question about psych meds - page 2

hello psych nurses!!!! i have a question about the purpose of meds given to a psych patients. one is seroquel. i looked up in the med book and the indication for this medication is to treat... Read More

  1. by   MickyB-RN
    Quote from PRNMEDS
    I work primarily with Adolescents and we use both of these medications regularly = and rarely for Schizophrenia.
    Depakote started as anti-siezure med, but is used often as a Mood Stabilizer. That is what it is used for most often at my hospital. Bipolar and/or borderline patients often respond well to this, as it cuts down on the mood swings. Biggest problem I see is weight gain, and some patients find it somewhat sedating (this generaly decreases as they get used to it.).
    Seroquel we use for aggressive and impulsive behaviors. NOT to make patients sleep, but to help take that aggressive edge off and help them think prior to acting. Used in conjuction with TENEX (yes the same Tenex used for Hypertension), it can be very effective with minimal sedation and side effects.
    I am seeing a big switch to Abilify. It isn't supposed to have the sedation or weight gain side effects that Depakote, Seroquel and Zyprexa have.


    Kelly
  2. by   leslie :-D
    my 15 yo dtr who is being discharged tomorrow from a psyche facility is on lithium, abilify, effexor and strattera- what a marked and positive improvement i have seen in 1 month....i'm very pleased w/her psychiatrist as she's a new person and happy. yes!


    leslie
  3. by   MickyB-RN
    Quote from earle58
    my 15 yo dtr who is being discharged tomorrow from a psyche facility is on lithium, abilify, effexor and strattera- what a marked and positive improvement i have seen in 1 month....i'm very pleased w/her psychiatrist as she's a new person and happy. yes!


    leslie
    That's great news. If you don't mind me asking, was she on a different antipsychotic before abilify, such as zyprexa? I was just wondering if she noticed a marked improvement related to lethargy.


    Kelly
  4. by   elizabells
    Quote from KellyMarie37
    I am seeing a big switch to Abilify. It isn't supposed to have the sedation or weight gain side effects that Depakote, Seroquel and Zyprexa have.


    Kelly
    When I was on Zyprexa, I gained 25lbs in about two months. Lost it just as fast when they put me on Wellbutrin. Didn't they put out a warning about diabetes r/t Zyprexa? Something about glucose metabolism problems? It's entirely possible I'm making that up, just finished day 1 of nursing school and I am tiiiiired.
  5. by   CHATSDALE
    a lot of our pts are on clozaril...they do very good on it, some better that others, but the doctor decided that wanted to try zyprexia so he titrated them off of clozaril and increased the zyprezia...
    poor patients they just completely lost it...became incontinent, slurred speech, aggressive insommia
    it takes a while for this to leave the system and another while to reach peak . i think it was two weeks but this has been a couple of years ago
    cbc has to be closely monitored on cclozaril because really bad blood problems can develop...usually the labs are sent to pharmacy and if white blood count is gone array meds are held...
    we too give a lot of depakote, zyprexia, godan, and just about any psyche drug you can thin of
  6. by   StuPer
    One of our psychiatrist has started using Seroquel in the same fashion as chlorpromazine, for rapid tranquillisation, it hasnt as many side-effects and has a similar effect. The other use is as others have said to help calm aggression in dementing patients, either that or a low dose of haloperidol 1mg nocte for example.
    As for Abilify I have yet to see any patient benefit from it, and these patients swapped to it from another antipsychotic invairably suffered a relapse. Also I noticed in the FDA approval that it destroyed the retinas of albino rabbits, the company were ordered to conduct further research after approval, but as yet I dont think this has been done. It makes me wonder what possible long term side-effects there could be from Abilify use.
    regards StuPer
  7. by   MickyB-RN
    As for Abilify I have yet to see any patient benefit from it, and these patients swapped to it from another antipsychotic invairably suffered a relapse.>>

    That's not good news. Relapse for schizophrenic patients or as in manic episodes r/t Bipolar?


    Kelly
  8. by   RickRN
    Quote from graduatenurse
    hello psych nurses!!!!

    i have a question about the purpose of meds given to a psych patients. one is seroquel. i looked up in the med book and the indication for this medication is to treat schizophrenia. but i give them to a patient who does not have schizophrenia, but this patient is very agitated. is this med used like desyrel? when my patient take this medicine, he is knocked out. another medication is depakote. i dont understand why this medication is given also. both seroquel and depakote are given at bedtime. are these medications given to induce sleep to these patient? i appreciate your help :d

    seroquel and other atypical antipsychotics are often used off label to help control mood disorders and even as a sleep enhancer (although i've never had one of our docs admit that was the primary reason for using it). depakote is also used for mood stabilization and for things like impulse control. unfortunately i believe that these meds are often used to sedate "problem" patients.
  9. by   Thunderwolf
    From 2001-2003, I was on several meds for a severe PTSD and depressive (not on meds prior or after this time period) episode.
    Depakote, Seroquel, Klonopin, Serzone, Prozac, and Desyrel. It was the only thing that allowed me to prevent the nightmares and flashbacks, to reduce the agitation and restlessness because I became so wired, and to reduce my vegetative symptoms of depression. It did come with a cost....weight gain like you wouldn't believe. I was plump as a plum. It came off when I no longer needed the medication any more. Like I said, I was on it for 2 years. Now off for 2 years. Med free and Doc free and doing well. The medication was helpful. I needed it then. First and only episode, but it dropped me to my knees. Medication has its place.
  10. by   sgent
    Is one of the best drugs around for atypical depressives and hypomanics who can't sleep. I've seen them not blink at a max dose of ambien, and be completely knocked out by 25mg of Seroquel. Its a very common script in these areas for temporary use re/sleep. I've also seen it used in high doses (as much as 1000mg) as a substitute for IM haldol in someone who has been awake for multiples of days, and maybe having hallucinations, etc.
  11. by   utahliz
    What is the difference between extrapyramidal side effects and tardive dyskinesia? Is TD always permanent? There was a general lack of substance in our Psych Nursing lectures, and I see both of these mentioned in relation to antipsychotics.
  12. by   txspadequeenRN
    My husband is on Abilfiy and I think he has been worse here latley. He is a classic Bi Polar but he is mean to boot. Today they increased his Abilfy and added seroquel. I guess he told them his wife had the divorce papers in her hand. I think he is still on Lithium as well.
  13. by   Thunderwolf
    utahliz,

    There are several possible extrapyramidal side effects, one beginning...tardive dyskinesia, which yes, can become permenent. The other possibilities are: akathisia (uncontrollable restlessness), pseudoparkinsonism (mask-like face, shuffling gait, lessened arm swing), and dystonias (abnormal muscle spasms) which can be painful. The older antipsychotics tend to create more of a risk of their development. If they occur, the offending medication is quite often reduced or stopped all together and/or switching/adding a different med to reduce the presentation of it. For example, Cogentin to counter act an acute dystonia.

close