Psychiatric Drug Introduction Psychiatric medications can be broken down into the following categories antidepressants antipsychotics bipolar medications anxiolytics Overview Drugs fluoxetine paroxetine sertraline citalopram fluvoxamine Mechanism serotonin-specific reuptake inhibitors (SSRIs) takes 2-3 weeks for antidepressants to have an effect should try for at least 6 weeks prior to this time, persistence of symptoms indicates inadequate trial Clinical use depression OCD bulimia social phobias Toxicity much milder than other depression therapies anxiety, agitation, insomnia weight gain GI distress sexual dysfunction (anorgasmia) serotonin syndrome diagnose using using the Hunter Serotonin Toxicity Criteria presence of one of the following sets of features spontaneous clonus inducible clonus with agitation or diaphoresis ocular clonus with agitation or diaphoresis tremor and hyperreflexia hypertonia, temperature above 100.4° F (38° C), and ocular or inducible clonus. characterized by autonomic instability (HR changes, sweating, shivering, flushing), mental status changes treatment includes: withdrawal of the offending agent benzodiazepines to treat agitation and tremor cyproheptadine as an antidote neuromuscular paralysis, sedation, and intubation for criticall ill patients risk factors dietary tryptophan concurrent medications anti-depressants, amphetamines, and analgesics