Two Cents Worth: April 2006

Haloperidol
Brand name: Haldol

Pharmacology - Antipsychotic
Indications
Haloperidol is indicated in the management of manifestations of acute and chronic psychosis, including schizophrenia and manic states.
Warnings
Tardive dyskinesia is known to occur in patients treated with neuroleptics with antipsychotic properties and other drugs with substantial neuroleptic activity. Although the dyskinetic syndrome may remit partially or completely if the medication is withdrawn, it is irreversible in some patients. At the present time there is uncertainty as to whether neuroleptic drugs differ in their potential to cause tardive dyskinesia.

Tardive dyskinesia Pronunciation: 'tär-div- dis-k&-'nE-zh(E-)Function: noun: a central nervous system disorder characterized by twitching of the face and tongue and involuntary motor movements of the trunk and limbs and occurring especially as a side effect of prolonged use of antipsychotic drugs

Benztropine
Brand name: Cogentin

Pharmacology - Antidyskinetic
Indications
Antidyskinetics are used to treat Parkinson's disease, sometimes referred to as ``shaking palsy.'' By improving muscle control and reducing stiffness, this medicine allows more normal movements of the body as the disease symptoms are reduced. It is also used to control severe reactions to certain medicines such as reserpine (e.g., Serpasil) (medicine to control high blood pressure) or phenothiazines, chlorprothixene (e.g., Taractan), thiothixene (e.g., Navane), loxapine (e.g., Loxitane), and haloperidol (e.g., Haldol) (medicines for nervous, mental, and emotional conditions).
Common Side effects
Blurred vision; constipation; decreased sweating; difficult or painful urination (especially in older men); drowsiness; dryness of mouth, nose, or throat; increased sensitivity of eyes to light; nausea or vomiting

Aripiprazole
Brand name: Abilify

Pharmacology - antipsychotic
Indications
Abilify is used to treat Schizophrenia. Abilify has not been studied in children under 18 years of age
Some rare but serious side effects with Abilify include: Tardive dyskinesia (TD). Symptoms of TD include involuntary (uncontrolled) and abnormal muscle movements.

Mirtazapine
Brand name: Remeron

Pharmacology – antidepressants
Indications
Depression
Off-Label Uses: Panic/Anxiety, Bipolar Depression, Sleep Disorders, Chronic Fatigue, Fibromyalgia, Arthritis, Lupus, Irritable Bowel Syndrome
WARNING
Clinical Worsening and Suicide Risk: Patients, their families, and their caregivers should be encouraged to be alert to the emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down. Families and caregivers of patients should be advised to observe for the emergence of such symptoms on a day-to-day basis, since changes may be abrupt. Such symptoms should be reported to the patient's prescriber or health professional, especially if they are severe, abrupt in onset, or were not part of the patient's presenting symptoms. Symptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medication. Please see Prescribing Information and Medication Guide.

Methylphenidate
Brand Name – Concerta ER

Pharmacology - stimulant
Indications
Concerta is used to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and narcolepsy
WARNING
Do not take Concerta without first talking to your doctor if you have an allergy to Concerta, severe tension, and agitation, or anxiety, motor tics or have been diagnosed with Tourette's syndrome, a psychotic condition such as schizophrenia, or depression
Common Side Effects - slower weight gain and/or growth, tics (repetitive movements); insomnia (difficulty sleeping); nervousness, drowsiness, headache, blurred vision

Hydroxyzine hydrochloride
Brand name: Atarax

Pharmacology - antihistamine
Indications
Atarax is an antihistamine used to relieve the symptoms of common anxiety and tension and, in combination with other medications, to treat anxiety that results from physical illness. It also relieves itching from allergic reactions and can be used as a sedative before and after general anesthesia.
Common Side Effects
Drowsiness, the most common side effect of Atarax, is usually temporary and may disappear in a few days or when dosage is reduced. Other side effects include dry mouth, twitches, tremors, and convulsions. The last two usually occur with higher than recommended doses of Atarax.