Psychiatric Drugs common issues -by Dr. Spollen from Nick Gowen
Dr. Spollen gave us an excellent review of common adverse effects of antipsychotics and antidepressants last week. If you missed it, take a few minutes to go through these slides.
There were lots of really great points throughout the talk, and I will list a few of my favorites:
1) The antipsychotics that start with a vowel, aripiprazole and olanzapine, have no QT effects and can be given without even ordering an electrocardiogram. This is extremely useful to remember on the wards. (from slides 24 and 25).
2) Most antidepressants have minimal to no QT effect, and fluoxetine and sertraline are definitely safe from a cardiovascular perspective.
3) Antipsychotics are not effective and cause a significant (1.5-2x) increase the risk of death when used in elderly patients for behavioral issues with dementia. Citalopram is a better option. (slide 36)
4) Dr. Spollen's "dones and pines" is a very easy way to remember which adverse effects are more prominent with each drug class (slide 28-32). Metabolic risk is worse with the drugs that end in -pine, while EPS risks are worse with drugs that end in -done or -ole.
The algorithm from slide 24 and the accompanying article can be found here: http://eurheartj.oxfordjournals.org/content/35/20/1306.
Dr. Spollen gave us an excellent review of common adverse effects of antipsychotics and antidepressants last week. If you missed it, take a few minutes to go through these slides.
There were lots of really great points throughout the talk, and I will list a few of my favorites:
1) The antipsychotics that start with a vowel, aripiprazole and olanzapine, have no QT effects and can be given without even ordering an electrocardiogram. This is extremely useful to remember on the wards. (from slides 24 and 25).
2) Most antidepressants have minimal to no QT effect, and fluoxetine and sertraline are definitely safe from a cardiovascular perspective.
3) Antipsychotics are not effective and cause a significant (1.5-2x) increase the risk of death when used in elderly patients for behavioral issues with dementia. Citalopram is a better option. (slide 36)
4) Dr. Spollen's "dones and pines" is a very easy way to remember which adverse effects are more prominent with each drug class (slide 28-32). Metabolic risk is worse with the drugs that end in -pine, while EPS risks are worse with drugs that end in -done or -ole.
The algorithm from slide 24 and the accompanying article can be found here: http://eurheartj.oxfordjournals.org/content/35/20/1306.
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