MEDICATIONS COMMONLY PRESCRIBED 

Dennis B. Kottler, MD

Westlake Village, CA

Appointments:   818-991-8376 

Email:   doc@psychiatrix.com

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See Also:  Medication:  When Is It Needed?

See also:  Single Isomer Medication

The number and variety of psychiatric medications has increased enormously over the last few decades.   The medications listed below are categorized by the type of disorders for which they are commonly prescribed.   However, it is important to keep in mind that many medications have multiple uses.  All medications listed are by prescription only and should be thoroughly discussed with the physician. 

In the current treatment of DEPRESSION, the following medications are used (generic names given first - brands in parentheses):

1. tricyclic antidepressants (largely supplanted by #2 and #3 below) - These include such medications as desipramine (Norpramin), imipramine (Tofranil), amitriptyline (Elavil), doxepine (Sinequan), nortriptyline (Pamelor), protriptyline (Vivactil), and trazadone (Desyrel).

2. selective serotonin reuptake inhibitors (SSRI's) - These include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and fluvoxamine (Luvox).

3. other -  buproprion (Wellbutrin), venlafaxine (Effexor), and nefazodone (Serzone).

4. NEW:   Lexapro, the single-isomer form of Celexa.

In the treatment of various BIPOLAR DISORDERS (manic-depressive disorders), the following medications are commonly used:

1. lithium carbonate (Eskalith, Lithonate, etc.)
2. divalproex Sodium (Depakote)
3. carbamazepine (Tegretol)
4. olanzapine (Zyprexa)
5. Note:  various antiepileptic medications are increasing in usage, including, e.g.,  lamotrigine (Lamictal) and gabapentin (neurontin)

In the treatment of GENERALIZED ANXIETY DISORDER, the following are useful medications:

1. buspirone (Buspar)
2. alprazolam (Xanax)
3. lorazepam (Ativan)
4. clonzepam (Klonopin)
5. diazepam (Valium) - older and less often used
6. chlordiazepoxide (Librium) - older and less often used
7. venlafaxine (Effexor)
8. paroxetine (Paxil)

In  the treatment of PANIC DISORDER, the following medications have been quite helpful:

1. alprazolam (Xanax)
2. clonazepam (Klonopin)
3. sertraline (Zoloft)
4. paroxetine (Paxil)

In the treatment of OBSESSIVE-COMPULSIVE DISORDER, these medications are often recommended:

1. clomipramine (Anafranil)
2. fluvoxamine (Luvox)
3. fluoxetine (Prozac)
4. sertraline (Zoloft)
5. paroxetine (Paxil)

For SLEEP DISORDERS, especially difficulty falling asleep and staying asleep, these medications are used:

1. zolpidem  (Ambien)
2. temazepam (Restoril)
3. zaleplon (Sonata)
4. triazolam (Halcion)
5. trazadone (Desyrel)
6. nefazadone (Serzone)
7. amitriptyline (Elavil)

For ATTENTION DEFICIT/HYPERACTIVITY DISORDER, these medications are used:

1. methylphenidate (Ritalin)
2. dextroamphetamine (Dexedrine)
3. mixed amphetamine salts (Adderall)
4. buproprion (Wellbutrin)
5. clonidine (catapress) - especially for hyperactivity
6. various newer (better?) forms of #1 and #2 above

The above list of medications is by no means complete, but it is representative of the wide diversity of medications available to patients.

Several important points need emphasis regarding medication:

• All of the above medications are by prescription only and should only be prescribed by a physician adept at diagnosing and treating the indicated conditions.  

• In general, medication should be used as part of a comprehensive treatment plan, including some form of psychotherapy, whether psychodynamic or cognitive-behavioral, individual or group. Furthermore, the effects and side effects of the medication need to be periodically monitored by the physician.  The physician will also monitor the patient's compliance with the medication regimen, and whether an addition, deletion, or other change is needed.

• In some cases, it is useful to use more than one medication to treat a given disorder or combination of disorders.  In such cases the physician will need to assess the potential for medication interactions and compatibility.

• Some of the medications listed have more than one use.   For example, sertraline (Zoloft) is effective for depression, obsessive-compulsive disorder, panic disorder, and post-traumatic stress disorder.

• A knowledgeable physician will often use a medication "off-label."   Thus studies have shown that various medications are quite safe and effective in treating various conditions, but they are not officially labeled for such use by the manufacturer.  Many times this has to do with the expense of bringing a "new indication" to market as well as general market conditions.

• There is no simple formula the physician uses to select a medication for a given disorder.  The selection of medication is based on the physician's clinical evaluation of the patient and years of experience in treating similar problems.   In some cases, an initial medication choice will not work out, either due to lack of efficacy or intolerable side effects.   After a reasonable therapeutic trial, another medication may be tried by the physician.

• It is often helpful for a physician to know what has worked for a given patient in the past and sometimes even what has worked for other biologically-related family members.

It cannot be overemphasized that while medication represents an extremely useful tool in managing a host of different psychiatric disorders, it is invariably best prescribed in the context of a comprehensive treatment program.

The following link will take you to a list of recommended titles which you may purchase online.   The medication guides cover a wide range of medications in addition to psychiatric medications.

Suggested Readings

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Appointments:   818-991-8376 

Email:   doc@psychiatrix.com