Back from the Abyss: Psychiatry in Stories

(Almost) Everything about psych meds... in under 16 minutes


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Antidepressants, mood stabilizers, antipsychotics, benzodiazepines, stimulants.....READY SET GO!

Med cheat sheet
SSRIs
(selective serotonin reuptake inhibitors)-- Prozac, Lexapro, Paxil, Celexa, Zoloft, Luvox, Trintellix, Viibryd-- They are generally NOT antidepressants

Mainly helpful for OCD, body dysmorphia,  panic (if not from trauma), depression if postpartum or fueled by neuroticism or ruminative anxiety


SNRIs (serotonin norepinephrine reuptake inhibitors)-- Effexor/venlafaxine, Cymbalta/duloxetine

Mostly helpful for combined depression/anxiety, especially with insomnia


Wellbutrin/bupropion-- very stimulating (prison crack!), true antidepressant; can trigger/worsen anxiety


MAO  (monoamine oxidase) inhibitors-- powerful antidepressants, lots of side effects and med interactions


Lamictal/lamotrigine-- definitely ALL THAT and a bag of chips (see My Desert Island Meds in Season 1)


Atypical antipsychotics-  Abilify/aripiprazole, Latuda/lurasidone, Seroquel/quetiapine, Saphris/asenapine, Vraylar/cariprazine, Risperdal/risperidone, Zyprexa/olanzapine, Geodon/ziprasidone, Invega/paliperidone

Generally good mood stabilizers (in contrast to the putative "mood stabilizers" below); typically more helpful for severe depression and bipolar disorder than true psychosis (Zyprexa and Risperdal excepted)


"Mood stabilizers"- (big misnomer, most effective for  mania/agitation, not depression)-- Depakote/valproic acid, Trileptal/oxcarbazepine, Tegretol/carbamazepine


Lithium- it's not clozapine, but gets the silver medal as a true mood stabilizer (see My Desert Island Meds in Season 1)


Clozapine- the winner of the psychiatric med decathlon in most every event; needs weekly blood monitoring and has a few very serious potential side effects


Benzodiazepines- Xanax/alprazolam; Klonopin/clonazepam, Librium/chlordiazepoxide, Ativan/lorazepam, Valium/diazepam


Stimulants- Adderall/amphetamine; Vyvanse; Ritalin/Concerta/Focalin/methylphenidate

Amphetamines are more euphoria-inducing, thus more abused and addictive and also tend to have more side effects; both amphetamines and methylphenidate are roughly equally effective for ADD/ADHD


BFTA
https://www.craigheacockmd.com/podcast-page/

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Back from the Abyss: Psychiatry in StoriesBy Craig Heacock MD

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