Psychiatric Drug Indications

Front 1

Clonidine/Guanfacine

Back 1

1) Withdrawal from Opioids, Alcohol, Benzodiasepines, Nicotine
2) Tourette's Disorder - Second line, behind Dopmine Receptor Antagonists (DRAs) haloperidol and pimozide, and Serotonin-Dopmaine Antagonists (SDAs) Risperidone and Olanzapine. Use when worried about adverse effects of DRAs and SDAs.
3) Hyperactivity and Aggression in Children - Alternative Tx for ADHD in place of sympathomimetics and antidepressants (risk of paradoxical worsening). Can improve mood, reduce activity level, improve social adaptation.
4) PTSD - Acute exacerbations may be associated with hyperadrenergic symptoms (hyperarousal, startle response, etc). Guanfacine superior b/c of overnight benefit due to longer half life.

Front 2

Beta-blocker indications

Back 2

Definitely Effective
1) Performance Anxiety - also used in panic disorder, PTSD, generalized anxiety disorder. In panic disorder, less effective then benzos and SSRIs.
2) Lithium-induced Tremor - also for other drug induced tremors (ex. TCAs)
3) Neuroleptic induced akathisia (superior to benzos and anticholinergics)
Probably Effective
1) Adjunctive Tx for alcohol withdrawal
2) Adjunctive Tx for aggressive/violent behavior
Possibly Effective
1) Antipsychotic Augmentation
2) Antidepressant Augmentation

Front 3

Barbiturates

Back 3

1) Anesthetic for ECT
2) Seizures - generalized tonic-clonic and simple partial
3) Narcoanalysis
4) Used to determine extent of tolerance to barbiturates or other hypnotics to guide detoxification

Front 4

Gabapentin

Back 4

1) FDA approved Tx for postherpetic neuralgia
2) Other pain conditions - trigeminal neuralgia, central pain syndromes, compression neuropathies, radiculopathies, meralgia paresthetica
3) Anxiolytic properties beneficial to patients with panic attacks and social anxiety disorder
4) Decreases craving for alcohol, facilitating abstinence and detoxification.
***Renally exreted, so safe for use among patients with liver disease

Front 5

Pregabalin

Back 5

1) Diabetic peripheral neuropathy
2) Postherpetic neuralgia
3) Adjunctive Tx of partial onset seizures
4) Some benefit to SOME patients with generalized anxiety disorder. This use rejected by FDA, but accepted by European Medicines Agency

Front 6

Topiramate

Back 6

1) Weight loss - patients lose weight on Topiramate, used to counteract weight gain of many psychotropic drugs
2) May reduce frequency of cutting and other forms of self-mutilation in patients with Borderline Personality Disorder
3) Benefit in Primary Alcoholism
4) Benefit in PTSD
5) Effective in treating neuropathic pain, migraines, and binge-eating disorder.

Front 7

Tiagabine

Back 7

Occasionally used as an anxiolytic or hypnotic agent in patients who have not responded to, or tolerated, standard treatments. It has NOT been found to be useful in treating manic symptoms, whether used alone or as adjunctive therapy.

Front 8

Zonisamide

Back 8

Sometimes used as alternative Tx for acute mania
Sometimes used as alternative Tx for drug-induced weight gain

Front 9

Levetiracetam

Back 9

Used in treatment of acute mania, as add-on therapy to antidepressants to prevent the emergence of mania or cycling, and as an anxiolytic

Front 10

Buproprion

Back 10

1) Depression (though overshadowed by SSRIs, has good therapeutic efficacy)
2) Seasonal Affective Disorder (SAD) prevention of major depressive episodes
3) Smoking cessation
4) Bipolar disorders - less likely then tricyclics to precipitate mania in Bipolar type I. Less likely than other antidepressants to exacerbate or induce rapid-cycling Bipolar type II
5) ADHD second line drug after sympathomimetics. Good when ADHD with co-morbid depression
6) Cocaine detoxification
7) Hypoactive sexual desire disorder - used to counteract sexual side effects of drugs like SSRIs. may improve arousal, orgasm completion and sexual satisfaction.

Front 11

Mirtazapine

Back 11

Effective in treatment of depression. Because two major side effects are sedation/somnolence and increased appetite, it is a useful agent in particular co-morbid patients, such as depressed patient with loss of appetite.
Antagonism of 5-HT(2) and 5-HT(3) receptors serves to decrease anxiety, relieve insomnia, and stimulate appettite. Also it reduces nausea and diarrhea, therefore combined with SSRIs or venlafaxine (SNRI) to both augment antidepressant response and counteract serotonergic side effects, particularly nausea, agitation and insomnia.