Efek Samping Obat Psikiatri

Oleh : Yenni Meftha Fauzia

Pembimbing : dr. Andri Sudjatmoko, Sp.KJ
Obat-obat Psikotik
Medicine Usual dose per How we think it How long it takes to Some of the main side effects * How long you could or How to stop it
day might work work should take it for
(probably) Drowsiness Muscle stiffness Weight gain Dry mouth Sexual
etc problems

Newer ones (atypicals, second generation)

Risperidone (e.g. 4-6mg a day Mainly blocks ● ●● ●● ● ●●

Usually there may be
Risperdal®) dopamine
an effect in a few days,
receptors
with the effect building
over 3-4 weeks
Paliperidone 6mg a day ● ●● ●● ● ●●
(Invega®)

Olanzapine 10-20mg a day Blocks dopamine ●●● ● ●●● ● ●

(Zyprexa®) and other
receptors
Quetiapine Around 600mg a ●●● ● ●● ● ● If taking one of these
(Seroquel XL®) day
medicines for a first
episode of psychosis or Should be no problem
Aripiprazole 10-30mg a day Regulates As above but you ● ● O O O possible schizophrenia, but we suggest that
(Abilify®) dopamine might get a bit more
taking it for at least 2 stopping it gently over
agitated before
years will reduce the several weeks or
getting better
chances of the symptoms months is the safest
coming back. way

If taking it for
Clozapine Usually around Blocks a wide Usually there may be ●●● ● ●●● ●●● ● schizophrenia that keeps
(Clozaril®, 300- range of receptors an effect in a few coming back, then taking it
Denzapine®, 600mg a day days, with the effect for at
Zaponex®) building over 3-4 least 5 years will much
- only for resistant
weeks. Can be up to 6 reduce the
schizophrenia
months for clozapine chances of the
symptoms come
back.

If for symptoms of
psychosis, then it may
only be needed for a
Other antipsychotics
few weeks or months

Haloperidol 5-20mg a day ● ●●● ●● ● ●●●

Usually there may be
Block dopamine
an effect in a few days,
Amisulpride 400-800mg/d receptors
with the effect building ● ●● ●● ● ●●● Should be no problem
over 3-4 weeks but stopping it gently
Sulpiride 400- ● ●● ●● ● ●●● over several weeks or
1600mg/d months is the safest
way
Zuclopenthixol 10-25mg a day ●● ●● ●●● ●● ●●●
Obat Anti Depresi
Medicine Usual dose per day How we think it might How long it takes to work Some of the main side effects * How long you could or How to stop it
work (probably) should take it for
Drowsiness Nausea Feeling strange Dizziness

Main medicines (licensed or which are proven to help)

SSRIs e.g. escitalopram Escitalopram 10mg a Boosts serotonin ● ●●● o O

(Cipralex®), day. Paroxetine
Paroxetine. Other 20mg a day
SSRIs may also work Takes about 3-4 weeks. The
Stop gradually over a
symptoms may get a bit
few weeks if taken for
worse in the first couple of
Venlafaxine 75mg a day ● ●●● o O more than a few
weeks before then getting
(e.g. Efexor XL®) As long as you want. months
Boosts serotonin and better
Taking for at least 6
Duloxetine 60mg a day noradrenaline
● ●●● o O months reduces the
(Cymbalta®) chances of getting
unwell again
Pregabalin (Lyrica®) Around 300mg Slows down excitatory A week or so, builds over 3-4 ●● ● ● ●●● No problem, best
messages weeks stopped over a few days
though

Buspirone 30mg Boosts serotonin 4 weeks at full dose ● o ●●● ● No problem

(e.g. Buspar®)

Benzodiazepines Lorazepam up to Boosts the effect of A few hours ●●● o ● O

(shorter-acting e.g. 4mg. GABA, the brain’s
lorazepam, oxazepam, Oxazepam up to natural inhibitory or
clonazepam) 30mg calming chemical
messenger Usually for up to a Should be done slowly if
month or so, but can taken for more than a
Benzodiazepines (longer-acting Up to about A few hours to a few days be longer few months
●●● o ● O
e.g. 15mg
diazepam, chlordiazepoxide)

Beta-blockers e.g. Up to 120mg a day Stops the heart A few hours o o ● ● As long as you feel you Should be done slowly if
propranolol or oxprenolol maximum beating too fast and want or need to taken for more than a
reduces tremor few months

Unlicensed (usually only where the main treatments have failed or as an add-on)

Other SSRIs (e.g. Fluoxetine & Boosts serotonin As paroxetine/ escitalopram ● ●●● o O As SSRIs above As SSRIs above
fluoxetine, citalopram, citalopram 20mg a above
sertraline) day

Antipsychotics e.g. Pericyazine around 5- Sedative and calming Within a few hours ●●● o o ●● Usually when required No problem
pericyazine 30mg
Obat Anti Ansietas
 Medicine Usual dose per day How we think it might How long it takes Some of the main side effects * How long you could or How to stop it
work to work should take it for
Drowsi -ness Weight gain Nausea Dry mouth Sexual problems Sleep problems
(probably)

SSRIs : citalopram, Citalopram, paroxetine and Stop paroxetine slowly

● ● ●●● ● ●●● ●
escitalopram fluoxetine 20mg a day. over several weeks. No
(Cipralex®), fluvox- amine, Sertraline 50-100mg a day. big problems with the
paroxetine, sertraline, Escitalopram 10mg a day. others
fluoxetine
Boost serotonin

Venlafaxine 75-225mg each morning Stop slowly over at least 4

● ● ●●● ●● ●●● ●●●
(e.g. Efexor XL®) weeks

Mirtazapine 30mg at bedtime Should be no problems

●●● ●●● O O O ●
(e.g. Zispin®) (15mg is too low)

Tricyclics e.g. dosulepin, Usually 125150mg a day.

lofepramine, clomipramine,
●●● ●● ●● ●●● ●● ●●●
Lofepramine 140- Boost the amount of
imipramine, amitriptyline, 280mg a day Taking an antidepressant
serotonin and nor-
trimipramine for 6 months after a first
adrenaline
bout
of depression Stop slowly over about 4
will really reduce weeks
the chances of
They take about 4 becoming
Duloxetine 60-120mg each morning weeks for the full ● ● ●●● ●● ●●● ●●● depressed again.
(Cymbalta®) effect. But For a second
you should start to episode, 1-2
Agomelatine (Valdoxan®) 25-50mg at bedtime Regulates feel a bit better No known problems
O O O O O O years seems best.
melatonin, boosts after a week or
noradrenaline and two. For a third episode or
dopamine more of depression,
taking an antidepressant
for at least 3-5 years
reduces the chance of
relapse. You might want
Trazodone 100-300mg at bedtime Boosts serotonin to think about taking an Stop slowly over about 4
●●● ● ●● O ● O antidepressant life-long. weeks

Reboxetine (Edronax®) 8-12mg each morning Boosts noradrenaline Should be no problems

O O O ●●● O ●

MAOIs e.g. Tranylcypromine and Stop slowly over

● ●●● ●● ●● ● ●●●
tranylcypromine, isocarboxazid 30mg a about 4 weeks
phenelzine, isocarboxazid day. Phenelzine 4590mg
(needs special diet) a day.
Stop the breakdown of
serotonin and nor-
adrenaline

Moclobemide 300-600mg a day

● ● ●● ●● ● ●●
Tryptophan 3-6g a day Increases serotonin Should be no problems
O O O O O O
(Optimax®)only for resistant production
depression
 Sumber
• South Staffordshirre and NHS Shrospire
Healthcare. NHS Foundation. di akses melalui
www.choiceandmedication.org/south-staffs
TERIMAKASIH