Notes from a Medication Management class
These are my notes, I probably misspelled some things. This is not medical advice, just what I learned. I hope it will be of some use to you. (sorry its so long) It was taught by a RN from a local hospital. Some of the information I question, but put here anyway. Basically if you have questions talk with your doctor/pharmacist.

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Bipolar<o></o>

<o></o>Medications for Bipolar
-Lithium (Lithium Carbonate, LIC03)
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Anti Convulsants
-Tegretol (Carbamazepine)
-Depakote (Valproic Acid)
-Trileptil (Oxycarbamazepine)
-Lamictal (Lamotrigine)

Atypical Antipsychotics
-Abilify
- Zyprexa
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Side Effects
-Sedation
-Low white blood cell count
For most medications blood tests are required to check for steady liver levels.<o></o>

Lithium
-Gold standard of medication for manic depression
- Been around for almost 60 years
-Two types of lithium
- Don’t know how it works, it just does
-Great for reducing suicidal thoughts
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Risks: excessive thirst, weight gain, lithium toxicity, hand tremors, emotional dulling. Important to monitor kidney levels, normal levels of lithium in blood at 0.5 to 1.5 any more than that can cause lithium toxicity.
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Stay hydrated! Monitor kidneys and thyroid.
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**Thyroid problems can cause psychotic symptoms.**<o></o>
**UTI’s can cause psychotic symptoms. **<o>

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Lamictal
-Good for depressive cycles
-Risk of rash (Stevens Johnson Syndrome)
-Does not require blood tests
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Anti Depressants
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Medications
Tricyclic Anti depressants
(Likely to cause manic episodes in bipolar patients)
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-Imipramine & Amitryptiline (most side effects)
-Desipramine & Nortriptyline (fewer side effects)
-Doxepine & Chlormipramine (Also used to treat OCD)
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Side effects: Anticholinergic side effects: Dry mouth, blurred vision, constipation, urinary retention, postural hypotension, sedation, dizziness, cardiac problems at high doses.
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Selective Serotonin Re-uptake Inhibitors (SSRI’s)
(Not likely to cause manic episodes in bipolar patients)
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-Prozac (Fluoxetine)
-Zoloft (Sertaline)
-Paxil (Paroxitine)
-Celexa (Citalopram)
-Lexapro (Escitalopram)
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Side effects: GI nausea, diarrhea, vomiting, sleepiness/insomnia, anxiety, headaches, sexual dysfunction, weight loss/gain.
Risk: Serotonin Syndrome
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Other Anti Depressants
-Wellbutrin (Bupropion) –also used for bipolar patients and for those who are trying to quit smoking. Not used in people with a history of seizures or head injury.
-Remeron (mirtaxaprine) –some sleep difficulties when started but helps with sleep afterwords. Side effects: weight gain.
-Desyrel (Traxadone) –used for sleep, not used much for depression.
-Effexor (Venlafaxine)
-Cymbalta (Duloxetine)
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MAOI
-Nardil (Phenelzine)
-Pamate (Tranylcypromine)
-Marplan (Isocarboxazid)
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Many interactions with medications both prescribed and un-prescribed
Need special diet, tryamine containing foods cause hypertension, so severe it can be life threatening.
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Other treatments for depression
-ECT
-Psychotherapy
-Alternate therapies
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Anti Anxiety Medications
Benzodiazepines: Schedule II controlled substances
-Klonopin (Clonazepan)
-Ativan (Lorazepan)
-Valium (Diazepam)
-Xanax (Alpraxolam)
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Anti histamines
-Benadryl (Diphenhydramine)
-Vistaril (Hydeoxy Hydrochloride)
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Azaspirodecanedione derivative
-BuSpar (Buspirone Hydrochloride)
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Medications for Sleep
-Restoril (Temazepam)
-Lunesta (Eszopiclone)
-Ambien (Zolpidem)
-Sonata (Zaleplon)
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-Benadryl (Diphenhydramine)
-Seroquel (Questiapiane)
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</o> *Medications can take 4 to 6 weeks to take effect*<o></o>
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*If you have any questions about your medications or the interactions between medications talk with your pharmacist!!**<o></o>

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Helpful tips for anyone on medication

-take your medication at the same time each day
-if a little bit is good, a lot is worse
-tell your doctor about any over the counter or herbal supplements you are taking
-medication is not magic. It wont cure all your symptoms/situations
-Tell doctor of any side effects (this also helps prevent noncompliance)
-Don’t double up on doses
-Medications can cause serious birth defects (tell doc if you are or plan to become pregnant)
-Alcohol and drugs to not mix well with psychotic medications
-Many medications cause photo (light) sensitivity. Wear sunscreen and protect yourself from the sun
-In the summer, patients can get dehydrated. Drink lots of fluids
-Dental/oral hygiene is very important. (Medications can cause dry mouth)
-Eat healthy, exercise and get the recommended amount of sleep each night.

Thank you for sharing these!

[You did do well in this class right?]

:)

Very informative and helpful Zoie! Thanks! Hope you did do well in this class...sounds like you desrved it!
Jackers

I am pretty sure I am doing well in the class, considering its only a two day class and friday is the last day. There was more information. Thats just what I thought others with BP may find useful.

Wow, Zoie, you took great notes...:)

Did they tell you what type of thyroid problems that can cause psychotic problems:confused:? I was diagnosed (at my early childhood) with underactive thyroid which, since then, I've been taking medication for. That is very interesting!

And, why is Paroxetine listed as a Selective Serotonin Re-uptake Inhibitors (SSRI’s) and not Anti-depressant? Or are they the same thing?:confused:

SSRI is a "class" of antidepressant. Basically there are different classes of antidepressants like the SSRI's, TCAs, MAOIs, and MRIs.

SSRI is a "class" of antidepressant. Basically there are different classes of antidepressants like the SSRI's, TCAs, MAOIs, and MRIs.

Okay, thank you, netsavy! That does make sense!

They did not go into thyroid problems, Just that they can cause psychotic symptoms. As with dehydration (if your medication builds up in your system--so drink fluids)

They did not go into thyroid problems, Just that they can cause psychotic symptoms. As with dehydration (if your medication builds up in your system--so drink fluids)

Thank you, Zoie!

Yup, it seems that I am suppose to drink a lot of fluids (which I do anyway for other reasons) with my other prescribed meds. But I don't like the taste of just plain water (bottled or tap - doesn't matter), I have to have "flavored" water or I drink "electrolyte" drinks. That would work wouldn't it?

Yep. Fluid is the important word. I just like water more than anything.

I think things like soda pop or coffee can dehydrate you more (not sure about this though) but I know electrolyte drinks are good

I recently found out that antipsychotics are basically major tranqs. I was stunned. There is so much about our meds that we don't know. Thanks for sharing your experience with us.

Yep. Fluid is the important word. I just like water more than anything.

I think things like soda pop or coffee can dehydrate you more (not sure about this though) but I know electrolyte drinks are good

How well I know... I drank only "Dr. Pepper" for a while when I was 19, and developed a "Urinary Infection" which was so bad, I wanted to die because of the pain. Yup, I only drink soda pop only once in awhile, if any at all. I prefer Sweet Tea (A southern style iced tea:))... but try not to drink too much. Don't know if it's a diuretic or not. I've heard it is.:confused:

Good Notes! Looks like this RN teaches a good class! I liked what you had in bold type. I didn't know (after 15 years in medicine) until last month that UTI's can cause altered mental status, particularly in the elderly and frail. Thyroid dysfunction can cause MANY problems, including psychosis. Hyperthyroid is usually responsible for most of the more noticable problems, although hypothyroid can cause serious problems as well. Both very treatable once diagnosed. Thyroid function is a hormonal process and there are a variety of places for things to go wrong in the chain of events...

And very true that most meds take up to 4-6 weeks to work, particularly agents that affect serotonin levels.

Good Notes! Looks like this RN teaches a good class! I liked what you had in bold type. I didn't know (after 15 years in medicine) until last month that UTI's can cause altered mental status, particularly in the elderly and frail. Thyroid dysfunction can cause MANY problems, including psychosis. Hyperthyroid is usually responsible for most of the more noticable problems, although hypothyroid can cause serious problems as well. Both very treatable once diagnosed. Thyroid function is a hormonal process and there are a variety of places for things to go wrong in the chain of events...

And very true that most meds take up to 4-6 weeks to work, particularly agents that affect serotonin levels.

So that means, then, that it's Hyperthyroidism that can cause psychosis? That sounds logical to me! Not too mention other problems (heart problems).. That's why my dr had to take me off of Regular thyroid (Armour Thyroid - was taking 90 mg) and put me on a smaller dose of Synthroid because it affected my heart rate increasing it too much. I'll bet taking the larger amounts affected my thinking, too, maybe?? Well, yes, obviously!

Yup. I kind of think of the thyroid as a speed dial. Turn it up to far and up goes the heartrate, metabolism, psychosis, etc. Turn it down, the metabolism slows, the heartrate slows, cell production slows, lethargy, and coma.

Yup. I kind of think of the thyroid as a speed dial. Turn it up to far and up goes the heartrate, metabolism, psychosis, etc. Turn it down, the metabolism slows, the heartrate slows, cell production slows, lethargy, and coma.

Yep, and it does seem hard to regulate... which is why I have to have a periodic blood test to make sure my thyroid is functioning properly from my medication. Thanks, CAUM!