Antidepressant & Anti-anxiety Medication Guide PDF

Antidepressants 1. Zoloft (Sertraline) Classification: Selective Serotonin Reuptake Inhibitor (SSRI) Indication: Treatment of major depressive disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and premenstrual dysphoric disorder. Mechanism of Action: Inhibits the reuptake of serotonin in the brain, increasing serotonin levels in the synaptic cleft, which helps improve mood. Contraindications: Concurrent use with monoamine oxidase inhibitors (MAOIs), pimozide, or disulfiram (with the oral concentrate); known hypersensitivity to sertraline. Side Effects/Adverse Effects: Nausea, diarrhea, insomnia, dizziness, dry mouth, sexual dysfunction, increased risk of suicidal thoughts in young adults. Nursing Responsibilities: ○ Before Administration: 1. Assess for history of bipolar disorder or seizure disorders. 2. Obtain baseline liver function tests. 3. Evaluate for any history of suicidal ideation. ○ During Administration: 1. Administer with or without food, preferably at the same time each day. 2. Monitor for signs of serotonin syndrome, especially when combined with other serotonergic drugs. 3. Observe for any signs of worsening depression or emergence of suicidal thoughts. ○ After Administration: 1. Monitor for side effects such as gastrointestinal disturbances or sleep disturbances. 2. Ensure patient adherence to medication regimen. 3. Educate patient about the importance of not abruptly discontinuing the medication. 2. Lexapro (Escitalopram) Classification: Selective Serotonin Reuptake Inhibitor (SSRI) Indication: Treatment of major depressive disorder and generalized anxiety disorder. Mechanism of Action: Increases serotonin levels in the brain by inhibiting its reuptake into the presynaptic neuron. Contraindications: Concurrent use with MAOIs; known hypersensitivity to escitalopram. Side Effects/Adverse Effects: Nausea, insomnia, fatigue, sexual dysfunction, increased risk of suicidal thoughts in young adults. Nursing Responsibilities: ○ Before Administration: 1. Assess for history of bipolar disorder. 2. Obtain baseline electrolyte levels, especially sodium. 3. Evaluate for any history of suicidal ideation. ○ During Administration: 1. Administer once daily, with or without food. 2. Monitor for signs of serotonin syndrome. 3. Observe for any signs of increased anxiety or agitation. ○ After Administration: 1. Monitor for side effects such as gastrointestinal disturbances or sleep disturbances. 2. Ensure patient adherence to medication regimen. 3. Educate patient about the importance of not abruptly discontinuing the medication. 3. Paxil (Paroxetine) Classification: Selective Serotonin Reuptake Inhibitor (SSRI) Indication: Treatment of major depressive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and obsessive-compulsive disorder. Mechanism of Action: Inhibits the reuptake of serotonin in the brain, increasing serotonin levels in the synaptic cleft. Contraindications: Concurrent use with MAOIs or thioridazine; known hypersensitivity to paroxetine. Side Effects/Adverse Effects: Nausea, drowsiness, dizziness, sexual dysfunction, increased risk of suicidal thoughts in young adults. Nursing Responsibilities: ○ Before Administration: 1. Assess for history of bipolar disorder. 2. Obtain baseline liver and kidney function tests. 3. Evaluate for any history of suicidal ideation. ○ During Administration: 1. Administer in the morning to reduce insomnia. 2. Monitor for signs of serotonin syndrome. 3. Observe for any signs of increased anxiety or agitation. ○ After Administration: 1. Monitor for side effects such as gastrointestinal disturbances or sleep disturbances. 2. Ensure patient adherence to medication regimen. 3. Educate patient about the importance of not abruptly discontinuing the medication. 4. Clozaril (Clozapine) Nursing Responsibilities: ○ Before Administration: 1. Obtain baseline white blood cell (WBC) count and absolute neutrophil count (ANC). 2. Assess for history of seizures or cardiac issues. 3. Evaluate for any history of agranulocytosis or hypersensitivity to clozapine. ○ During Administration: 1. Monitor WBC and ANC weekly for the first 6 months, then biweekly as per protocol. 2. Watch for signs of myocarditis (chest pain, dyspnea, palpitations). 3. Monitor for signs of CNS depression or sedation. ○ After Administration: 1. Educate the patient to report signs of infection (fever, sore throat). 2. Monitor weight, lipid profile, and glucose levels regularly. 3. Reinforce the importance of regular blood tests to continue therapy. 5. Prozac (Fluoxetine) Classification: Selective Serotonin Reuptake Inhibitor (SSRI) Indication: Treatment of major depressive disorder, obsessive-compulsive disorder, bulimia nervosa, panic disorder, and premenstrual dysphoric disorder. Mechanism of Action: Inhibits the reuptake of serotonin in the presynaptic neuron, increasing serotonin activity in the CNS. Contraindications: Concurrent use with MAOIs or pimozide; use within 14 days of MAOI therapy; known hypersensitivity to fluoxetine. Side Effects/Adverse Effects: Nausea, headache, insomnia, anxiety, sexual dysfunction, increased risk of suicidal ideation (especially in young adults), and serotonin syndrome. Nursing Responsibilities: ○ Before Administration: 1. Assess for history of bipolar disorder or seizures. 2. Obtain a medication history to avoid drug interactions (e.g., MAOIs, other SSRIs). 3. Assess for suicidal thoughts or behaviors. ○ During Administration: 1. Administer in the morning to reduce insomnia. 2. Monitor for signs of serotonin syndrome. 3. Observe for increased agitation or mood changes, especially in early treatment. ○ After Administration: 1. Educate patient about potential delayed onset of therapeutic effects (1–4 weeks). 2. Reinforce adherence to prescribed dose—do not abruptly stop medication. 3. Monitor for gastrointestinal side effects and report significant weight changes. Anti-anxiety 1. Ativan (Lorazepam) Classification: Benzodiazepine Indication: Treatment of anxiety disorders and short-term relief of anxiety symptoms. Mechanism of Action: Enhances the effects of gamma-aminobutyric acid (GABA) in the brain, producing a calming effect on the brain and nerves. Contraindications: Hypersensitivity to lorazepam or other benzodiazepines; acute narrow-angle glaucoma. Side Effects/Adverse Effects: Drowsiness, dizziness, weakness, unsteadiness, and potential for dependence with prolonged use. Nursing Responsibilities: ○ Before Administration: 1. Assess the patient's level of anxiety and need for medication. 2. Review the patient's history for substance abuse. 3. Check for potential drug interactions. ○ During Administration: 1. Administer the medication as prescribed, monitoring for immediate adverse reactions. 2. Ensure the patient is in a safe environment due to potential sedation. 3. Monitor vital signs, especially respiratory rate. ○ After Administration: 1. Evaluate the effectiveness of the medication in reducing anxiety. 2. Monitor for signs of dependence or withdrawal symptoms. 3. Educate the patient about avoiding alcohol and operating heavy machinery. 2. Valium (Diazepam) Classification: Benzodiazepine Indication: Management of anxiety disorders, muscle spasms, and alcohol withdrawal symptoms. Mechanism of Action: Enhances the effects of GABA in the brain, producing a calming effect on the brain and nerves. Contraindications: Hypersensitivity to diazepam or other benzodiazepines; severe respiratory insufficiency; sleep apnea syndrome. Side Effects/Adverse Effects: Drowsiness, fatigue, muscle weakness, and ataxia. Nursing Responsibilities: ○ Before Administration: 1. Assess the patient's level of anxiety and muscle spasm severity. 2. Review the patient's history for substance abuse. 3. Check for potential drug interactions. ○ During Administration: 1. Administer the medication as prescribed, monitoring for immediate adverse reactions. 2. Ensure the patient is in a safe environment due to potential sedation. 3. Monitor vital signs, especially respiratory rate. ○ After Administration: 1. Evaluate the effectiveness of the medication in reducing anxiety or muscle spasms. 2. Monitor for signs of dependence or withdrawal symptoms. 3. Educate the patient about avoiding alcohol and operating heavy machinery. 3. Xanax (Alprazolam) Classification: Benzodiazepine Indication: Treatment of anxiety disorders and panic disorders. Mechanism of Action: Enhances the effects of GABA in the brain, producing a calming effect on the brain and nerves. Contraindications: Hypersensitivity to alprazolam or other benzodiazepines; concurrent use with ketoconazole or itraconazole. Side Effects/Adverse Effects: Drowsiness, light-headedness, and potential for dependence with prolonged use. Nursing Responsibilities: ○ Before Administration: 1. Assess the patient's level of anxiety and need for medication. 2. Review the patient's history for substance abuse. 3. Check for potential drug interactions. ○ During Administration: 1. Administer the medication as prescribed, monitoring for immediate adverse reactions. 2. Ensure the patient is in a safe environment due to potential sedation. 3. Monitor vital signs, especially respiratory rate. ○ After Administration: 1. Evaluate the effectiveness of the medication in reducing anxiety. 2. Monitor for signs of dependence or withdrawal symptoms. 3. Educate the patient about avoiding alcohol and operating heavy machinery. 4. BuSpar (Buspirone) Classification: Anxiolytic (non-benzodiazepine) Indication: Management of generalized anxiety disorder or short-term relief of anxiety symptoms. Mechanism of Action: Exact mechanism not fully understood; believed to involve partial agonist activity at serotonin 5-HT1A receptors and some dopamine receptor affinity. Contraindications: Hypersensitivity to buspirone; use with MAO inhibitors can cause hypertensive reaction. Side Effects/Adverse Effects: Dizziness, headache, nausea, nervousness, lightheadedness, blurred vision. Nursing Responsibilities: ○ Before Administration: 1. Assess baseline anxiety level using appropriate scales. 2. Check for liver or renal impairment (dose may need adjustment). 3. Review medication list to avoid interactions, especially with MAOIs. ○ During Administration: 1. Administer consistently (with or without food) to maintain stable blood levels. 2. Monitor for onset of side effects (dizziness, headache). 3. Educate the patient that therapeutic effects may take 1–2 weeks. ○ After Administration: 1. Reassess anxiety levels to evaluate effectiveness. 2. Monitor adherence to therapy; emphasize not to double doses if one is missed. 3. Educate about avoiding alcohol and grapefruit juice (which may increase side effects). 5. Librium (Chlordiazepoxide) Classification: Benzodiazepine Indication: Treatment of anxiety disorders and alcohol withdrawal symptoms. Mechanism of Action: Enhances GABA activity in the CNS, resulting in anxiolytic, sedative, and muscle relaxant effects. Contraindications: Hypersensitivity to chlordiazepoxide or other benzodiazepines; narrow-angle glaucoma; severe respiratory insufficiency. Side Effects/Adverse Effects: Drowsiness, ataxia, confusion, constipation, risk of dependence and withdrawal. Nursing Responsibilities: ○ Before Administration: 1. Assess baseline anxiety level or symptoms of alcohol withdrawal. 2. Check for history of substance abuse or respiratory conditions. 3. Review current medications for interactions (e.g., CNS depressants). ○ During Administration: 1. Administer with or without food; monitor for sedation. 2. Regularly assess respiratory status and level of consciousness. 3. Ensure safety precautions due to fall risk in sedated patients. ○ After Administration: 1. Evaluate the effectiveness in relieving anxiety or withdrawal symptoms. 2. Monitor for signs of dependence, especially with long-term use. 3. Educate patient on the importance of not stopping abruptly (to avoid withdrawal seizures). Anti-Schizophrenia 1. Haldol (Haloperidol) Classification: First-generation (typical) antipsychotic Indication: Treatment of schizophrenia, other psychotic disorders, tics caused by Tourette syndrome, and certain severe behavioral problems in children. Mechanism of Action: Blocks dopamine receptors in the brain, reducing the effects of dopamine and helping to manage psychotic symptoms. Contraindications: Hypersensitivity to haloperidol; severe CNS depression; Parkinson's disease; comatose states. Side Effects/Adverse Effects: Constipation, dizziness, drowsiness, dry mouth, uncontrolled movements, blood disorders, and heart rhythm changes. Nursing Responsibilities: ○ Before Administration: 1. Assess baseline mental status and vital signs. 2. Evaluate for history of cardiovascular disorders. 3. Check for potential drug interactions. ○ During Administration: 1. Monitor for extrapyramidal symptoms. 2. Observe for signs of orthostatic hypotension. 3. Ensure proper administration technique, especially if given intramuscularly. ○ After Administration: 1. Reassess mental status and symptom improvement. 2. Monitor for tardive dyskinesia. 3. Educate patient about potential side effects and the importance of adherence. 2. Thorazine (Chlorpromazine) Classification: First-generation (typical) antipsychotic Indication: Treatment of schizophrenia, bipolar disorder, and nausea and vomiting. Mechanism of Action: Blocks dopamine receptors in the brain, reducing psychotic symptoms. Contraindications: Hypersensitivity to chlorpromazine; severe CNS depression; bone marrow suppression. Side Effects/Adverse Effects: Constipation, dizziness, drowsiness, uncontrolled movements, blood disorders, and low blood pressure upon standing. Nursing Responsibilities: ○ Before Administration: 1. Assess for history of cardiovascular disease. 2. Evaluate liver function tests. 3. Review current medications for interactions. ○ During Administration: 1. Monitor for signs of sedation. 2. Observe for extrapyramidal symptoms. 3. Ensure patient safety due to potential dizziness. ○ After Administration: 1. Reassess mental status and symptom control. 2. Monitor for signs of agranulocytosis. 3. Educate patient on avoiding alcohol and sudden position changes. 3. Prolixin (Fluphenazine) Classification: First-generation (typical) antipsychotic Indication: Treatment of psychotic disorders, such as schizophrenia. Mechanism of Action: Blocks dopamine receptors in the brain, reducing psychotic symptoms. Contraindications: Hypersensitivity to fluphenazine; severe CNS depression; bone marrow suppression. Side Effects/Adverse Effects: Blurred vision, dizziness, drowsiness, dry mouth, uncontrolled movements, blood disorders, and low blood pressure upon standing. Nursing Responsibilities: ○ Before Administration: 1. Assess for history of seizures. 2. Evaluate liver and kidney function. 3. Review patient's medication history. ○ During Administration: 1. Monitor for extrapyramidal symptoms. 2. Observe for signs of orthostatic hypotension. 3. Ensure proper administration technique, especially for depot injections. ○ After Administration: 1. Reassess mental status and symptom improvement. 2. Monitor for tardive dyskinesia. 3. Educate patient about the importance of regular follow-up appointments. 4. Loxitane (Loxapine) Nursing Responsibilities: ○ Before Administration: 1. Assess for history of respiratory or cardiac disorders. 2. Evaluate baseline mental status and vitals. 3. Review for other CNS depressants or interactions. ○ During Administration: 1. Monitor for extrapyramidal symptoms (e.g., muscle rigidity, tremors). 2. Observe for orthostatic hypotension or excessive sedation. 3. Ensure proper positioning and supervision post-dosing, especially if given as inhalation (Adasuve form). ○ After Administration: 1. Reassess psychotic symptoms and behavioral response. 2. Watch for tardive dyskinesia or neuroleptic malignant syndrome (rare but serious). 3. Educate the patient on adherence and avoiding alcohol or operating machinery. 5. Abilify (Aripiprazole) Classification: Atypical (second-generation) antipsychotic Indication: Treatment of schizophrenia, bipolar I disorder, major depressive disorder (adjunct), irritability associated with autism, and Tourette syndrome Mechanism of Action: Partial agonist at dopamine D2 and serotonin 5-HT1A receptors and antagonist at serotonin 5-HT2A receptors. This modulates dopamine and serotonin activity in the brain. Contraindications: Known hypersensitivity to aripiprazole or any components of the formulation Side Effects/Adverse Effects: Headache, akathisia (restlessness), insomnia, nausea, anxiety, weight gain, dizziness, and risk of suicidal thoughts (especially in younger patients) ([Source: WebMD – Aripiprazole Oral]) Nursing Responsibilities: ○ Before Administration: 1. Assess for history of cardiovascular disease, seizures, or suicidal thoughts. 2. Evaluate baseline mental and neurological status. 3. Check weight and vital signs; screen for diabetes risk (can affect glucose metabolism). ○ During Administration: 1. Monitor for signs of restlessness (akathisia) or other extrapyramidal effects. 2. Observe for mood changes or worsening depression. 3. Ensure the patient takes it consistently, with or without food. ○ After Administration: 1. Reassess psychiatric symptoms and level of functioning. 2. Monitor for long-term side effects like weight gain, elevated glucose, or lipid abnormalities. 3. Educate the patient and family about adherence, avoiding alcohol, and reporting unusual behaviors. Anti-psychotic 1. Risperdal (Risperidone) Classification: Atypical (second-generation) antipsychotic Indications: Treatment of schizophrenia, bipolar I disorder (acute manic or mixed episodes), and irritability associated with autistic disorder. Mechanism of Action: Risperidone functions as an antagonist at dopamine D2 and serotonin 5-HT2 receptors, helping to balance neurotransmitters in the brain. Contraindications: Known hypersensitivity to risperidone or any of its components. Side Effects/Adverse Effects: Common side effects include drowsiness, dizziness, sedation, and seizures. Patients should avoid activities requiring alertness, such as driving or operating machinery, until they know how the medication affects them. Nursing Responsibilities: Before Administration: 1. Assess baseline mental status and behavior patterns. 2. Evaluate renal and hepatic function tests. 3. Review patient's history for cardiovascular diseases. During Administration: 1. Monitor for signs of extrapyramidal symptoms (e.g., tremors, rigidity). 2. Observe for orthostatic hypotension; advise patient to rise slowly from sitting or lying positions. 3. Ensure medication is taken consistently, with or without food. After Administration: 1. Reassess mental status to determine efficacy. 2. Monitor for tardive dyskinesia, especially with long-term use. 3. Educate patient on the importance of adherence and reporting any side effects. 2. Zyprexa (Olanzapine) Classification: Atypical (second-generation) antipsychotic Indications: Management of schizophrenia, bipolar I disorder (manic or mixed episodes), and agitation associated with these disorders. Mechanism of Action: Olanzapine antagonizes dopamine D2 and serotonin 5-HT2 receptors in the central nervous system, contributing to its antipsychotic effects. Contraindications: Known hypersensitivity to olanzapine or any of its components. Side Effects/Adverse Effects: Common side effects include drowsiness, dizziness, sedation, and seizures. Patients should avoid activities requiring alertness, such as driving or operating machinery, until they know how the medication affects them. Nursing Responsibilities: Before Administration: 1. Assess baseline mental status and behavior patterns. 2. Evaluate liver function tests. 3. Review patient's history for cardiovascular diseases. During Administration: 1. Monitor for signs of sedation and advise caution with activities requiring alertness. 2. Observe for orthostatic hypotension; advise patient to rise slowly from sitting or lying positions. 3. Ensure medication is taken consistently, with or without food. After Administration: 1. Reassess mental status to determine efficacy. 2. Monitor for weight gain and advise on diet and exercise. 3. Educate patient on the importance of adherence and reporting any side effects. 3. Seroquel (Quetiapine) Classification: Atypical (second-generation) antipsychotic Indications: Treatment of schizophrenia, bipolar disorder (manic and depressive episodes), and as an adjunct in major depressive disorder. Mechanism of Action: Quetiapine's mechanism involves antagonism of multiple neurotransmitter receptors in the brain, including serotonin 5-HT2 and dopamine D2 receptors. Contraindications: Known hypersensitivity to quetiapine or any of its components. Side Effects/Adverse Effects: Common side effects include dizziness, drowsiness, and fainting. Patients should avoid activities requiring alertness, such as driving or operating machinery, until they know how the medication affects them Nursing Responsibilities: Before Administration: 1. Assess baseline mental status and behavior patterns. 2. Evaluate liver function tests. 3. Review patient's history for cardiovascular diseases. During Administration: 1. Monitor for signs of sedation and advise caution with activities requiring alertness. 2. Observe for orthostatic hypotension; advise patient to rise slowly from sitting or lying positions. 3. Ensure medication is taken consistently, with or without food. After Administration: 1. Reassess mental status to determine efficacy. 2. Monitor for weight gain and advise on diet and exercise. 3. Educate patient on the importance of adherence and reporting any side effects. 4. Geodon (Ziprasidone) 1. Classification of Drug: Atypical (second-generation) antipsychotic 2. Indication of the Drug: Used to treat schizophrenia and acute manic or mixed episodes associated with bipolar disorder. 3. Mechanism of Action: Antagonizes dopamine D2 and serotonin 5-HT2 receptors in the brain, helping to balance neurotransmitters and improve mood and behavior. 4. Contraindication: Hypersensitivity to ziprasidone or any of its components; known QT prolongation or recent myocardial infarction. 5. Side Effects/Adverse Effects: Common side effects include dizziness, drowsiness, and nausea. Serious side effects may include QT prolongation, which can lead to serious heart rhythm problems. 6. Important Nursing Responsibilities: ○ Before Administration: 1. Assess baseline mental status and behavior patterns. 2. Evaluate cardiac history and perform ECG if necessary. 3. Review patient's history for electrolyte imbalances. ○ During Administration: 1. Monitor for signs of sedation and advise caution with activities requiring alertness. 2. Observe for orthostatic hypotension; advise patient to rise slowly from sitting or lying positions. 3. Ensure medication is taken consistently, with or without food. ○ After Administration: 1. Reassess mental status to determine efficacy. 2. Monitor for signs of QT prolongation and advise patient to report any palpitations or dizziness. 3. Educate patient on the importance of adherence and reporting any side effects. 5. Haldol (Haloperidol) 1. Classification of Drug: First-generation (typical) antipsychotic 2. Indication of the Drug: Used to treat schizophrenia, acute psychosis, and tics associated with Tourette syndrome. 3. Mechanism of Action: Blocks dopamine D2 receptors in the brain, which helps to reduce symptoms of psychosis and agitation. 4. Contraindication: Hypersensitivity to haloperidol or any of its components; Parkinson's disease; severe central nervous system depression; coma. 5. Side Effects/Adverse Effects: Common side effects include drowsiness, dizziness, and dry mouth. Serious side effects may include extrapyramidal symptoms (e.g., tremors, rigidity), tardive dyskinesia, and neuroleptic malignant syndrome. 6. Important Nursing Responsibilities: ○ Before Administration: 1. Assess baseline mental status and behavior patterns. 2. Evaluate renal and hepatic function tests. 3. Review patient's history for cardiovascular diseases. ○ During Administration: 1. Monitor for signs of extrapyramidal symptoms and advise patient to report any involuntary movements. 2. Observe for orthostatic hypotension; advise patient to rise slowly from sitting or lying positions. 3. Ensure medication is taken consistently, with or without food. ○ After Administration: 1. Reassess mental status to determine efficacy. 2. Monitor for signs of tardive dyskinesia and neuroleptic malignant syndrome. 3. Educate patient on the importance of adherence and reporting any side effects.

Antidepressant & Anti-anxiety Medication Guide PDF

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