Complementary therapies I take in addition to my
medication:
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GNC Mega Men Sport Multi-Vitamins
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Attention:
This
website is probably more suitable for people whom are 18
years of age or older. I use vulgarity from time to time,
and I sometimes talk about things that are generally
inappropriate. Sorry you 1st graders. Beat it.
All psychiatric drugs have side effects. Some are mild and not
distressing. Some are annoying and may interfere with some
aspect of your functioning. Some can be dangerous and require
immediate medical attention. This page discusses the side
effects that you may experience when you take a psychiatric drug.
Each side effect is associated with one or more drugs.
Following each drug name is a number that estimates the seriousness
of the side effect and what you should do about it. (1)
denotes medications for which side effects are generally mild,
though they may be annoying, and will not cause you any harm.
Discussion with your doctor at the next appointment is generally
sufficient, although you may want to consult sooner if you have any
specific concerns that you don't feel should wait. (2) denotes
medications for which side effects are more severe, though not
dangerous; these side effects may worsen with continued use of the
drug. You should contact your physician within a day or two to
discuss the best way of managing it. (3) denotes a medication
side effect that requires immediate intervention to prevent any
further harm. You should contact your doctor immediately to
discuss whether you should continue on any of these medications and
the need for any emergency medical care.
The Side Effects
If you notice a side effect
not described here, contact your physician. If you experience
a side effect that is listed, but not associated with the drug you
take, it is wise to contact your physician to ensure your safety.
Boldface type indicates side effects described elsewhere in this
section.
If you'd like to learn the names of the medications that cause
certain side effects then go to the
medications page and look at the names and trade names of
different psychiatric drugs.
Abdominal Pain Nefazodone, phenothiazins, tacrine, and
valproate (3) can cause liver damage and failure. If
you experience abdominal tenderness, especially if it is accompanied
by yellow eyes or skin (sign of jaundice), consult your
doctor immediately. Stimulants (1) commonly cause
abdominal pain. Though not medically dangerous, it can be
unpleasant. Take a dose after meals may be helpful, although
this may reduce effectiveness. A medication change is another
option. Top
Acne Disulfiram and lithium (1) cause acne. It
generally persists as long as you are on the drug. Topical
tetracycline may improve it somewhat. Dosage reduction is
generally ineffective. If it is from lithium and it is severe,
consider other mood stablizers. Top
Agitation Antihistamines, antidepressants, stimulants,
SSRIs, and other antidepressants (2) can cause agitation.
Agitation generally persists, and most people do not become used to
it. Dosage reduction or a medication change are options.
If the agitation is accompanied by rapid speech, hyperactivity,
racing thoughts, euphoric or irritable mood, and insomnia, you may
be experiencing a manic episode and uncommon, but potentially
serious reaction that requires immediate attention from your
physician. Antipsychotics (1) can cause a feeling of
restlessness or agitation. This can be akathisia.
Rarely, bensodiazepines (2) can cause agitation. Though not
dangerous, it is unpleasant. Stopping the benzodiazepine is
usually the best course of action. Buprenorphine and
methadone (1) can cause agitation that is not serious, but can
be unpleasant. A dosage reduction or stopping the drug are the
only remedies. Top
Agranulocytosis Clozapine, carbamazepine, and mirtazapine
(3) can cause this extremely serious problem. Agranulocytosis
is a medical condition in which your bone marrow doesn't produce
enough white blood cells, which are necessary for your body to fight
infection. It is possible to develop an infection severe
enough to cause death. Carbamazepine causes agranulocytosis at
a fairly low rate: 3-5/100,000. The rate for mirtazapine is
1/1500. Monitoring your blood for a few months after you start
carbamazepine or mirtazapine is generally sufficient to ensure your
safety. In the first six months of use, the time of greatest
danger, you should contact your physician and consider getting a
blood test to measure your white blood cells if you notice any sign
of an infection, such as fever or sore throat. Clozapine
causes agranulocytosis in 1 percent of those who try it. A
montoring system was developed in order to ensure early detection of
agranulocytosis for those on clozapine. This system requires
weekly blood counts for six months (the time of greatest risk) and
every other week thereafter. While this system has detected
many cases of agranulocytosis, permitting immediate discontinuation
of clozapine with no long-lasting effects, some people have died.
The rate of death is approximately 1 percent of those developing
agranulocytosis, or 1/10,000 for all patients on clozapine.
The treatment for agranulocytosis requires immediate discontinuation
of whichever drug you are on. Consultation with a
hematologist, a specialist in blood disorders, is essential, in
order to consider the usefulness of drugs to stimulate the bone
marrow to produce more white blood cells as rapidly as possible.
Top
AkathisiaAntipsychotics (2) induce akathisia,
an inner restlessness that is very uncomfortable. Dosage
reduction is one remedy. Beta-blockers can generally provide
significant relief. Benzodiazepines can help as well, though
they are habit-forming. Antiparkinsonian can sometimes provide
some relief. Top
AkinesiaAntipsychotics (2) induce akinesia, one
of the symptoms of pseudoparkinsonism. Akinesia is a
lack of muscle movements. Antiparkinsonian agents provide
significant relief. Top
AnxietyAmantadine, amoxapine, bupropion,
clomipramine, guanfacine, maprotiline, naltrexone, SSRIs,
stimulants, topiramate, and yohimbine (1) can cause anxiety.
Though not dangerous, it is unpleasant and unlikely to go away.
Either dosage reduction or a change in medications is the most
effective remedy. Top
Aplastic AnemiaCarbamazepine (3) causes
aplastic anemia at a rate of a 1/2 per hundred thousand people who
take it. Aplastic anemia is a potentially fatal medical
condition in which your bone marrow does not make the red blood
cells that carry oxygen, the white blood cells that fight infection,
and platelets to assist in blood clotting. Symptoms of plastic
anemia include unusual bleeding or bruising, sores in the mouth,
fever, or sore throat. You should contact your physician
immediately and consider getting a blood test to monitor your blood
cells if you notice any of these symptoms. Treatment requires
immediate discontinuation of the medication. Consultation with
a hematologist, a specialist in blood disorders, is essential in
order to consider the usefulness of drugs to stimulate the bone
marrow to improve as rapidly as possible. Top
Appetite-DecreasedStimulants (1) can decrease
appetite. Children on stimulants need to be closely monitored
to ensure adequate weight gain. Drug holidays, periods of time
off the medication, are the only remedy. Adults generally
don't lose significant amounts of weight unless they take excessive
amounts. Buprenorphine, donepezil, methadone, and tacrine
(1) can cause significant weight loss. Monitor your weight to
ensure that you maintain your weight. Bupropion,
clomipramine, and SSRIs (1) also decrease appetite, but not
enough to induce significant weight loss. Topiramate
(1) causes weight loss in some people. This may be useful if a
person is overweight or if other mood stabilizers have caused weight
gain. Top
Appetite-IncreasedAntidepressants, antipsychotics,
and mood stabilizers (1) often increase appetite and cause
weight gain. Weight gain is generally slow and gradual, but
the amount of weight can be substantial. You may gain as much
as 10 to 20 percent of your premedication body weight, some people
even more. Dosage reduction is the only remedy for the
excessive craving to eat. Obesity can contribute to an
increased risk of heart attacks, high blood pressure, and diabetes.
These complications can lead to significant illness, impairment of
functioning, and increased mortality. It is important,
therefore, to plan your diet and maintain your weight as close to
your ideal weight as possible. It is easier to keep weight off
than to lose it, so address this as soon as you realize your weight
is increasing. Top
Ataraxia Induced by standard antipsychotics (1),
ataraxia is an unpleasant zombielike feeling in which you are aware
of your surroundings but have little reaction to them.
Atypical antipsychotics generally do not cause this side effect.
Consider changing to them if you experience ataraxia. Dosage
reduction is the only other remedy. Top
BedwettingClozapine (1) often causes bedwetting
due in part to its tendency to cause pronounced sedation.
Eliminating caffeine, which increases urination, restricting fluids
for three hours before bedtime, and emptying your bladder just
before sleeping are usually sufficient to stop bedwetting. If
it persists after doing this, consider consultation with a
urologist, who may recommend administration of oxybutinin (Ditropam)
tablets or desmopressin spray (DDAVP), drugs that treat urinary
incontinence. Top
BleedingCarbamazepine (3) can cause bleeding
from aplastic anemia, and valproate can cause bleeding
from thrombocytopenia. Both are potentially
life-threatening reactions. If you notice unusual bleeding,
contact your physician immediately. Top
Blood Pressure-High In combination with certain foods
or medicines, MAOIs (3) can cause elevations in blood
pressure that can be severe enough to cause strokes and brain
damage. Possible symptoms of elevated blood pressure include
headaches, heart palpitations, neck stiffness, nausea, vomiting,
sweating, dilated pupils, and changes in heart rate. If you
suspect that your blood pressure is too high, it is essential that
you be evaluated immediately. Treatment will include stopping
the MAOI and lowering your blood pressure with other drugs.
Stimulants and venlafaxine (1) can also cause an elevation in
blood pressure. The rise is usually mild and not clinically
significant. Monitor your blood pressure until maintenance
dose is attained and you know your blood pressure is in the normal
range. Top
Blood Pressure-LowTricyclic antidepressants,
antihistamines, antiparkinsonian agents, antipsychotics,
beta-blockers, nefazodone, and trazodone (1) can all lower your
blood pressure. Symptoms include light-headedness, especially
when you arise from sitting or laying down, becoming easily
fatigued, and rapid heart rate (except for beta-blockers). The
symptoms of low blood pressure are generally mild and don't require
intervention, although the elderly are more sensitive to these
effects and may have a higher rate of falls. Ensure adequate
fluid intake and eliminate caffeine, which acts as a diuretic and
causes you to excrete water excessively. Dosage reduction is
the only remedy, but it is rarely needed. Top
Blurry Vision Many antidepressants, antipsychotics,
antihistamines, and antiparkinsonian agents (1) may cause mild
blurry vision when you first begin taking them. Your eyes will
gradually improve as your dose stabilizes, although some slight
impairment may remain. Though unpleasant, blurry vision isn't
dangerous. Dosage reduction is the only remedy.
Obtaining a new or different prescription for eyeglasses may be
helpful. Top
Breathing-DifficultyBeta-blockers (3) can
sometimes worsen asthma and making breathing more difficult.
Consider changing to antiparkinsonian agents if you take
beta-blockers for antipsychotic-induced akathisia.
Clozapine (3) can rarely cause sudden shortness of breath due to
pulmonary embolism, a potentially life-threatening reaction
requiring immediate medical attention. It can also impair
breathing at night due to pooling of saliva and the sensation of
choking. This is unpleasant, though not dangerous.
Top
Breathing-SlowedBenzodiazepines (3) can
sometimes slow the rate of breathing. Generally this effect is
unnoticeable. Ingested with alcohol, however, it may be severe
and potentially life-threatening. The combination of
clozapine and benzodiazepines (3) can sometimes lower the rate
of breathing to dangerous levels and has been associated with some
deaths. Top Bruising-FrequentFrequent bruising can be a
sign ofaplastic anemia or thrombocytopenia rare
side effects of carbomazepine and valproate (3),
respectively. If you notice bruising with any other
medication, however, you should consult your physician immediately
to discuss a formal evaluation of your blood counts and the ability
of your blood to clot. Top
CataractsPhenothiazines (1) can cause tiny
cataracts after years of use. They are generally of no
significance and do not significantly impair vision.
Premarketing testing of quetiapine (2) on dogs revealed
cataracts. It is not clear whether quetiapine causes cataracts
in humans. If you take quietiapine for more than a few months,
periodic examination of your eyes (once a year) by an
ophthalmologist or optometrist appears prudent until this matter is
resolved. Top
ChokingClozapine (1) can lead some people to
feel a choking sensation at night. This is probably due to the
pooling of saliva that occurs because people swallow less on
clozapine. Though uncomfortable, this is generally not
dangerous. Top
Cognition ImpairmentBenzodiazpines (1) impair
cognition (thinking processes). Memory impairment is generally
the most noticeable effect, but attention span and visual perceptual
analysis are also compromised. Lithium (1) may cause a
decrease in creativity in some people. Antiparkinsonian
agents, antidepressants, antipsychotics, and topiramate (1) may
impair your ability to think clearly, although the effect is
generally quite mild. Top
Confusion Toxic amounts of any drug (3) can
cause confusion. Therapeutic doses of antiparkinsonian agents
may combine with other medications to cause confusion. No
matter what the cause, however, confusion is a matter of great
concern, and you should call your physician immediately.
Top
ConstipationAntidepressants, antihistamines,
antiparkinsonian agents, antipsychotics, especially clozapine,
buprenorphine, and methadone (1) commonly cause or worsen
constipation. They generally do this by absorbing water from
the stool in the large intestine. It is generally
uncomfortable and frustrating. It can also require intrusive
medical intervention if it becomes severe, so it's important to
address as soon as you notice it. Although you should avoid
water restriction, drinking large amounts of water generally
provides minimal improvement. The most effective remedy is to
alter your diet. Minimize your intake of foods that are likely
to worsen constipation, such as white rice, bananas, cheese, white
bread, and peanut butter. Make sure that you include adequate
fiber in your diet by eating fruits, vegetables, and whole-grain
breads and muffins. A bowl of bran cereal every day can help,
though you may want to spice up the taste with fruit or another
cereal. Try to avoid laxatives if you can, as your system will
come to rely on them and you will need them indefinitely to induce a
bowel movement. Docusate (Colace) and psyllium (Metamucil) are
stool softeners that promote the retention of water in the stool.
They provide significant aid without harming the bowel. Senna
(Senakot) and casanthronol (sold in combination with docusate as
Peri-Colace) are mild laxatives, which some people require on a
daily basis. Stronger laxatives should be taken only in
consultation with your physician. Top
DepressionAmantadine, antipsychotics,
benzodiazpines, and guanfacine (1) can cause depression when
taken for extended periods of time. The effect may be gradual,
and there may be so many other things going on that depression goes
unnoticed. Undiagnosed, it can substantially impair your
ability to lead a satisfying and meaningful life. You should
not settle for being depressed if you take any class of drug.
Benzodiazpines can be gradually tapered and stopped, though it may
take a great deal of effort. Your mood, and other aspects of
your life, will likely improve once you get off them. Reducing
the dose of your antipsychotic or switching to an atypical
antipsychotic can both help. You might consider
antidepressants if you remain depressed on antipsychotics.
Topiramate (1) may cause depression. There has not been
sufficient experience with it to know how severe it is, or the best
way to manage depression if it occurs. Top
DiarrheaLithium (3,1) can cause diarrhea for
two reasons. It can be a sign of lithium toxicity, meaning a
level that is too high. Obtain a blood lithium level to ensure
that your level and dose are not too high. Sometimes people
experience diarrhea at therapeutic levels of lithium. This is
most common with generic lithium and Lithonate. Consider
switching to Lithobid, Eskalith CR, or liquid lithium citrate.
Donepezil, SSRIs, tacrine, and valproate (1) can cause
diarrhea as well. Dosage reduction is the only remedy.
If the dose is too low to provide therapeutic benefit, consider
switching to another medication. Top
DizzinessCarbamazepine, gabapentin, lamotrigine,
topiramate, and valproate (1) can cause dizziness when they are
first begun. This generally passes without difficulty once the
dose is stabilized. Dizziness can also occur if levels are too
high. If you notice the onset of dizziness while on a mood
stabilizer, consult your physician and consider obtaining a blood
level. A rise in blood level can sometimes accompany a cold or
viral illness in which there is some dehydration.
Antidepressants, antiparkinsonian agents, antipsychotics,
beta-blockers, and guanfacine (1) can cause low blood
pressure, of which dizziness is one of the manifestations.
The elderly are especially sensitive to changes in blood pressure.
The dizziness may be annoying but is rarely dangerous.
Measuring your blood pressure is useful if you are troubled by the
symptoms. Ensure adequate fluid intake and eliminate caffeine,
which acts as a diuretic and causes you to excrete water
excessively. Dosage reduction is another remedy but is rarely
needed. Buprenorphine, buspirone, donepezil, naltrexone,
sildenafil, and tacrine (1) can cause mild dizziness that is not
dangerous, though it may be unpleasant. Dosage reduction is
the only remedy. Top
DroolingAntipsychotic drugs (1) can cause
decreased muscle movements of the face (part of the syndrome of
pseudoparkinsonism). This can cause your mouth to remain
open and saliva to leak out. Antiparkinsonian agents generally
solve this problem. Clozapine (1) causes drooling
during sleep and a wet pillow because people don't swallow their
saliva. Although antiparkinsonian agents can sometimes improve
this, most people find the problem remains. There is no good
solution for this. Using a vinyl-covered pillow and changing
your pillow case every day may make this problem less unpleasant.
Top
Dry MouthAntidepressants, antihistamines,
antipsychotics, antiparkinsonian agents, and stimulants (1) all
cause dry mouth. Some people get dry mouth from other
medications as well. Your mouth is dry because the medication
decreases the production of saliva, not because you are dehydrated
or thirty. The lack of saliva can lead to dental caries
(cavities), so it is important to maintain good dental hygiene with
regular brushing and flossing after each meal. Drinking water
frequently is generally ineffective because the problem is not due
to dehydration. Sugarless gum and hard, nonsugar lozenges can
minimize the discomfort of a dry mouth, although they will not
prevent tooth decay. Preparations of artificial saliva that do
not require a prescription are available in drugstores.
Unfortunately, the effect lasts only a few minutes and is generally
not worth the inconvenience. Gel-like mouth moisteners last
longer and may be useful at night, but many people find them
unpleasant. Top
DystoniaAmoxapine and antipsychotics (3) cause
dystonia, which is a muscle spasm, often of the neck, jaw, mouth,
and eyes. Sometimes dystonia occurs in the limbs instead.
Standard antipsychotics are much more likely to cause this than the
atypical antipsychotics recently marketed. Dystonia is
intensely uncomfortable. Rarely, it affects the airway in the
throat, in which case it can be dangerous. It is best to get
treatment immediately both for your safety and because it will not
subside spontaneously. An intramuscular injection of
diphenhydramine (Benadryl) or benztropine (Cogentin) usually
corrects the problem within an hour. You don't need to stop
the antipsychotic if you have a dystonia. Regular doses of
benztropine or other antiparkinsonian agents prevent it from
occuring again. Top
Ear RingingAny drug (1) can cause ear ringing,
or tinnitus. Though it is unpleasant, it is rarely serious.
There is no specific treatment for tinnitus except dosage reduction
or changing medications. Top
EuphoriaAntidepressants
(3) can cause euphoria as part of a manic episode. This is a
serious reaction as it may progress to psychotic thinking and poor
judgment. Contact your physician immediately.
Buprenorphine and methadone (1) cause euphoria as part of their
routine effect. It is generally milder than heroin or other
narcotics and tends to decrease in intensity with steady use.
Top
Emotional BluntingAntipsychotics and benzodiazpines
(1) blunt emotions. Although this can usually decrease the
intensity of feelings that are more intense than warranted, the
effect can be so pronounced that normal emotions are decreased as
well. Antipsychotics are more noticeable in this regard, and
many people who take them are distressed by this problem.
Atypical antipsychotics are less likely to cause blunting than
standard antipsychotics. Dosage reduction is the only remedy,
but even subtherapeutic doses can still be troublesome. You
may be unaware of this problem if you take benzodiazepines, or even
grateful for the relief from the waxing and waning of anxiety.
You may be surprised, if you begin to taper the benzodiazepine, how
much of your emotional life you are missing. This may be
uncomfortable at first, but you will recapture an important part of
your life once you get off the benzodiazepines.
Top
FaintingBuprenorphine and methadone (3) can
cause fainting. This can be due to low blood pressure or an
overdose. In either case you should contact your physician
immediately. Top
Falls The elderly are especially sensitive to the
effects of antidepressants, antipsychotics, benzodiazepines, and
mood stabilizers (2) on their balance and blood pressure.
They are likely to experience unsteadiness on their feet and
light-headedness. As a result, they have a much higher rate of
falls if they take any of these medications. If the symptoms
do not gradually improve once the dose is stabilized, the only
remedies are dosage reduction or a change in medication.
Top
FatigueAntidepressants, antihistamines,
antipsychotics, benzodiazepines, naltrexone, zaleplon, and zolpidem
(1) can all cause fatigue. Most people find the fatigue from
benzodiazepines eases up after the first week or two. Dosage
reduction is the only remedy. Top
Fever Fever is generally a sign of infection. It
can also be the first sign that the medication you are taking is
causing a serious blood problem that makes it hard for your body to
fight infection. Carbamazepine (3) can cause
aplastic anemia, clozapine and mirtazapine (3) can cause
agranulocytosis, and amoxapine and antipsychotics (3)
can cause neuroleptic malignant syndrome, disorders for which
immediate medical attention is necessary. If you develop a
fever on any of these drugs, consult your physician immediately to
consider stopping the medication and the necessity of a physical
examination and blood tests. Top
FlushingMAOIs (3) can cause flushing, a sudden
redness of your face, if you are having hypertension reaction in
which your blood pressure suddenly increases. This is a
medical emergency, as elevated blood pressure can cause you to have
a stroke, and you should contact your physician immediately to
consider the need for immediate treatment to lower you blood
pressure. Clomipramine, sildenafil, and SSRIs (1) can
cause flushing as an annoying, but not serious, reaction.
Top
Gait UnsteadinessLithium (3) can cause an
unsteady gait when the level is too high. Obtain a lithium
level immediately if you notice any impairment of you gait or
coordination. Other mood stabilizers (1) commonly cause
and unsteady gait when you first start them or the dose is raised.
It generally lasts only a few days, but you shouldn't drive a car or
operate heavy machinery until you know that your coordination and
gait have returned to normal. Top
GalactorrheaAmoxapine and antipsychotics (1)
often cause milk leakage from the breasts in women. It is not
dangerous but can be unpleasant. You can use a pad in your bra
if it's noticeable. Dosage reduction can improve it as well.
Top
Hair LossValproate (1) can cause your hair to
fall out at a more rapid rate than usual. Initially, you will
notice only that your hair seems to be falling out. This may
seem alarming, but the hair is growing back in as fast as it's
falling out. Many people notice that their hair is thinner
while they remain on valproate. Your hair will resume its
normal growth pattern if you stop valproate. Top
Hallucinations The excessive combination of medications
that block the neurotransmitter acetylcholine can sometimes cause
visual hallucinations. These include tricyclic,
antidepressants, antihistamines, antiparkinsonian agents, and
antipsychotics (3). Hallucinations can occur if they stop
benzodiazepines (3) abruptly. Top
HeadachesMAOIs (3) can cause headaches if you
are having hypertensive crisis in which your blood pressure suddenly
increases. This is a medical emergency, as elevated blood
pressure can cause you to have a stroke, and you should contact your
physician immediately. Stimulants (1) often cause
headaches. A mild pain reliever such as acetaminophen can be
sufficient. Other remedies involve a dosage reduction in
medication. Antidepressants, antihistamines, amantadine,
buprenorphine, guanfacine, clozapine, disulfiram, donepezil,
methadone, naltrexone, sildenafil, tacrine, zaleplon, and zolpidem
(1) can cause headaches. These are generally mild and not
medically dangerous. A mild pain reliever such as
acetaminophen, aspirin, or ibuprofen is usually sufficient.
Dosage reduction or a change in medication are rarely necessary.
Top
Heart Rate-HighTricyclic antidepressants,
phenothiazines, and clozapine (1) can cause an elevated heart
rate. This is generally not medically significant unless you
are elderly or have high blood pressure or heart problems.
Top
Heart Rate-LowBuprenorphine, beta-blockers,
guanfacine, and methadone (2) lower your heart rate. This
is usually not medically significant, although you should contact
your physician if it goes below 60 beats per minute. Your
pulse should be monitored when you first start until the dose is
stabilized. If you notice that you are easily fatigued, your
pulse may be too low, and you may need a dosage adjustment.
Top
Hives Hives from any drug (3) are raised red
patches of skin that occur rather suddenly. They may be a sign
that you are allergic to a medication. If you notice them, you
should consult your physician to consider stopping the medication
and emergency medical treatment to prevent a more severe reaction.
Top
HyperactivitySSRIs (3), can cause hyperactivity
as a sign of the serotonin syndrome, a serious reaction requiring
emergency medical care to stabilize your pulse and blood pressure.
Rarely, antihistamines and stimulants (2) can cause
hyperactivity. Though not medically dangerous, hyperactivity
as a result of stimulants is a sign of ineffectiveness, and they
should generally be stopped. Bupropion and yohimbine
(2) can cause hyperactivity. Depending on how effective the
medicine is, you may want to stay it. Dosage reduction may be
somewhat helpful. Top
Hypertensive CrisisMAOIs (3) slow the breakdown
of epinephrine and other chemicals that affect blood pressure.
If you ingest and food or medicine that has a substance similar to
epinephrine, such as tyramine while you are on MAOI, you blood
pressure can rise dramatically and dangerously. Symptoms of
hypertensive crisis include a headache, neck stiffness,
palpitations, nausea, vomiting, sweating, and dilated pupils.
A fever may or may not be present. Heart rate may be high or
low. High blood pressure can lead to a stroke, in which a
blood vessel in your brain bursts, leading to brain damage. It
is essential that you follow the diet and avoid the medications
outlined in the previous chapter. If you experience symptoms
that suggest you are having hypertensive crisis, contact your
physician immediately, or go to an emergency room for immediate
treatment. Top
IndigestionAntipsychotics, donepezil, naltrexone,
quetiapine, sildenafil, and tacrine (1) can cause mild
indigestion. It is not medically dangerous. It can be
minimized by taking the dose with food or dosage reduction.
Top
InsomniaStimulants (2) can cause insomnia when
taken close to bedtime. All that is usually needed is to take
the dose a little bit earlier in the day. Clomipramine and
SSRIs (1) can cause insomnia. Sometimes this occurs only
when the medication is first begun. If insomnia persists,
there are three options. Dosage reduction can be tried but is
rarely effective. Use of a sleeping aid can be helpful.
Trazodone is commonly used to aid SSRI-induced insomnia.
Zolpidem is another possibility. Benzodiazepines are often
helpful at first but are habit-forming and generally lose their
effectiveness over some weeks. The last option is to switch
medications. Many people who experience insomnia on one SSRI
do not experience it on another, so it can be reasonable to try a
different one. Tricyclics, especially nortriptyline and
amitriptylin, are antidepressants that often improve sleep.
Rarely, benzodiazepines (2) can cause insomnia. It is
unpleasant, though not dangerous. Stopping the benzodiazepines
is the only remedy. Discontinuing benzodiazepines can lead to
insomnia as a part of a withdrawal syndrome. Buprenorphine,
donepezil, methadone, and naltrexone (1) can cause insomnia.
This may persist. Dosage reduction is the only remedy.
Top
Jaundice Liver damage caused by disulfiram,
lamotrigine, phenothiazines, tacrine, or valproate (3) can
manifest itself by yellow eyes and skin, a condition called
jaundice. This is a serious reaction. You should consult
your physician immediately about stopping your medication.
Top
Kidney DysfunctionLithium can cause kidney
impairment when used on an extended basis. In the vast
majority of cases, the impairment is mild and lithium can be
continued. Kidney damage is possible but extremely rare.
You won't notice any signs of the mild kidney impairment caused by
lithium. It is diagnosed by a blood test for creatinine.
A creatinine test should be performed every 6-12 months, and more
frequently if any impairment is noted. Top
Light-HeadednessAntidepressants, antipsychotics,
and beta-blockers (2) can cause low blood pressure, of which
light-headedness is on of the manifestations. The elderly are
especially sensitive to changes in blood pressure. The
dizziness may be annoying but is rarely dangerous. Measuring
your blood pressure is useful if you are troubled by the symptoms.
Ensure adequate fluid intake and eliminate caffeine, which acts as a
diuretic and causes you to excrete water excessively. Dosage
reduction is the only remedy, but it is rarely needed.
Top
Memory ImpairmentBenzodiazepines (1) impair
memory for events after you take a dose. If you take them for
many months, there may be a lot that is hard for you to remember.
Antiparkinsonian agents, antidepressants, antipsychotics,
gabapentin, topirmate, zaleplon, and zolpidem (1) may also
impair memory. There is no remedy except changing medications.
The impairment resolves after you stop the medication.
Top
Menstrual IrregularitiesAntipsychotics (1) can
cause irregular periods and lead some women to stop menstruating
altogether. This may accelerate the process of osteoporosis,
the decalcification or thinning of bones as you age, and increase
the likelihood of bone fractures. If you miss more than an
occasional period, obtain a consultation with a gynecologist and
consider hormone treatments to induce periods and prevent the
exacerbation of osteoporosis. SSRIs (1) can cause an
occasional missed period, which is generally not significant.
Top
Mental Status ChangesAmantadine, amoxapine, and
antipsychotics (3) can cause neuroleptic malignant syndrome (NMS)
a dangerous reaction that can cause you to be confused, delirious,
and unresponsive. SSRIs (3) can cause the serotonin
syndrome, another dangerous reaction that can also lead to
confused and delirious thinking. You should consult your
physician or go to an emergency room immediately if you suspect you
have either syndrome to receive treatment to reverse the process and
stabilize your pulse and blood pressure. Top
Milk LeakageAmoxapine and antipsychotics (1)
often cause milk leakage (galactorrhea) from the breasts in
women. It is not dangerous but can be unpleasant. You
can use a pad in your bra if it's noticeable. Dosage reduction
can improve it as well. Top
Muscle AchesClomipramine can cause mild muscle
aches. These are not dangerous but can be unpleasant.
Either dosage reduction or a change in medication is the only
remedy. Top
Muscle Coordination, PoorBenzodiazepines, mood
stabilizers, zaleplon, and zolpidem (1) can impair coordination,
especially when first begun. There is a higher rate of car
accidents and falls in people who take benzodiazepines. Make
sure you know how to react to these medications before you drive a
car or operate heavy machinery. Toxic levels of lithium
(3) can cause an unstable gait and poor coordination. Obtain a
blood level of lithium if you notice that your gait is unsteady or
that you are poorly coordinated, in order to evaluate the usefulness
of temporarily stopping your lithium (for a day or two) and
restarting it at a lower dose. Top
Muscle CrampsAntipsychotics (3) can cause an
acute muscle cramp or spasm, called dystonia.
Donepezil (1) can cause muscle cramps. These are
uncomfortable, but not dangerous. Dosage reduction is the only
remedy. Top
Muscle RigidityAmantadine, amoxapine, and
antipsychotics (3) can cause neuroleptic malignant syndrome (NMS),
a dangerous reaction that can cause you to be confused, delirious,
and unresponsive. You should consult your physician or go to
an emergency room immediately if you suspect NMS.
Antipsychotics (2) can also cause pseudoparkinsonism, of
which one of the symptoms is muscle rigidity.
Top
Muscle TwitchingAntidepressants and antipsychotics
(1) can cause muscle twitching. Though uncomfortable, it is
not dangerous. Dosage reduction is the only remedy.
Top
Nasal CongestionLamotrigine and sildenafil (1)
can cause nasal congestion. Annoying but not dangerous, dosage
reduction is the only remedy. Top
NauseaLithium (3,1) can cause nausea if the
level gets too high. If you notice the onset of nausea after
you've been on lithium for awhile, obtain a level to see if the
level has risen too high, and whether you should temporarily stop
the lithium until the level comes down (this usually takes a day or
two). Sometimes people experience nausea at therapeutic
levels. This is the most common with generic lithium and
Lithonate. Consider switching to Lithobid, Eskalith CR, or
liquid lithium citrate. SSRIs (1) commonly cause nausea
when first begun or when the dose is raised. It generally
passes within three to fourteen days. Amantadine,
antihistamines, antiparkinsonian agents, antipsychotics, guanfacine,
mood stabilizers, naltrexone, tacrine, yohimbine, zaleplon, and
zolpidem (1) can also cause nausea. Either dosage
reduction or a change to other medications in the same class is an
option if nausea significantly troubles you.
Top
Neck StiffnessMAOIs (3) can cause stiff neck as
a symptom of hypertensive crisis. Top
Neuroleptic Malignant SyndromeAmantadine, amoxapine,
and antipsychotics (3) can cause neuroleptic malignant syndrome
(NMS), a toxic reaction that is potentially fatal. Symptoms of
NMS include a high fever, muscle rigidity, mental status changes,
irregular pulse, and blood pressure and sweating. Muscle
damage and renal failure can occur and lead to death. NMS is a
life-threatening emergency that requires immediate medical attention
to reverse the process with medication and stabilize your pulse and
blood pressure. Top
PalpitationsStimulants and antidepressants (2)
can cause palpitations, or rapid heart beats. It often
resolves once your dose stabilizes and your body adjusts to the
drug. It is generally not dangerous, but it can be
uncomfortable. Either dosage reduction or a change in
medication is the only remedy. Top
PriapismTrazodone (3) can cause priapism, which
is sustained erection of the penis not due to sexual arousal.
Priapism can damage the penis and calls for immediate intervention.
Treatment generally consists of an injection into the penis.
Though uncomfortable, there are no long-lasting effects.
Rarely, surgical intervention has been required with resultant
impotence. Top
PseudoparkinsonismAmoxapine and antipsychotics
(2) can cause pseudoparkinsonism, a constellation of several
symptoms that mimic Parkinson's disease: akinesia, a lack of
muscle movements, muscle rigidity, and tremor.
Standard antipsychotics are more likely to cause this than atypical
antipsychotics. Dosage reduction and the use of
antiparkinsonian agents generally provide sufficient relief so that
only minimal symptoms remain. Top
PsychosisAmantadine, antidepressants,
antiparkinsonian agents, and stimulants (3) can cause psychotic
thinking, such as visual or auditory hallucinations (seeing or
hearing things that aren't there). Consult your physician
immediately about stopping your medication and getting any needed
treatment. Top
Pulmonary Embolism Rarely, clozapine (3) can
cause pulmonary embolism, which occurs when a blood clot forms in
the leg, breaks off, and travels to the lung. This can be
dangerous as it can lower the amount of oxygen in your blood to
insufficient levels. If you suddenly become short of breath,
the primary symptom of pulmonary embolism, you should consult your
physician or go to an emergency room immediately for evaluation and
treatment. Top
RashLamotrigine (3) can cause a severe rash
that is potentially life-threatening. You should contact your
physician immediately if you notice a rash while on lamotrigine.
Any other medication can also cause a rash. This is
often a sign of an allergic reaction. You should consult your
physician about whether it is safe to stay on the drug.
Top
Respiratory InfectionsTopiramate (1) can cause
respiratory infections (colds) that are not generally serious,
though they may be annoying. Top
Sedation Some antidepressants, antihistamines, and
antipsychotics, as well as amantadine and disulfiram (1), cause
sedation. By and large, this effect does not go away.
Dosage reduction or a change to another drug in the same class are
the only remedies. Some benzodiazepines (1) cause
sedation, which can be useful when they are used to induce sleep but
can be problematic during daytime use. Mood stabilizers
(1) often cause sedation initially. The sedation may persist
with gabapentin and topiramate. If it does not persist, dosage
reduction is the only remedy. Top
Seizures A seizure is a epileptic convulsion in which
your brain cells all fire at once, cause you to lost consciousness
and all your muscles to clench at the same time. Sometimes
there is no muscle clenching, and the sole effect is that you lose
consciousness. A seizure generally lasts for less than a
minute. Abrupt withdrawal of benzodiazepines, carbamazepine,
gabapentin, lamotrigine, topiramate, and valproate (3) can cause
seizure. These drugs should be tapered slowly if you decide to
go off them. Rarely, antidepressants, antipsychotics, and
stimulants (3) can cause seizures. If you have a seizure,
you should contact your physician to discuss whether you should stop
the drug and whether you need any further treatment.
Top
Serotonin SyndromeSSRIs (3) can cause the
serotonin syndrome when used together or in combination with other
drugs that can increase serotonin, including tryptophan and St.
John's wort. Symptoms include fever, hyperactivity, mental
status changes, and potentially dangerous alterations in pulse and
blood pressure. The serotonin syndrome is a medical emergency
for which you need immediate medical attention to ensure
stabilization of your pulse and blood pressure.
Top
Sexual DysfunctionAntidepressants, antipsychotics,
buprenorphine, and methadone (1) can impair sexual function by
decreasing your sexual drive and your ability to become aroused and
achieve orgasm. SSRIs (1) in particular cause these problems,
while tricyclic antidepressants and bupropion (1) are less
likely to be troublesome. Some antipsychotics, notably
risperdone and thioridazine (1), can cause retrograde
ejaculation in men, which is when the semen is expelled into the
bladder during orgasm. Sexual dysfunction may ease up on its
own, though this does not usually occur. Dosage reduction can
sometimes improve any of these problems. Unfortunately, you
may experience a return of your psychiatric symptoms if your dosage
is lowered. There are three medications that may help.
Yohimbine can sometimes increase sexual drive and desire when taken
on a daily basis. When taken prior to sexual activity, it can
enhance arousal. Cyproheptadine (Periactin) doesn't enhance
desire but may increase arousal and restore the ability to achieve
orgasm. Sildenafil restores potency in men. It was
initially tested only on men but has restored the capacity for
arousal and orgasm in some women as well. Top
StutteringOlanzapine (1) can sometimes cause
stuttering. Rarely, other antidepressants, antipsychotics,
gabapentin, and topiramate (1) can, too. It is not
dangerous, though, it may be frustrating or embarrassing.
Dosage reduction is the only remedy. Top
SunburnPhenothiazine antipsychotics (1), as
well as other antipsychotics and antidepressants can cause severe
sunburns. It is essential to use suntan lotion with a sun
protection factor of 15 or more when you are out in the sun.
Top
SweatingAntidepressants and yohimbine (1) can
cause sweating as a side effect. Though unpleasant, it is not
medically dangerous. Benzodiazepines (3) can cause
sweating if you are going through withdrawal. Disulfiram
(3) can cause sweating if you drink alcohol as part of the toxic-dislfiram
reaction. Antipsychotics (3) can cause sweating as a
part of the neuroleptic malignant syndrome, and SSRIs
(3) can cause sweating as part of the serotonin syndrome, two
serious mental disorders that require immediate medical attention.
Top
Tardive DyskinesiaAntipsychotics and amoxapine
(1) cause tardive dyskinesia (TD), a disorder than consists of
involuntary, shythmical, nonpainful movements. It is most
commonly effects the tongue and muscles in the mouth, where it can
look like you are chewing gum. It can also affect the trunk,
hands, and feet. It can unsightly, but most people don't find
it uncomfortable unless their mouth becomes sore. The
movements can be quite pronounced, though they are usually mild.
The movement generally occur only after at least one year of use.
Women, the elderly, and people with brain damage are more likely to
get TD. People who take standard antipsychotics develop TD at
the rate of 10 to 20 percent a year. Atypical antipsychotics
appear to cause it at a much lower rate: 1 to 5 percent. Once
symptoms develop, they usually stay about the same level of
severity, although other areas of the body may gradually be
affected. Some people find that the symptoms gradually improve
after a few years, but some people find that they worsen.
Antihistamines, antiparkinsonian agents, and tricyclic
antidepressants can make the symptoms worse. There is no cure
for TD, although buspirone and vitamin E can sometimes improve the
symptoms. Top
Thirst-IncreasedLithium (3,1) can cause
increased thirst. Generally this is not significant but can be
a sign of toxic lithium levels. If you have other symptoms of
lithium toxicity (pronounced tremor, nausea, diarrhea, an unsteady
gait, or confusion), consult your physician and consider obtaining a
lithium level. Antidepressants, antihistamines,
antipsychotics, and antiparkinsonian agents (1) all cause dry
mouth. Some people get dry mouth from other medications as
well. Your mouth is dry because the medication decreases the
production of saliva, but not because you are dehydrated or thirsty.
The lack of saliva can lead to dental caries (cavities), so it is
important to maintain good dental hygiene with regular brushing and
flossing after each meal. Drinking water frequently is
generally ineffective because the problem is not due to dehydration.
Sugarless gum and hard, nonsugar lozenges can minimize the
discomfort of a dry mouth, although they will not prevent tooth
decay. Preparations of artificial saliva that to not require a
prescription are available in drugstores. Unfortunately, the
effect lasts only a few minutes and is generally not worth the
inconvenience. Gel-like mouth moisteners last longer and may
be useful at night, but many people find them unpleasant.
Top
Throat ConstrictionMAOIs (3) can cause throat
constriction as a part of a hypertensive crisis, a reaction
that requires immediate medical attention. Amoxapine and
antipsychotics (3) cause dystonia, which is a muscle
spasm, often of the neck, jaw, mouth, and eyes. Standard
antipsychotics are much more likely to cause this than the atypical
antipsychotics recently marketed. Dystonia is intensely
uncomfortable. Rarely, it affects the airway in the throat, in
which case it can be dangerous. It is best to get treatment
immediately for safety and because it will not subside
spontaneously. An intramuscular injection of diphenhydramine
(Benadryl) or benztropine (Cogentin) usually corrects the problem
within an hour. You don't need to stop the antipsychotic if
you have a dystonia. Regular doses of benztropine or other
antiparkinsonian agents prevent it from occuring again.
Top
ThrombocytopeniaValproate (3) can cause
thrombocytopenia, which is a medical condition in which you do not
make platelets, the blood cells necessary for clotting.
Without platelets, any internal or external bleeding will be
prolonged and put you at risk for excessive blood loss, low blood
pressure, cardiovascular shock, and even death. The symptoms
are easy bruisability and prolonged bleeding. Consult your
physician immediately should you notice either symptom to consider
stopping the medication and the need for medical treatment to
restore the platelets. Top
Thyroid DysfunctionLithium (1) can cause
hypothyroidism, or impaired thyroid function, which can cause
lethargy, fatigue, depression, decreased appetite but weight gain,
sensitivity to cold, decreased mental and physical activity, and dry
hair and skin. Quetiapine (1) can impair thyroid
function in people with hypothyroidism. In both cases, thyroid
function is easily measured by a blood test and easily treated with
synthetic thyroid hormone, which has no side effects, since it is
identical to the hormone produced by your body.
Top
TicsStimulants (2) can cause motor or vocal
tics, which are more or less involuntary muscle contractions.
There can be snorting sniffing grunting, barking, or involuntary
word vocalizations. As the tics can be permanent, most
psychiatrists recommend that the stimulant be stopped at the first
sign of tics. Top
TinglingTopiramate (1) can sometimes cause
tingling in the extremities. Vitamin B6 and dosage reduction
are possible remedies. Top
TinnitusAny drug (1) can cause tinnitus.
Thought it is unpleasant, it is rarely serious. There is no
specific treatment for tinnitus except dosage reduction or changing
medications. Top
TremorBupropion, gabapentin, lithium, and
stimulants (1) can cause an intention tremor, which occurs when
your hands are active, such as using a spoon. It is not
medically dangerous, but it can be annoying. The beta-blockers
propranolol or nadolol can be useful in minimizing it.
Amoxapine and antipsychotics (2) can cause a tremor that occurs
when your hand is at rest. This is usually part of the
syndrome of pseudoparkinonism. Antiparkinsonian agents
generally provide substantial relief. It can also be a symptom
of tardive dyskinesia. Top
Urinary-DifficultyTricyclic antidepressants,
antihistamines, antiparkinsonian agents, antipsychotics,
buprenorphine, maprotiline, methadone, nefazodone, and trazodone
(2) can impair urination by preventing the bladder from fully
emptying. This can lead you to urinate small amounts
frequently and predispose you to infections. It is unpleasant
and can be uncomfortable. Either dosage reduction or a change
in medications is a remedy. Top
Urinary-Increased FrequencyLithium (3,1) can
cause increased urination. It may be a sign that your level is
too high if this occurs rather quickly with other signs of toxicity,
such as nausea, diarrhea, an unsteady gait, slurred speech, and
confusion. If this is the case, obtain a blood level of
lithium immediately to consider the usefulness of stopping your
lithium temporarily (a day or two is generally enough).
Sometimes people experience frequent urination on therapeutic
levels. If this is the case, ensure adequate fluid intake.
Dosage reduction will help some, but this may cause your level to be
too low. Top
Urinary IncontinenceTricyclic antidepressants,
nefazodone, trazodone, antihistamines, antipsychotics, and
antiparkinsonian agents (2) can impair urination by preventing
the bladder from fully emptying. This can lead you to urinate
small amounts frequently, even when you don't mean to. It may
help some to restrict your fluids and eliminate caffeine, which
increases urination. Consider dosage reduction or a change in
medications. Consider consultation with a urologist, who may
recommend administration of oxybutinin (Ditropam) tablets or
desmopressin spray (DDAVP), drugs that treat urinary incontinence.
Top
Urinary RetentionTricyclic antidepressants,
antihistamines, antiparkinsonian agents, antipsychotics,
buprenorphine, maprotiline, methadone, nefazodone, and trazodone
(3) can impair urination by preventing the bladder from full
emptying. When pronounced, this can prevent urination almost
entirely. Men with enlarged prostates are more vulnerable to
developing retention. Besides being extremely uncomfortable,
this can cause kidney damage. You should consult your
physician immediately or go to a hospital emergency room for
evaluation and probable catheterization. Consider a dosage
reduction or changing medications. Top
Vision ChangesTricyclic antidepressants, nefazodone,
trazodone, antihistamines, antipsychotics, and antiparkinsonian
agents (1) often cause blurry vision. It is not medically
dangerous, and generally improves once the dosage stabilizes.
Sildenafil (1) can cause color-tinged vision, which is not
dangerous. Topirmate (1) may cause double vision and
other visual abnormalities. Such changes can be annoying but
are not dangerous. Dosage reduction is the only option if the
effects persist. Top
Weight GainAntidepressants, antipsychotics,
lithium, topirmate, and valproate (1) can increase your
appetite. This can lead to a gradual but substantial weight
gain over a period of time. Obesity can contribute to a high
risk of diabetes, high blood pressure, heart disease, and heart
attacks. These complications can lead to significant illness,
impairment of functioning, and increased mortality. It is
important, therefore to maintain your weight as close to your ideal
weight as possible. You should weight yourself a couple times
a month when you are on the medication. If you notice any
weight gain, discuss this with your physician. Dosage
reduction is generally ineffective. Changing antidepressants
to bupropion or an SSRI may be helpful, although these drugs have
side effects of their own. Developing and maintaining a strict
diet can be a good option, although some people find it hard to stay
on a restricted diet. Top
Weight LossStimulants (1) can cause weight loss
by decreasing appetite. Children on stimulants need to be
closely monitored to ensure adequate weight gain. Drug
holidays, periods of time off the medication, are the only remedy.
Adults generally don't lose significant amounts of weight unless
they take excessive amounts. Bupropion, SSRIs, topiramate,
venlafaxine, and other antidepressants (1) can sometimes
decrease appetite and lead to mild weight loss.
Top
Yellow Skin or Eyes Liver damage caused by
disulfiram, lamotrigine, phenothiazines, tacrine, or valproate
(3) can manifest itself by yellow eyes and skin, a condition called
jaundice. This is a serious reaction. You should
consult your physician immediately about stopping your medication.
Top
All of this is from the book The Complete Guide to Psychiatric
Drugs by Edward Drummond, M.D.
ZacharyOdette.com
Name:Zachary Adam Odette Birthdate:06-06-1985 Location:Swartz Creek, Michigan USA Diagnosis: schizoaffective Medications Taken Daily: 40mg of
Abilify at night, 300mg of Wellbutrin in the morning, 600mg of Trileptal at
night, 50mg of Revia at night Complementary Therapies: talk-therapy
once every two weeks, 4g of omega-3 EPA fish oils taken daily, 1000 I.U. vitamin E taken daily,
1000mg of VItamin C taken daily, Mega Men Sport multi-vitamins taken daily,
Magma Plus Green Foods supplement taken daily, animal-assisted therapy (dogs), go running and
exercise daily,
taking two classes at local college, no street drugs taken since year 2005, and
I'm tryin' to give up cheap booze...
