Generic Name

Brand Name Classification Dosage/route Indication Contraindication Adverse reaction Nursing Consideration

Clomipramine

Desipramine

Anafranil

Norpramine

Antidepressant

tricyclic antidepressants (TCAs)

The usual adult dose is 100-200 mg daily. The maximum dose is 300 mg daily.

The usual dose of doxepin is 75 to 300 mg daily administered at bedtime or in three divided doses. Doses greater than 300 mg daily are not more effective.

Adults: Depression of varying etiology and symtomatology; Obssessive-compulsive syndromes; phobias and panic attacks

For depression

Hypersensitivity to clomipramine or excipients, cross-sensitivity to tricyclic antidepressants of the dibenzazepine group.

Hypersensitivity to drugRecovery phase of myocardial infarction(MI)MAO inhibitor use within past 14 days

Very common: drowsiness, fatigue, restlessness, tremor, myoclonus, increase appetite, dry mouth, sweating, constipation, visual disturbances

CNS: sedation, weakness, anxiety, restlessness,insomnia, delusions, confusion,agitation, hallucinations, disorientation,extrapyramidal reactions,EEG changes, CV: hypotension, hypertension, tachycardia,

-Monitor patient with history of CVD (including previous MI, stroke, tachycardia, or conduction abnormalities. -monitor BP, pulse every 4hrs; if systolic BP drops 20mmHg hold drug, notify physician.-monitor blood studies.-assess mental status.

For Depression Hypersensitivity; mania, glaucoma, neonates (topical); lactation.

palpitations, EENT: blurred

vision, dry eyes, laryngitisDrowsiness, dizziness, confusion, headache, dry mouth, constipation, blurring of vision, hypotension, tachycardia, rashes. Topical: Burning, stinging, scaling, oedema and dryness.

Drowsiness, tremor, dry mouth and constipation.

Postural hypotension,

-Assess patient’s condition before therapy and regularly thereafter to monitor drug effectiveness. -assess baseline mental status and monitor throughout therapy-monitor VS regularly-determine alcohol consumption

Doxepin

Trimipramide

Sinequan, Adapin

Surmontil

Nardil

tricyclic antidepressant

The usual starting dose for adults is 50 to 75 mg per day, split into equal, smaller doses (for example, 25 mg three times daily). Doses are gradually increased every 2 to 3 weeks.

PO 15 mg 3 times/day. Up to 4 times/day if there is no response after 2 wk. Severe

Depressive illness, especially where sllep disturbance, anxiety or agitation is a presenting symptom.

For Atypical depression.

Concurrent use of monoamine oxidase inhibitors (MAOIs), an interval of at least 15 days should separate both treatments. Narrow angle glaucoma. Risk of urinary retention.

Uncontrolled hypertension; cerebrovascular disease; CHF; phaeochromocytoma; history of hepatic disease or abnormal LFTs; severe renal impairment or renal disease.

oedema; dizziness, headache, drowsiness, sleep disturbances, fatigue; rash; decreased sexual ability; constipation, wt gain, xerostomia; urinary retention; leukopenia; hepatitis, jaundice; weakness, tremor; blurred vision.

Postural hypotension, oedema; dizziness, headache, drowsiness, sleep disturbances, fatigue; rash; decreased sexual ability; constipation, wt gain, xerostomia; urinary retention; leukopenia; hepatitis, jaundice; weakness, tremor; blurred vision.

Phenezine

Fluvoxamine

Luvox, Luvox CR

Pamelor, Aventyl

selective serotonin reuptake inhibitors (SSRIs)

Tricyclic Antidepressants (TCAs)

(hospitalised): ≤30 mg 3 times/day. Gradually reduce dose for maintenance.

The usual starting dose for adults is 50 mg daily given as a single dose at bedtime. The dose may be increased in 50 mg increments every 4-7 days to achieve the desired response. The maximum dose is 300 mg/day.

The usual dose of nortriptyline in adults is 25 mg given 3 to 4 times daily. In children, doses usually are 30 to 50 mg once

For depression, OCD and Social Anxiety Disorder

For Depression.

Hypersensitivity. Not to be used with thioridazine, terfenadine, astemizole, cisapride, pimozide, aloestron, tizanidine. Lactation

Mania, recent MI, arrhythmias (particularly heart block); severe liver disease; children <6 yr.

Headache, asthenia, tremor, palpitations, nausea, diarrhoea, constipation, anorexia, vomiting, flatulence, somnolence, insomnia, dry mouth, nervousness, dizziness, tremor, anxiety, agitation, decreased libido, depression, CNS stimulation

Tachycardia, slows conduction and prolongation of PR interval, lowers seizure threshold, peripheral neuropathy, dry mouth, constipation, urinary hesitancy, confusion and blurred vision, nausea, sweating, hypersensitivity reactions.

Nortriptyline

Bupropion

Nefazodone

Wellbutrin

Serzone

Antidepressant

antidepressant

daily or in divided doses. It is advisable to begin at a low dose and increase the dose slowly.

Given in one, two or three daily doses. For immediate-release tablets, no single dose should exceed 150 mg and each dose should be separated by 6 hours.

The recommended dose range is 150-300 mg twice daily.

treatment of major depressive disorder

For depression

treatment for depression

Contraindicated in patients with a seizure disorder.

Hypersensitivity to phenylpiperazine antidepressants. Active liver disease or elevated baseline serum transaminase concentrations. Previous history of hepatocellular injury with nefazodone use. Concurrent use or within 14 days of discontinuing treatment with MAOI.

Hypersensitivity

Agitation, dry mouth, insomnia, headache/migraine, nausea/vomiting, constipation, and tremor.

Nausea, dry mouth, insomnia, somnolence, agitation, constipation, asthenia, dizziness, lightheadedness, orthostatic hypotension, confusion, blurred vision, abnormal vision, eye pain, sinus bradycardia, bronchitis, syndrome of inappropriate secretion of anti-diuretic hormone, impotence.

Blurred Vision, Dry

Trazodone

Sertraline

Desyrel

Zoloft

Eskalith CR

antidepressant

selective serotonin reuptake inhibitors (SSRIs)

Adult dose is 150-600 mg per day

50mg/day once daily. May be increased to 200 mg/day over a period of 2 wks by 50mg increments.

Symptoms of depression in patients with or without history of mania. Obsessive-Compulsive disorders.

Lithium is indicated in the treatment of manic episodes of Bipolar Disorder.

Hypersensitivity to the drug or any ingredient in the formulation, in combination with MAOI or within 14 days of discontinuing a MAOI. Co-adiminstration fluvoxamine with cisapride.

Lithium should generally not be given to patients with significant renal or cardiovascular disease, severe debilitation or dehydration, or sodium depletion, and to patients receiving diuretics, since the risk of lithium toxicity is

Mouth, Hypotension, Dizziness/Lightheadedness, Drowsiness, Nervousness, Nausea/Vomiting.

Nausea, loose stools, dyspepsia, tremor, dizziness, insomnia, somnolence, dry mouth, increased sweating and male sexual dysfunction.

Lithium Toxicity

Lithium Carbonate

Carbamazephine

Tegretol

Depakene

Antimanic

Anticonvulsants

Anticonvulsants

Acute Mania- 600 mg t.i.d.Long-Term Control - 0.6 to 1.2 mEq/L

PO Epilepsy Initial: 100-200 mg 1-2 times/day, may increase slowly

Initially 10-15 mg/kg daily. Dosage should be increased by 5-10 mg/kg/wk.

Oral forms: Epilepsy. Acute mania; maintenance for bipolar affective disorders.

Treatment of generalized epilepsy particularly w/ absence, myoclonic, tonic-clonic, atonic & mixed patterns of seizures; & partial epilepsy particularly w/ simple or complex, secondary generalized, specific syndromes.

very high in such patients.

Hypersensitivity; bone marrow depression; porphyria, pregnancy.

Hypersensitivity to Na valproate or valproic acid, porphyria. Acute & chronic hepatitis, history of severe hepatitis esp drug-related.

Dizziness, drowsiness, ataxia; dry mouth, abdominal pain, nausea, vomiting, anorexia; leucopenia, proteinuria, renal failure, heart failure and hyponatraemia.

Hemorrhage, bruising, hyperammonemia, nausea, vomiting, increased appetite, thrombocytopenia, anemia, bone marrow suppression, pancreatitis. GI irritation.

-assess for seizures: character, location, duration, intensity, frequency, presence of aura.-assess for trigeminal neuralgia.-check for water retention, with decreased osmolality and concentration of Na+ plama, esp. in elderly patients with cardiac disease.

Valproic A

Nimodipine

Nimotop

Isoptin

Nootropics & Neurotonics/Neurotrophics / Peripheral Vasodilators & Cerebral Activators

Calcium Antagonists

Maintenance: Adult 20-30 mg/kg. Childn 30 mg/kg/day. Elderly Should be determined by seizure control. Monitor patients when receiving daily doses >50 mg/kg.

IV infusion: initially, !mg for 2hrs. dose may increase after 2hrs to 2mg if no marked reduction in BP.

Isoptin tab Adult 40-80 mg tid-qid. Max: 480 mg daily. Childn >6 yr 40-120 mg bid-tid, up to 360 mg daily, ≤6 yr 40 mg

Prophylaxis and treatment of ischaemic neurological deficits caused by cerebral vasospasm following subarchnoid hemorrhage of aneurismal origin.

Diltiazem is used in the management of angina pectoris and hypertension.

Management of tourette disorders;

Sick sinus syndrome, 2nd or 3rd

degree heart block, hypotension less than 90 mm Hg systolic, hypersensitivity.

Contraindicated in patients with the sick sinus syndrome, pre-existing second or third degree atrioventricular block or marked bradycardia.

Severe toxic CNS depression or

Peripheral oedema, hypotension, palpitations, tachycardia, flushing, dizziness, headache, nausea, increased micturition frequency, lethargy, eye pain, mental depression, visual disturbances, gingival hyperplasia, myalgia, tremor.

Constipation, dizziness, nausea. Rarely, vertigo, headache, hypotension, erythromelalgia, paresthesia, neuropathy; bradycardiac arrhythmias, CHF, dyspnea, raised prolactin levels, single cases of galactorrhea.

Extrapyramidal symptoms, tardive

-assess potential for interactions with other pharmacological agents and herbal products patient may be taking. -monitor I and O ratios and daily weight. -assess for signs of CHF. -assess therapeutic effectiveness.

-assess fluid volume status: I-O ratio and record.-monitor BP and pulse.Monitor ALT, AST, bilirubin daily-monitor cardiac output.

-assess patient’s disorder and mental

Verapamil

Haloperidol

Fluphenazine

Haldol

Prolixin

Leponex

Antipsychotics

Antipsychotics

bid-tid. Isoptin SR 180 Coronary insufficiency 1 tab bid.

Adult As a neuroleptic agent: acute paranoia 5-10 mg IM to be repeated hourly until sufficient symptom control is achieved. Max: 60 mg/day.

Adult: PO Mania; Psychoses; Schizophrenia Initial: 2.5-10 mg/day in 2-3 divided doses. Maintenance: 1-5 mg/day. Adjunct in severe anxiety

control of adults; mgt of severe behavioural problems in children and adults.

For Schizophrenia, severe anxiety or behavioral disturbances.

Schizophrenia in patients who are non-responsive to or intolerant to classical antipsychotics. Suicidality in

comatose states from any cause; pakinson disease.

Hypersensitivity; comatose or severely depressed states; blood dyscrasias; liver disease; bone marrow depression; phaeochromocytoma;

History of bone marrow disorders including agranulocytosis, circulatory collapse, alcoholic or toxic psychosis,

dyskinesia, neuroleptic malignant syndrome, other CNS effects, GI symptoms, endocrine effects, CV effects. Hypersensitivity reactions.

Tardive dyskinesia, sedation, mental confusion; hypotension; hyperprolactinaemia leading to galactorrhoea and amenorrhoea in women; loss of libido, impotence and sterility in males.

Drowsiness, dizziness, headache; nausea, vomiting, constipation; anxiety, confusion, fatigue, transient

status before drug therapy and reassess regularly thereafter. -monitor for possible adverse reactions.-monitor VS during initial treatment.-assess for constipation and urinary retention daily.

-assess mental status.-check for swallowing of oral medication.-Monitor I-O ratio, palpate bladder if low urinary output

Clozaphine

Olanzadine

Zyprexa

Seroquel

Antipsychotics

Antipsychotics

or behavioral disturbances 1 mg twice daily, up to 2 mg twice daily if needed.

12.5mg once to twice a day on the 1st day, 25 or 50mg on the 2nd day, followed by stepwise dosage increases up to 300-450 mg per day in divided doses.

Tablet: initially 5-10 mg once a day.

patients with Schizophrenia or schizoaffective disorders.

Oral: acute and maintenance treatment of schizophrenia and other psychoses where positive symptoms and negative symptoms are prominent.

Treatment of acute and chronic psychoses, including schizophrenia. Manic episodes associated with bipolar disorder.

drug intoxication, uncontrolled epilepsy, severe renal, hepatic or cardiac disease;

Known hypersensitivity to the drug.

Hypersensitivity

fever, hypersalivation.

Headache, dizziness, somnolence, agitation, postural hypotension. Tntramuscular injection site discomfort, postural hypotension, bradycardia with or without hypotension or syncope, tachycardia.

Headache, asthenia, abdominal pain, back pain, fever, chest pain, postural and orthostatic hypotension, hypertension,

occurs. -assess for constipation, urinary retention daily, if these occur, increase bulk, water in diet.

-assess mental status, orientation, mood, behavior, presence of hallucinations and type before initial administration and every mouth. -monitor swallowing of oral medication.-assess dizziness, faintness, palpitations, tachycardia on rising.-assess for neuroleptic malignant syndrome.

-assess other medications patient is taking for effectiveness and interactions.-assess results of laboratory tests, therapeutic

Quetiapine

Ziprazidone

Zeldox

Antipsychotics

Antipsychotics

25 mg twice daily on day 1, increase to 50 mg twice daily on day 2, 100 mg twice daily on day 3 and 150 mg twice daily on day 4.

Capsule: 40mg twice daily. Dosage may be adjusted up to maximum of 80mg twice daily. Injection: 10-20 mg intramuscularly up to maximum of 40mg/day.

Capsule: Management of schizophrenia and other psychotic disorders and maintenance of clinical improvement and prevention of relapse during continuation therapy.

Known QT-interval prolongation; acute myocardial infarction; uncompensated heart failure, cardiac arrhythmias requiring treatment with class I and III antiarrhythmic drugs.

constipation, dry mouth, dyspepsia, diarrhoea, leucopenia.

Asthenia, extrapyramidal syndrome, nausea, somnolence, respiratory disorders. Rarely seizures.

effectiveness. -assess mental status for depression and suicidal ideation. -assess swallowing of oral medication.-monitor weight.

-assess mental status before initial administration.-check swallowing of oral administration.-monitor input-output ratio.-assess dizziness, faintness, palpitations, tachycardia on rising.-monitor BP standing and laying.