question about psych meds

[Ms.RN]

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

[txspadequeenRN, BSN, RN]

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.

[Thunderwolf, MSN, RN]

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.

[kathi yudin]

Hi

For several years now Depakote has been approved for treatment of Bipolar Disorder and is considered a First-line medication for this. It's true that it was originally marketed for treating seizure disorders but research has shown that many of the problems of bipolar disorder also have origins in the same area of the brain that can induce seizures. Incidentally Depakote has also recently been approved for migraine headaches (another "off-label" use). Depakote, Tegretol, Gabitril and other anticonvulsant medications have been used for years in the treatment of bipolar disorder and is equal to lithium in efficacy.

Check with the drug reps sometime and they can give you more information

Will

many of the medications used for psych are not used for their labeled use.. depakote and that grouping were originally used as antiseizure meds.. they have been found to work well on stabilizing moods and decreasing impulsivity... seroquel.. given at night is to help reduce the side effect of sedation.. it should be started slowly and increased as needed...while being used for bipolar.. it is more seen as an antipsychotic to help decrease the striking out and yelling behaviors..

[utahliz]

Thanks, Thunderwolf.

[RickRN]

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.

Tardive, as an adjective, is defined as "Having symptoms that develop slowly or appear long after inception. Used of a disease". It comes from the same French word that "tardy" comes from.

TD happens over a longer period of time. EPS is an acute problem.

Often i hear the terms used interchangably by seasoned psych nurses so I would not worry too much about your own confusion. Do some google searches or check out http://www.ninds.nih.gov/disorders/tardive/tardive.htm for more information.

[Thunderwolf, MSN, RN]

Here is a good web page which explains pretty well what I discussed above. Just found it tonight. "It also describes TD as a EPS", just late onset...good page.

http://www.medicalnewstoday.com/medicalnews.php?newsid=13702