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TREATMENT OF

ACUTE MANIA ABD


HYPOMANIA
If pt taking
antipsychotics then
check compliance and
dose, increase if
necessary , consider
adding lithium or
valproate ,
If taking lithium check
plasa levels , consider
increasing dose to give
level 1 -1.2 mmmol/l
to treat axcute episode
and not for
maintenance and
adding an
antipsychotics
If taking valproate
check plasma level ,
increase dose to give
levels upto 125mg /l if
tolerated and
consider adding
antipstychotic
If taking lithium, and
valproate and mania
is severe check levels
and add
antipsychotics
If taking
carbamazepine
consider adding
antipsychotics .
All pt consider adding
short term
benzodiazepine like
lorazepam or
clonazepam .
DRUG TREATEMNT OF
MANIA=
Lithium dose starting
from 400mg and
increasing upto 800mg
and checking plasma
levels .
Or valproate inform
of semisodium 250mg
tds and increasing
accordiong to
tolerability and
plasma levels . and
may be effective at 15-
20-30mg per kg per
day.
Or aripiprazole 15mg
-30mg per day
Or olanzapine 10 mg
-15 mg -30mg per
day .
Or rispridone 2-4-6mg
per day
Or quetiapine 100mg
-300mg -800mg per
day
0r haloperidol 5-10-
15mg per day
Or lorazepam upto
4mg per day
Or clonazepam 8mg
per day.
OTHER POSSIBLE
TREATEMNT FOR
MANIA=
Alupurinol 600mg per
day
Or clozapine or
gabapentin 2400mg
per day or
Lamotrigine upto
200mg per day or
Levetracetam upto
4000mg per day or
Memantine 10- 30
mg per day or
Oxcarbazepine 300-
3000mg per day or
phenytoin300-400mg
per day or tamosxifen
10-140mg per day or
topiramate 300mg per
day
ESTABLISHED
TREATMENTS FOR
BIPOLAR
DEPRESSION=
Lamotrigine 50mg
per day has efficacy
and beter dose is
500mg per day and
upto 1200 mg can be
used ,
Lithium and
antidepresents ;;tca
and mao are are
avoided, ssri are
reconmendedd,
venlafaxine and
bupropion have been
used.
Lithium also effctuive
in bipolar depression
Olanzapine and
fluoxetine dose is 6mg
/25 And can be
increased upto
12/50mg
Quetiapine==
In bipolar disorder in
doses of 300-600mg
per day.
Or valproate also
given
ALTERNATIVE
TREATEMNT FOR
BIPOLAR
DEPRRESSION ==
ANTIDEPRESENTS LIKE
fluoxetine ,
venlafaxine or
moclobamide
Or carbamazepine
may be effcctive in
combination with
other mood stabi;lizers
Or other possible
treatment may be
Aripiprazole , or
gabapentin , or or
modafanil or or
romega 1-2 g/day or
or thyroxine
RECOMMENDED
TREATEMNT
STRATEGY FOR RAPID
CYCLING BIPOLAR
AFFECTIVE DISORDER=
STEP 1;; withdraw
antidepresents
Step 2 ;; evaluate
possibler precipitants
like alcohol, throid
dysfunction and
external stressers
Step 3= optimize
mood stabilizer
treatment using
plasma levels or
consider combining
mood stabilizers like
lithium+valproate , or
lithium plus
lamotrigine .
Step 4= consider other
options like
aripiprazole 15-30mg
or clozapine or
lamotrigine upto
225mg per day or
levetracetam 2000mg
per day or olanzapine
or quetiapine 300-
600mg per day,
risperidone upto 6mg
per day, or thyroxin
150-4 00ugm per day
or topiramate upto
300mg per day .
PROPYLAXES IN
BIPOLAR AFFECTIVE
DISORDDERS;;
First line = lithium
Second line =
valproate (but not in
child bearing age )
olanzapine or
quetiapine third line =
alternative
antipsychotics like
carbamazepine ,
lamotrigine
Always combine
mood stabilizer and
antipsycotics for
propylaxess acute
treatment regimn.
Avoid ong term
antidepresents.
Nice GUIDELINES FOR
TREATENMNT OF
DEPORESSION;;
Antidepresent should
not be used as first
line of traetemnt but
do cbt or exercise .
For moderate to
severe depression
and dysthymia use
antidepresents .
Ssri should be
presecribed as usual .
Inform pt about
withdrwal procedure
of tapering
Treatment resistant
depression use
augmentation with
lithium or
antipsychotic or
another
antidepresents
Ist episode should be
treated for 2years
Use of ect in
treatment resistant
depression.
DEPRESSION And
ANXIETY =
Tab citalopram 20-
40mg
10mg for one week
and increasing upto
40mg per day.
Also used in panic
disorder and
agoraphobia
Escitalopram = used in
depression and panic
disorder and
agoraphobia
Dose id 5mg per week
then increasing to
20mg per day .
Also indicated in
social anxety,
generalize anxiety
disorder and ocd
F;luoxetine indicated
in depression, ocd ,
bulimia nervosa , dose
20-60mg per day age
between 10-20 give
10-20mg per day
20-60mg per day in
ocd and bulimia
nervosa
In ocd usual dose
upto 6omg per day
Fluvoxamine used in
depression, ocd , and
dose is 100-300mg
per day
Paroxetine used in
depression ocd , panic
disorder,
agoraphobia , social
pobia , ptsd , gen
anxiety disorder dose
is 20-50mg per day
Setraline in anxiety
25mg per day and in
depression, ocd , and
ptsd dose is 50-200mg
A mitryptaline
depression 50-200mg
per day
Nocturnal
enuresis=age less than
10 give 25mg but
above 15year give 25-
50mg per day
Clomipramine used in
depression(30-250)
and phobia and ocd
(100-150mg )
Dotheipine
(protheidine )75-
225mg
Imipramine ;;
depression=50-200mg
Nocturnal enuresss;;
25-75mg at night
NortryptaLINE
DEPRESSION == 75-
150MG
NOCTURNAL
ENURESES=10-35MG
MIRTAZEPINE = major
depression=15-45 mg
per day
Traziodone=
depression plus
anxiety =150-300mg
In anxiety == upto 75-
300mg per day
SUICIALITY ==
ANTIDEPRESENTS
Should be used for 6-
9 episode after
st
recovery from 1
episode
In those who had
multiple episode give
upto 2 year
MINIMUM DOSES OF
ANTIDEPRESENTS ;;
TRICYCLIC 25- 125MG
CITALOPRAM 20MG
PER DAY
ESCITALOPRAM
10MG PER DAY
FLOUXETINE 20MG
PER Day
Fluvoxamine 50mg
per day
Paroxetine 20mg per
day
Sertraline 50mg per
day
duloxetine 60mg per
day
mirtaZEPINE 30MG
PER DAY
TRAZODONE 150MG
PER DAY
VENLAFAXINE 75MG
PER DAY
DRUG TREATMENT OF
DEPRESSION=
Discuss choice of
drug with patient
Ssri first choice if
sedation required
Then start
antidepresent and
titrate to therapeutic
dose and assess
efficacy over 2weeks
If no effect with
antidepresent then
assess weekly for
further 2 weeks
If stil no response
increase dose SWITCH
TO different
antidepresent and
assess over 3-4 weeks
if stil no response
then mirtaZEPINE IF
STILL NO EFFECT WITH
MIRTAZEPINE THEN
GIVE DRUGS GIVEN
FOR RESISTENT
DEPRESSION
If antidepresent is
effective continue for
6-9month at full
therapeutic dose
Especialy in recurrent
depression
IF FIRST
ANTIDEPRESENT IS
POORLY TOLERATED
THEN SWITCH TO A
DIDFFERENT
ANTDEPRESENT IF
STILL SECOND IS NOT
TOLERATED THEN
SWITCH TO ANOTHER
IF STILL NO RESPONSE
RD
THEN 3
ANTIDEPRESENT
OPTION IF STILL NO
RESPONSE THEN GIVE
TREATMENT FOR
RESSISTENT
DEPRESSION.
If antidepresent is
poorly tolareraTED
THEN SWITCH TO A
DIFFERENT
ANTIDEPRESENT AND
ASSESS OVER 3-
4WEEKS IF STILL NO
RD
RESPONSE THEN 3
ANTIDEPRESENT
OPTION IF STILL NO
RESPONSE THEN GIVE
TREATMENT FOR
RESSISTENT
DEPRESSION.
TREATMENT OF
REFRACTORY
DEPRESSION
First choice is
citalopram if fail then
give either of following
bupropion or
venlafaxine or
setralline .
Also if citalopram
failes then we may add
bupropion or add
buspiron
If secod option of
venlafaxine,
sertraline , bupropion
or buspiron not
effective then either
switch to mirtazapine
or nortryptaline or
Another choice of
augmentation is add
lithium or add
thyroxin
If still no response to
mirtaxzepine or
venlafgaxine o lithium
or t3 not effective
then give tranyl
cyporomin or
mirtazapine plus
venlafaxine
TrEATMENT OF
REFRACTORY
DEPRESSION FIRST
CHOICE
ADD LITHIUM AND
check plasma level of .
4-.mmol per litre and
increase upto
1mmmol /l
Or ECT or add
thyroxin 20-
50ugm/day
Or combine
olanzapine and
fluoxetine
12.5/50mg /day or
Add quetiapine 150-
300mg per day or
add risperidone .5-
3mg per day
Or add aripiprazole
2-20 mg per day or
ssri plus bupropion
upto 400mg per day or
sssri (or venlafaxine )+
mirtazapine(30-45mg
Per day )
Treatment of
refractory depreseion
second choice =
Add ketamine .5mg
per kg iv over
40minutes
Or add lamotrigine
200-400mg daily or
ssri plus buspirone
upto 60mg per day
Or venklafaxine upto
more than
venlafaxine .
Other option for
treatment of
refractory depression
are add amantadine
upto 300mg per day
or add cabergoline
2mg per day or
Add zinc 25mg per day
or
Add ziprasidone
160mg per day or
Dexamethasone 3-
4mg per day or
Hyoscine 4hgm /kg iv
or ketoconazole 400-
800mg per day or
modafganil 100-400mg
per day or
nortryptaline and
lithium or omega 3
fatthy acids 1-2gm per
day or riluzole 100-
200mg per day or sri
plus tca or tca high
dose or teastosterone
gel or venlafaxine
upto 600mg per day,
or venlafaxine plus iv
clomipramine
SUMMERY OF
TREATMENT OF
REFRACTORY
DEPRESSION
Step 1= ssri
Step 2= other ssri or
snri
Step3 = switch to
mirtazapine or
vortioxetine or
agomealtine or
augment with
mirtazapine or
mianserin or
aripiprazole or lithium
or t3 or or buspirone
or bupropion
Step 4= consider
alternative
augmentation strategy
Step 5= mao or tca
plus lithium or
ketamine or
lamotrigine
augmentation or tca
plus maoi or ssri plus
tca
SUMMERY OF
PSYCHOTIC
DEPRESSION
Tca first choice
When poorly
tolerated tca then ssri
or snri are alternative
choice
Then if fails then
augmentation of
antideprsent with
olanzapine and
quetiapine
When treatment fails
then ECT IS choice .
PSYCHPOSTIMULANTS
IN DEPRESION
Monotherphy in
uncomplicated
depression miodafanil
100-200mg per day or
methylphenidate 20-
40mg per day or
dexamfetamine 20mg
per day
Adjunctive theraphy
in depression =ssri
plus
methylphenydtate 10-
20mg per vday or ssri
plus modafanil 400mg
per day
Adjunctive treatment
of depression witrh
fatigue and hyper
somnia
Ssri plus modafanil
200mg per day or ssri
plus methylphenydte
10-40mg per day
Adjunctive therapy in
refaractiory
depression
Ssri plus modafanil
100-400mg per day
Adjunctive theraphy in
bipolar depression
mood stabilizer and or
antidepresent and
modafinil 100-200mg
per day
Monotheraphy in late
stage terminal cancer
Methyphenydate 5-
30mg per day or
methylphenidate
20mg per day plus
mirtazapine 30mg per
day ,
Monotherphy for
depression in very old
methyl phenydate
1.25- 20mg per day
Monotheraphy in
post stroke
deporession=
Methylphenidate 5-
40mg per day or
modafanil 100mg per
day
Monotherphy in
depressionsecondary
to medical illness
Methylphenidate 5-
20mg per day
dexfetamine 2.5-30mg
per day
Monotheraphy I n
depression and
fatigue associated with
hiv
Dexfetamuine 2.5-
40mg per day
POSTSTROKE
DEPTRESION
We usually give SSRI
OR NORTRYPTALINE
PLUS ZANTAC
DOSE FOR
PROPYLAXES IN
DEPRESSION
Dusalphan 75mg per
day
In unipolar depression
use lithium plus
nortryptaline and also
lithium protects
against suicide .
Antidepresents are not
addictive ,
Changiing from
citalopram to
mirtazapine
Citalopram usual dose
is 40 and reduce to 30
(first week ) 20(second
rd
week ) and 10mg (3
week )
And then stop
Mirtazapine nill then
15(first week ), 30mg
(second week ),
rd
30mg(3 week ) and
45mg od 4rth week
Cardiac effects of
antidepresents ==
Ssri , then alternative
is mirtazapine
ANTIDEPRESENT
INDUCED
ARRYTHMIASS
Tricyclic causes
arrhythmias
Non trycyclics no
arrhythmias
Sertraline is
recommended in post
mi , then anioother
choice is ssri then
mirtazapine other
drugs are avoided
ANTIDEPRESENT AND
DIBETES MELLITUS
Use ssri first line
particularly fluoxetine
Snri second choice
Avoid tca and mao
Moniter bloosd
glucose and HBA1C
ANTIDEPRESENTS
AND SEXUAL
DYSFUNCTION
Given agomelatonine
then amfebutmine
these have no sexual
side effects
Also bupropion some
time ssri plus
mirtazapine have no
sexual side efctrs
Trazodone no sexual
side efcts
Sildenafil and
taladafil given in
improving erryctylw
dysfunction in male
and bupropion in
female .
UPER GI BLEEDING
AND CEREBRAL
HAEMIORAGE ARE
COMMON IN SSRI
AND RISK IS
INCREASED IF
FURTHUR ASPIRINE ,
NSAID ADEDD
WE SHOULD GIVE
PROTON PUMP
INHIBITERS IN THESE
ABOVE CASES
SUMMERY OF
TREATMENT OF
DEPRESSION IN
CHILDREN AND
ADOLESENTS
First line fluoxetine
plus cbt
Second line =
escitalopram and cbt
Third line = sertraline ,
citalopram
4rth venlafaxine ,
mirtazapine, adding
quetiapine
arripiporazole to bn
ssri treatment
In children
recomernded first line
treatment for acute
mania =
ARIPIPRAZOLE 10Mg
daily
Olanzaoine 5-20mg
per day
Quetiapine 400mg
per day
Risperidione .5-
2.5mg per daily
RECOMMENDED
FIRST LINE
TREATMENT FOR
BIPOLAR DEPRESSON
OLANZAPINE 5-20MG
DAILY
QUETAPINE UPTO
300MG DAILY AND
CBT NEED TO BE DONE
SUMMERY OF DRUG
TREATMENT IN
PSYCHOSES IN
CHILDREN AND
ADOLESENTS
FIRST CHOICE
=ARIPIPRAzole upto
10 mg
Olanzapine upto 10mg
Risperidonne upto
3mg
Second choice switch
to alternative from list
above
Third choice
clozapine
TYPICAL DOSAGE OF
MEDICATION FOR
TREATMENT OF
ANXIETY DISORDER IN
CHILDREN AND
ADOLESENTS
SSRI sertraline start
from 12.5mg and
usual dose range is
25-200mg
Fluoxetine starting
dose is 5-10mg and
dose range 10-60mg
N fluvoxamine
starting dose is 12.5-
25mg and dose range
is 50-200mg
Paraxetine starting
dose 5-10 and dose
range is 10-40mg od
Citalopram starting
dose is 5-10 a nd
dose range is 10-
40mg per day
SNRI
Venlafaxine extenged
release starting dose
37.5mg and dose
range is 37.5 Mg
-225mg
Serotonine partia;l
agonist
Buspirone 5mg tds
and dose range is 15-
60mg
Tetracyclic 7.5mg
-15mg and dose range
is 7.5-30mg at night
Benzodiazepines=
clonazepam .25mg
-.5mg
Lorazepam .5mg
1mg
TREATMENT
OPTIOONS FOR OCD
IN CHULILDRN AND
YOUNG PEOPLES
MILD FUNCTIONAL
IMPARMENT
=CONsider guided self
helpo support and
information for family
If ineffective
Cbt plus exposure
and response
prevention
If moderate and se
vere functional
impoairment then also
cbt plus EXPOSURE
AND RESPONSE
PREVENTION
IF CBT OR EXPOSURE
AND RESP[ONSE
PREVENTION NOT
EFFECTIVE THEN
CONSIDER SSRI
IF INEFFCTIVE
SSRI PLUS CBT PLUS
EXPOSURE AND
RESPONSE
PREVENTION .
CAREFULLY OBSERVE
FOR ADVERSE EFFCTS
IF NO RESPONSSE
THEN DIFFERENT SSRI
OR CLOMIPRAMINE
TYPICAL DOSAGE OF
MEDICATIOON FOR
TREATMENT OF PTSD
IN CHILDREN AND
ADOLESENTS
SSRI
Sertraline starting
dose is 12.5-25 and
dose range 50- 200mg
per day
Citalopram starting
dose 5-10mg and
dose range 10-40mg
per day
ANTIADRENERGIC
CLONUIDINE .05NOCT
AND DOSE RANGE IS .
1-.2NOCT
GUANAFAXCINE
STARTING DOSE .5BD
AND DOSE RANGE IS
1-3NOCT
PRAZOCIN STARTING
DOSE 1NOCT AND
DOSE RANGE 2-4
NOCT
PROPRANIOLOL
10MG TDS
SECOND GENERATION
ANTI PSYCHOTICS
RISPERIDONE starting
dose .5mg and dose
range .5-1od
Quetiaspine starting
dose 25-50 and dose
range 50-200mg at
night
SUMMERY OF
TREATEMNT OF
AUTENSION DEFECIT
HYPERACTIVITY
DISORDER
Asses mentally and
physically by specialist
and start drug
treatment
For moderate cases
psychological
INTERVENTION
FOR SEVERE CASES
GIVE MEDICATION AS
FIRST LINE OF
TREATMENT
WHICH INCLUDE
METHYLPHENYDATE,
DEXAMFETAMINE ,
AND ATOMOXITINE
METHYLPHENYDATE IS
FIRST LINE
TREATMENT BUT
CONSIDER ALSO TIC
AND TOURETTE
SYNDROME LIKE
COMORBID
CONDITIONS
MONITORED FOR
HEIGHT , WEIGHT, BP
AND HEART RATE.
USE OF RISPERIDONE
IN AUTISM SPECTRUM
DISORDERS
IF WEIGHT LESS THAN
20KG THEN GIVE ON
DAY 1-3 .25MG AND
ON DAY 4-14 .5MG
AND DOSE RANGE IS .
5-1.5MG
IF WEIGHT MOTRE
THAN 20KG
THEN .5MG AT 1-3
DAYS AND AT 4-14
DAYS GIVE 1MG AND
DOSE RANGE IS 1.0-
2.5MG
DOSE PER KG IS
AROUND .01MG
-.02MG PER KG POER
DAY
USE OF FLUOXETINE IN
CHILDREN AND
ADOLESENTS
LLIQUID FLUOXETINE
20MG PER 5ML SO
ONE ML WILL HAVE
4MG FLOEUXETIONE
AND USE 2.5MG PER
DAY FOR 1 WEEK SO
GIVE HALF ML TO ONE
ML
MELATONIN
SUMMERY OF
RECOMMENDATION
If sleep hygiene and
behaviiural
interventions are not
effective then
Use melastonmin 2mg
if no response then
more than 5 mg if stil
no response then
discontinue melatonin.
If response to 5mg
good then use
minimal effective dose
IF ORAL ROUTE IS
REFUSED BY PATEINEt
and is on
antipsychotics so give
inj hakloperidiole plus
inj zyclidine im stat
and then sos
COMMONLY USED
DRUGS IN
CHILDRWEN \
ANTIPSYCHOTICS
Aripiprazole 2mg daily
upto 5-15mg daily
according to response
Clozapoine 6.25-
12.5mg
Haloperidol .5-1mg
and upto 4mg
Olanzaopine 2.5-5mg
Quetaoine 25-150-
200mg
Riasperidone .25-2mg
ANTIEPTRESENTYS
AMYTRYPTALINE 5-
10MG AT NIGHT
ESCITALOPRAM, 5MG
-10-20MG
FLOUXETINE 5-10MG
SETRALINE 25-50MG
-100MG
MOOD STABILIZERS
Carbamazepine 5mg
per kg per day
Lithium 100-200mg
per day
Valproate 10-20mg
per kg per day
ALCOHOL
DEPENDANCE=
LOW RISK UPTO 21 IN
MEN AND UPTO 14 IN
FEMALE
INCREASING RISK IN
MAN UPTO 22-50
AND IN WOMEN
UPTO 15-35MG
HIGH RISK IS MORE
THAN 50 IN MEN AND
MORE THAN 35 IN
WOMEN
SEVERTY OF ALCOHOL
DEPENDANCE
MILD LESS THAN 15
MODERATE SADQ
BETWEEN 15-30 AND
SEVERE MORE THAN
30
FEATURE OF ALCOHOL
WITHDRWAL
SOMATIC
COMPLAINT =
NUBERIL FORT
SEIZURE = BZD COVER
WERNICKES
ENCEPHALOPATHY=
PARENTERAL
THYIAMINE
DELIRIUM TREMENS =
ALSO BZD
MODERATE ALCOHOL
DEPENDANCE = DOSE
OF
CHLOPRODIZEPIOXIDE
Dose
total daily dose
Day 1
20qid
80mg
2
15qid
60mg
3
10qid
40mg qid
4
5mg qid
20mg
5
5mg bd
10mg
SEVERE ALCOHOL
DEPENDANCE DOSE
OF
CHLOPRODIZEPIOXIDE
DOSE
TOTAL DAILY DOSE
DAY 1
40MG QID +40MG
PRN 20MG
2
40MG QID
160MG
3
30MG QID
120MGG
4
25MG QID
100MG
5
20MG QID
80MG
6
15MG QID
60MG
7
10MG QID
40MG
8
10MG TDS
30MG
9
5MG QID
20MG
10
10MG NOCT
10MG
SOMATIC
COMPLUIANTS IN
ALCOHOL WITHDRWAL
DEHYDRATION =
BAADEQUETE FLUID
INTAKE AS IT CAN
CAUSE CARDIAC
ARRYTHMIAS
PAIN = PARACETAMOL
NAUSEA AND
VOMITING =
METOCHLOPEAMIDE
10MG OR
PROCHLOROPERAZINE
5MG EVERY 6HOURLY
DIAREA =
DIPHENOXYLATE AND
ATROPINE (LONMOTIL)
NAD LOPERAMIDE
SKIN ITCHING =
ANTIHISTAMINES
NALTREXONE = 50MG
PER DAY FOR RELAPSE
PREVENTION IN
MODERATE TO SEVERE
DRINKERS AND GIVEN
UPTO 6MONTHS AND
TREATMENT SHOULD E
STOPED IN DRINKERS.
DISULFRAM
COMBINED WITH
PSYCHOLOGUICAL
INTERVENTION AND
GIVEN 24 HOUR AFTER
LAST DRINKER AND
MONITORING EVERY
2WEEK FOR FIRST 2
MONTHS THEN
MONTHLY FOR
4MONTHS THEN
6MONTHLY
SUMMERY OF
RECOMMENDATION IN
DEMENTIA
ALL TYPER OF
DEMEBNTIA GIVE
TAB DONEP 10MG OD
AS FIRST CHOICE AND
GIVE SECOND CHOICE
IN MEMNTINE BUT
DONT GIVE DRUGS IN
VASCULAR DEMENTIA
NEITHER
ACETYLCHIOLINESTRA
SE I NHIBITER ANSD
NEITHER MEMNTINE
RECOMMENDATION
FOR TREATM,ERNT OF
PSYCHOSES IN
PRREGNANCY
CLOROPROMAZINE ,
TRIFLUOOPERAZINE ,
HALOPERIDOL,
OLANZAPINE,
QUETAOPINE, AND
CLOZAPINE DE
DEPRESSIOON IN
PREGNANCY =
AMITRYPTALINE,
IMIPRAMINE,
STRALINNE ,
FLOUXETINE,
RECOMMENDATION
FOR BIPOLAR
DISORDER IN
PREGNANCY
CARBAMAZEPINE PLUS
VITAMIN K IN
PREGNANCY AND ECT,
AND OLANZAPIBNE
AND FLOUXETINE
EPILEPSY DURING
PREGANANCY AND
POSTPOARTUM
VALPROATE AND
CARBAMAZEPINEPLUS
FOLATE AND VIT K
AFTER DELIVERY
RECOMENDATIOBN
FOR USE OF
PSYCHOTROPIC IN
PREGANNACY
ANTIDEORESENT=
NORTRYPTALINE ,
AMITRYPTALINE
IMIPRAMINE,
SETRALINE
ANTIPSYCHOTICS
CHLOROPROMAZINE,
TRIFLUEERAZINE,
HALOPERIDOL,
OLANZAPINE, N
RISPERIDONE,
QUETAOINE AND
ARIPIPRAZOLE
MOOD
STABUILIZERS=LAMOT
RIGINE, AND FOLATE
SEDATIVES= NO DRUG
ARE PREFERED
BZD AVOIDED AND
PROMETHAZINWE IS
WIDELY USED
SUMMERY OF
RECOMMENDATION I
N BREAST FEEDING V
ANTIDEPRESENTS =
SETRALINE,
PAROXETINE,
NORTEYPTALINE AND
IMIPRANMINE
ANTIPSYCHIOTICS =
OLANZAPINE
MOOD STABILIZERS=
MOOD ASTABILIZING
ANTIPSYCHOTYICS
AND THEN
VA;LPROATE
SEDATIOVES=
LORAZEPAM
RECOMMENDATION
OF USE OF
PSYCHOTROPIC IN
RENAL IMPAIRNMENT
ANTIPSYCHOTICS
=HAKLOPERIDOLE2-
6MG
AND OLANZAPINE
5MG PER DAY
ANTIDEPRESENTS=
CIATALOPRAM AND
SETRALINE
MOOD
STABUILUIZERS=
AVOID LITHIUM AND
GIVE VALPROT AND
CARBAMAXPINE OR
LAMOTRIGINE
ANXUIOLYTICS AND
AND HYPONOTICS
LORAZEPAM AND
ZOPICLONE
ANTIDEMENTIA
DRUGS=
RIVASTIGMINE
RECOMMENDATION
OF USE OF
PSYCHOTRPIC IN
HEPATIC IMPAIREMNT
ANTIPSYCHOTICS
=LOW DOSE
HALOPERIODOL OR
SULPIRIDE
/AMISULPIRIDE
ANTIDEPRESENTS=
IMIPRAMINE AND
PAROXETINE OR
CITALOPRAM
MOOD STABILIZERS=
LITHIUM
SEDATIVES=LORAZEPA
M , OXAZEPAM AND
TEAMZEPAM A ND
ZOPICLONE
EATING DISORDERS=
ANOREXIA NERVIOSA=
PSYCHOLOGICAL
INTRERVENTION AND
FLUOXETIN
BULEMIA NERVOSA=
SELF HELP PROGRAM
AND CBT AND
FLOUXETINE
INGE EATING
DISORDSER
CBT AND SSRI ARE
USED
RECOMMENDED
TRRAETEMNT FOR
ACUTELY VOILENT
AND DSITURBED
BEHAVIOUR
DESECALATION AND
TIMEOUT
ANTIPSYCHOTICS LIKE
QUETAPINE 50-100MG
, OLANZAPONE
10MG , RISPERIDONE
1-2MG AND
HALOPERIDOL 5MG.
BEST WITH
PROMETHAZI NE25MG
MONOTHERAPHY
WITH BUCCAL
MIDAZOLAM 10-20MG
AVOID NEED FOR IV
TRAETMENT
THEN AT LAST IM
LORAZEPAM , OR
PROMTHAZINE 50MG
OR
OLANZAOJNE10MG
OR ARIPIPRAZIOLE
9.75MG OR
HALOPERIDOL 5MG
AND REAPET AFTER
30-60MINUTES THEN
ATLAST IV DUIAZEAPM
AND THEN SEEK
ADVICE FROM SENIOR
PSYCJHIOTRIST