a dose, take it as soon as you remember. If it is • Mood Stabilizers near the time of your next dose, skip the missed dose and resume your usual dosing schedule. DO NOT double the dose. • Medications Used to Treat Extrapyramidal Side Effects TELL YOUR DOCTOR IF YOU: • Stimulants 1. Have had allergic reactions to drugs or food. 2. Are taking any other medications (including herbals and illicit drugs). **These medications are to be used only when 3. Are pregnant or breast-feeding. prescribed by your doctor. ** 4. Have diabetes, kidney, , or heart disease. 5. Are on a special diet or taking food supplements. Ask your doctor or pharmacist which category or 6. Drink alcohol or smoke. categories of medications you are taking. 7. Stop taking the prescribed medications.

8. Experience side effects. IF YOU HAVE ANY QUESTIONS OR PROBLEMS, ASK REMEMBER YOUR 1. Know your medications. • Doctor 2. Follow directions and read the label carefully. • Therapist 3. Store medications in a cool dry place. • Pharmacy 4. Keep medications out of the reach of children. 5. Ask about special precautions. 6. Find out about possible side effects. Mental Health Pharmacy Department 7. Keep your doctor informed. Revised 11/06 ANTIDEPRESSANTS ANTIPSYCHOTIC AGENTS Generic Name Brand Name Generic Name Brand Name TYPICALS Elavil, Endep Thorazine Asendin Prolixin * Anafranil Haldol Norpramin Loxitane Sinequan, Adapin Serentil

Imipramine Tofranil Moban

Maprotiline Ludiomil Trilafon

Nortriptyline Pamelor, Aventyl Mellaril

Thiothixene Navane Vivactil SSRI’s Stelazine Celexa ATYPICALS Lexapro Abilify Prozac Clozaril * Luvox Zyprexa Paxil Seroquel Zoloft Risperdal MAO INHIBITORS Geodon Phenelzine sulfate Nardil OTHER

Selegiline (patch) Emsam Olanzapine and Fluoxetine Symbyax

Tranylcypromine Parnate WHAT ARE THEY USED FOR? OTHERS Antipsychotic agents can be used to treat or Buproprion Wellbutrin . Schizophrenia causes disorganized Cymbalta thought, confusion, altered view of reality, and Remeron hallucinations. Bipolar disorder causes a person to alternate Serzone between depression and , see section “Mood Desyrel Stabilizer”. Antipsychotic agents may be able to reduce or Effexor stop these events by working with the natural substances in

*used mainly in obsessive compulsive disorder (OCD) your body to help you with the following: (1) organize your thoughts, (2) help you stay concentrated, (3) help reduce WHAT ARE THEY USED FOR? excitability, confusion, and withdrawal, (4) improve your They may be used to treat symptoms of depression, including: ability to communicate, and/or (5) improve your ability to - depressed mood - loss of interest control hallucinations. - lack of pleasure - changes in sleep & appetite These drugs work with the natural substances in your body to SIDE EFFECTS help make you feel well and happy. TYPICAL: Sleepiness, dry mouth, , blurred vision, rapid heart beat, stuffy nose, restlessness, muscle SIDE EFFECTS: stiffness, trembling and shaking may occur. These effects Common: drowsiness, lightheadedness, dry mouth, often disappear in 1 to 2 weeks. nervousness, , , rapid heart rate, change **Serious Side Effect: Tardive (TD), which is an in sexual function involuntary movement of the face or mouth, may occur and TRICYCLICS: Dizziness, blurred vision. These effects often can be irreversible. decrease in 1 to 2 weeks. ATYPICAL: These medications cause many of the same SSRI’s: , diarrhea, insomnia (sertraline, fluoxetine), side effects as the , but rarely cause (paroxetine, fluvoxamine), weight loss, and suicidal muscle stiffness, trembling, and restlessness. thoughts. **Serious Side Effects: MAOI’s: , edema, insomnia, agitation, - increase blood pressure - increase blood sugar blurred vision - increase - weight gain PRECAUTIONS: Clozapine requires frequent blo od test. • Antidepressants may take a month or more to take effect. • Avoid , alcohol, and illicit drugs. PRECAUTIONS • Do not operate a car or machinery if feeling sleepy. • Avoid barbiturates, alcohol, and illicit drugs if taking • If you are pregnant or breast-feeding, consult your doctor. these medications. They may increase the side effects of antipsychotic. IF YOU ARE TAKING A MAO INHIBITOR: • Avoid operating a car or machinery. • Do not drink or eat excessive amounts of caffeinated • Antipsychotic may take a month or longer to take effect. products (e.g. coffee, tea, chocolate.) • If you are pregnant, think you may be pregnant, or are • Do not drink alcohol, especially Chianti (red wine). breast-feeding, consult your doctor or pharmacist. • Do not eat cheese, sour cream, yogurt, or smoked meats. • Contact your doctor if you experience flu-like symptoms • Do not eat fava beans, avocadoes, or bananas. (fever, sore throat, and lethargy [lack of energy]). • These foods interact with the medication and increase your • Avoid extended sun exposure. Stay in the shade, drink blood pressure. water, use sun-block and KEEP COOL. MEDICATIONS USED TO TREAT STIMULANT MEDICATIONS EXTRAPYRAMIDAL SIDE EFFECTS (EPSE)

Generic Name Brand Name

Generic Name Brand Name Strattera

Amantadine Symmetrel Focalin Benztropine Cogentin Dextroamphetamin/A Adderall Akineton mphetamine Benadryl Dextroamphetamine Dexedrine Artane Desoxyn Concerta, Ritalin, Metadate Pemoline Cylert WHAT ARE EXTRAPYRAMIDAL SIDE EFFECTS? EPSE are side effects that usually occur from taking typical antipsychotic medications. Examples of EPSE include: WHAT ARE THEY USED FOR? - Akathesia: an uncontrollable feeling of restlessness Stimulant medications are mainly used to treat attention deficit or inability to stay still hyperactivity disorder (ADHD) in children who are unable to - Pseudoparkinsonism: a feeling of slowing down concentrate. Stimulant medications can do the following: and stiffness, trembling, and shaking • improve attention span - : a feeling of muscle tension or spasm • improve ability to follow directions The medications can minimize or eliminate the side effects from • decrease hyperactivity taking a typical antipsychotic medication. For a complete list of • improve ability to think before acting antipsychotic medications, see the section “Antipsychotic • decrease appetite Agents.”

SIDE EFFECTS: SIDE EFFECTS: Benztropine, trihexyphenidyl, diphenhydramine, and biperiden Common: can cause the following: - trouble falling asleep - rapid heart beat - dry mouth - sedation - - increased blood pressure - dry skin - blurred vision - stomach aches - crankiness -constipation - nausea - weight loss Of the medications listed, benztropine is the most sedating. - nervousness can cause the following: These often go away after two weeks or if the dose is lowered by your doctor. - irritability - - dizziness - agitation Serious: **Rare: hallucinations - muscle twitches/tics - sadness which lasts more than a few days - unusual behavior, e.g. suicidal thoughts PRECAUTIONS: Tell your doctor or pharmacist right away if you experience any • Avoid alcohol and illicit drugs with these medications as it of these side effects. may increase sedation. • Do not operate a car or machinery until you are sure that the medication does not adversely affect you. PRECAUTIONS: • If you are pregnant, think that you may be pregnant, or are • If you have schizophrenia or bipolar disorder, these breast-feeding, consult your doctor or pharmacist about the medications can worsen your symptoms. risk associated with these medications. • Physical addiction may occur in adolescents or adults. • High doses of these medications can lead to serious outcome. • Keep this medication where it will not be abused by others. • Contact your physician immediately if you experience any of • A child may not grow as fast as usual while taking this the following while taking these medication: medication. Growth usually catches up after stopping - flushed face medication. Monitor height and weight regularly. - rapid heart beat - fever

ANTI-ANXIETY & SLEEPING AGENTS MOOD STABILIZERS

Generic Name Brand Name Generic Name Brand Name Tegretol Alprazolam* Xanax Divalproex sodium Depakote

Chlorazepate Tranxene Lamotrigene Lamictal

Chlordiazepoxide Librium carbonate Eskalith, Lithobid

Clonazepam Klonopin Trileptal

Diazepam Valium Valproic acid Depakene Flurazepam* Dalmane Ativan Oxazepam Serax WHAT ARE THEY USED FOR? * Restoril These medications may be used to treat bipolar , NON-BENZODIAZEPINES also known as manic depression. This is a disorder where you Amitriptyline** (low doses) Elavil* alternate between mania and depression. Buspar Mania: When you are overly self-confident, reckless, Diphenhydramine Benadryl uncontrollable, sleepless, and excited. ** Lunesta Depression: When you feel low-spirited, hopeless, and Atarax extremely sad. ** (low doses) Topranil** These medications work on the natural substances in your body ** Sonata to do the following: ** Ambien - make you feel happy and confident *Primarily used for panic disorders - help stabilize your moods by controlling your highs **Primarily used for sleep disorders and lows. It may take up to two weeks for these medications to work.

WHAT ARE THEY USED FOR? These medications may be used to treat anxiety which can SIDE EFFECTS: include any or all of the symptoms following: Common: - an unreasonable and unpleasant state of tension - sedation - fatigue - uneasiness or fear (not normal tension) - dry mouth - shakiness - difficulty sleeping - stomach upset - drowsiness - muscle spasms - diarrhea - weight gain Anti-anxiety medications work with the natural substances in Lithium may cause thirst, muscle weakness, and slightly your body to help you feel relaxed and calm. They can cause impaired memory. mild sedation while giving relief from tension and anxiety. Carbamazepine may cause a rash. If this occurs it is very important that you contact your doctor.

SIDE EFFECTS Common: drowsiness, lightheadedness, clumsiness, depression PRECAUTIONS: BENZODIAZEPINES: slurred speech, confusion, headaches, • Be aware of your salt intake with Lithium. Do not restrict nausea, and physical addiction salt from your diet. A low salt concentration in your body **Rare: breathing difficulty, nervousness, or excitement may can cause fatigue, slurred speech and trembling. In severe occur. cases, coma or death may result. NON-BENZODIAZEPINES: , dizziness, nausea, • Avoid extended sun exposure. Stay in the shade, drink diarrhea water, use sun-block and KEEP COOL. Zolpidem (Ambien) may cause tremor. • Blood tests are necessary to ensure that the level in your blood are safe and effective while taking the following: - Lithium (Eskalith, Lithobid) PRECAUTIONS: - Valproic Acid (Depakene) • Avoid taking barbiturates, alcohol, and illicit drugs while - Divalproex sodium (Depakote) taking anti-anxiety medications. The combination can be - Carbamazepine (Tegretol) deadly. • If you are pregnant, think that you are pregnant, or are • Do not operate a car or machinery while taking these breast-feeding, consult your doctor or pharmacist about the medications. possible risks associated with these medications. • If you are pregnant, think you may be pregnant, or are • Do not stop taking these medications or reduce the dose breast-feeding, consult your doctor or pharmacist about the without first discussing it with your doctor. possible risks of using these medications. • Do not stop taking these medications or reduce the dose without first discussing it with your doctor. • May cause physical and/or psychological addiction.