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The Most Common Psychiatric Drugs


The Most Common Psychiatric Drugs

Psychiatric Drugs

The Most Famous 5 Psychiatric Drugs most Commonly used in the Psychiatric diseases are:

1- Alprazolam 💊

2- Clonazepam 💊 

3- Diazepam 💊

4- Lorazepam 💊

5- Temazepam 💊

1    

Alprazolam

Psychiatric Drugs

 

  • Brand Names: Xanax
  • Therapeutic Category: Benzodiazepine
  • Dosage Forms: oral (tablet/ solution)
  • Use: Psychiatric Drugs
  • Labeled Indications: Anxiety disorders/ Panic disorder
  • Dosing:
  • Dosing Adult: Anxiety disorders: Oral: Initial: 0.25 to 0.5 mg 3 times daily; titrate dose every 3 to 4 days; usual maximum: 4 mg/day
  • Panic disorder: Initial: 0.5 mg 3 times daily; titrate dose every 3 to 4 days in increments ≤1 mg/day. Mean effective dosage: 5 to 6 mg/day, in 3 or 4 divided doses
  • Pediatric: Immediate release: Initial: 0.005 mg/kg/dose or 0.125 mg/dose 3 times/day; increase in increments of 0.125 to 0.25 mg, up to a maximum of 0.02 mg/kg/dose or 0.06 mg/kg/day
  • Dose Adjustments
  • Renal Impairment:. No dosage adjustment
  • Hepatic Impairment:25 mg 2 to 3 times daily.
  • Adverse Drug Interaction:
    Drowsiness/ fatigue/ sedation/ ataxia/ memory impairment/ irritability/ cognitive dysfunction
  • Pharmacodynamics/Kinetics:
  • Time to peak, serum:Immediate release: 1 to 2 hours
  • Bioavailability: Immediate release: 84% to 92%
  • Metabolism: Hepatic
  • Half-life elimination: 11.2 hours
  • Important Notes:
  • Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
  • If this is taken drug for a long time or at high doses, it may not work as well and you may need higher doses to get the same effect. This is known as tolerance
  • Pregnancy & Lactation: Risk Factor D/ Present in breast milk
  • Drug safety issue:
    • ALPRAZolam may be confused with alprostadil, LORazepam, triazolam
    • Xanax may be confused with Fanapt, Lanoxin, Tenex, Tylox, Xopenex, Zantac, ZyrTEC

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Psychiatric Drugs

2

Clonazepam

Psychiatric Drugs

 

  • Brand Names: Rivotril
  • Therapeutic Category: Benzodiazepine
  • Dosage Forms: oral (tablet)
  • Use: Psychiatric Drugs
  • Labeled Indications: Seizure disorders/ Panic disorder
  • Off-Label: Bipolar disorder, manic or mixed episodes /Burning mouth syndrome/ Essential tremor/ Rapid eye movement (REM) sleep behavior disorder
  • Dosing Adult: Panic disorder: Oral: 0.25 mg twice daily/ target dose: 1 mg daily (maximum: 4 mg/day).
  • Seizure disorders: Oral: Initial daily dose not to exceed 1.5 mg given in 3 divided doses; may increase by 0.5 to 1 mg every third day
  • Pediatric: Infants, Children ≤30 kg: Initial daily dose: 0.01 to 0.03 mg/kg/day (maximum initial dose: 0.05 mg/kg/day) given in 2 to 3 divided doses
  • Dose Adjustments
  • Renal Impairment:. No dosage adjustment
  • Hepatic Impairment:25 mg 2 to 3 times daily.
  • Adverse Drug Interaction:
    Drowsiness/ fatigue/ panic disorder/ ataxia/ memory impairment/ behavioral problems
  • Pharmacodynamics/Kinetics:
  • Onset of action: 20 to 40 minutes
  • Bioavailability: 90%
  • Metabolism: Hepatic
  • Half-life elimination: 17 to 60 hours
  • Important Notes:
  • Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
  • Patients who take this drug may be at a greater risk of having thoughts or actions of suicide
  • Pregnancy & Lactation: Clonazepam crosses the placenta/ Present in breast milk
  • Drug safety issue:
    • ClonazePAM may be confused with cloBAZam, cloNIDine, clorazepate, cloZAPine, LORazepam
    • KlonoPIN may be confused with cloNIDine, clorazepate, cloZAPine, LORazepam

3

Diazepam

Psychiatric Drugs

 

  • Brand Names: Valium
  • Therapeutic Category: Benzodiazepine
  • Dosage Forms: oral (tablet/ solution)/ oral solution/ injection/ rectal gel
  • Use: Psychiatric Drugs
  • Labeled Indications: Acute ethanol withdrawal/ Anxiety/ Muscle spasm/ Seizures/ Status epilepticus
  • Off-Label: Sedation in the intensive care unit/ Status epilepticus (rectal)
  • Dosing Adult: Anxiety (symptoms/disorders): Oral: 2 to 10 mg 2 to 4 times daily if needed
  • Muscle spasm: Oral: 2 to 10 mg 3 or 4 times daily
  • Pediatric: Oral: Children: 0.2 to 0.3 mg/kg (maximum dose: 10 mg)
  • Febrile seizure prophylaxis: Oral: Children: 1 mg/kg/day divided every 8 hours; initiate therapy at first sign of fever and continue for 24 hours after fever is gone
  • Dose Adjustments
  • Renal Impairment:. No dosage adjustment
  • Hepatic Impairment: No dosage adjustment
  • Adverse Drug Interaction:
    Drowsiness/ Hypotension/ Headache/ ataxia
  • Pharmacodynamics/Kinetics:
  • Onset of action: Status epilepticus: IV: 1 to 3 minutes
  • Bioavailability: Oral: >90%
  • Metabolism: Hepatic
  • Half-life elimination: Diazepam accumulates upon multiple dosing and the terminal elimination half-life is slightly prolonged.
  • Important Notes:
  • Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
  • When taking this drug on a regular basis and stopping it all of a sudden, there may be signs of withdrawal.
  • Pregnancy & Lactation: Risk factor D/ Present in breast milk
  • Drug safety issue:
    • DiazePAM may be confused with diazoxide, dilTIAZem, Ditropan, LORazepam
    • Valium may be confused with Valcyte

4

Lorazepam

Psychiatric Drugs

 

  • Brand Names: Ativan
  • Therapeutic Category: Benzodiazepine
  • Dosage Forms: oral (tablet/ solution)/ solution injection
  • Use: Psychiatric Drugs
  • Labeled Indications: Anxiety/ Anesthesia premedication/ Status epilepticus
  • Off-Label: Agitation in the ICU patient/ Alcohol withdrawal syndrome/ Chemotherapy-associated nausea and vomiting/ Rapid tranquilization of the agitated patient
  • Dosing Adult: Anxiety usual dose: 2 to 6 mg daily in divided doses; however, daily dose may vary from 1 to 10 mg/day
  • Premedication for anesthesia: IM: 0.05 mg/kg administered 2 hours before surgery (maximum dose: 4 mg)
  • Pediatric: Chemotherapy-associated nausea and vomiting: Infants ≥1 month, Children, and Adolescents: Oral: 0.04 to 0.08 mg/kg/dose (maximum dose: 2 mg) once at bedtime the evening prior to chemotherapy and once the next day before chemotherapy
  • Dose Adjustments
  • Renal Impairment:. Oral: No dosage adjustment
  • Hepatic Impairment: Severe impairment: Use with caution
  • Adverse Drug Interaction:
    Drowsiness/ sedation/ Dizziness/ unsteadiness
  • Pharmacodynamics/Kinetics:
  • Time to peak: Oral: 2 hours
  • Bioavailability: Oral: 90%
  • Metabolism: Hepatic
  • Half-life elimination: Oral: 12 hours.
  • Important Notes:
  • Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
  • When taking this drug on a regular basis and stopping it all of a sudden, there may be signs of withdrawal.
  • Pregnancy & Lactation: Lorazepam and its metabolite cross the human placenta/ Present in breast milk
  • Drug safety issue:
    • LORazepam may be confused with ALPRAZolam, clonazePAM, diazePAM, KlonoPIN, Lovaza, temazepam, zolpidem
    • Ativan may be confused with Ambien, Atarax, Atgam, Avitene

5

Temazepam

Psychiatric Drugs

 

  • Brand Names: Restoril
  • Therapeutic Category: Benzodiazepine
  • Dosage Forms: oral (capsule)
  • Use: Psychiatric Drugs
  • Labeled Indications: Insomnia: Short-term treatment of insomnia
  • Dosing Adult: Insomnia: Oral: Usual dose: 15 to 30 mg at bedtime; some patients may respond to 7.5 mg in transient insomnia
  • Dose Adjustments
  • Renal Impairment:. Oral: No dosage adjustment
  • Hepatic Impairment: No dosage adjustment
  • Adverse Drug Interaction:
    Drowsiness/ euphoria/ Dizziness/ anxiety/ Blurred vision
  • Pharmacodynamics/Kinetics:
  • Half-life elimination: 3.5-18.4 hours
  • Time to peak, serum: 1.2-1.6 hours
  • Metabolism: Hepatic
  • Important Notes:
  • Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.
  • When taking this drug on a regular basis and stopping it all of a sudden, there may be signs of withdrawal.
  • When sleep drugs are used nightly for more than a few weeks, they may not work as well to help sleep problems. This is known as tolerance
  • Pregnancy & Lactation: Risk factor x / Present in breast milk
  • Drug safety issue:
    • Temazepam may be confused with flurazepam, LORazepam, tamoxifen
    • Restoril may be confused with Resotran, RisperDAL, Vistaril, Zestril

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