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AA

Quetiapina XR (50, 150, 200, 300, 400mg) x1/zi la distanta de mese

I:-SCH (ac+prevenire recaderi), TAB-ep depresiv+maniacal (ac+de intretinere), TDM (de asociere)

Efect: AD (150-300 mg/zi), timostab (200-800mg/zi), antip (600-800mg/zi)

SCH+ep maniacal: zI=300mg, zII=600mg, dz zilnica eficace 400-800mg/zi

TAB-ep depresiv: zI=50mg, zII=100mg, zIII=200mg, zIV=300mg=dz zilnica eficace

TDR: zi-II=50mg, zIII-IV=150mg

Varstnici: initiere cu 50mg/zi si crestere cu 50mg la 3-4 zile

E.a.:sedare, +G, hTA, ameteli, dislipidemie

+: spectru larg: simpt +/-/cognitive,timostab, agresiv, insomnia, anx, usor de adm, titrare rapida, nu este necesara
ajustarea dz in cazul trat de intretinere, nu +PRL

-:sedare

!NU este recomandat iin cazul psihozei associate dementei (poate fi in cea din B.Parkinson si D cu c. Lewy)

Risperidona 0,25/0,5/1/2/3/4mg; sol 1mg/ml; tb orod 0,5/1/2mg (T1/2 =20-24h)

I:SCH, t psihotice, TAB-ep maniacal+depresiv, tulb de comportam, impulsivitate

Psihoza si TAB: 2-8 mg/zi, initial 1-2mg/zi, apoi +1mg/zi (!efect hipotensiv al primei dz); raport optim eficienta/tolerab la
2-6mg/zi

E.a.: sedare, +G, ESP, +PRL (dep de dz), diabet, dislipidemie, hTA, disf sexuale, +riscul de deces si AVC la pac cu dementa

25(po-4mg/zi)-37,5-50mg/2sapt im; titrarea realiz la 4 sapt; se adm concomitant po 3 sapt de la prima injectie

Aripiprazol 2/5/10/15/20/30 mg; inj 9,75/1,3ml T1/2= 75h

I: SCH, TAB ep manical+depresiv (adjuvant), alte psihoze, tulb de comport in dementa, impulsivitate

DZ 15-30mg/zi

E.a.: ameteli, sedare, hTA, insomnia, akatisie, greata

+:pacienti supraponderali, obezi, cu DZ, dislipidemie; act anitpsihotica rapida, fara titrare, nu necesita ajustarea dz in
affect hepatice ori renale

Olanzapina 2,5/5/7,5/10/15/20mg; Velotab 5/10/15/20mg; REIM 5mg/ml (1fl=2,1ml=11mg) T1/2=21-54h;

I:SCH/agitatie ac; ep maniacal/mixt, TAB, depresie bipolara /rezistenta (+fluoxetine), TPB

Dz: 10-20mg/zi po/im; initial 5-10 mg/zi, apoi +5mg/zi la 1 sapt; im: max 20mg/zi, max 3 inj/zi , max 3 zile consecutive,
se repeta la 2 ore CI: hipersensib, glaucom cu unghi inchis !BZD se admi dupa 1 h !!!hTA se monitorizeaza 4 h

E.a.: hTA, sedare, +G, ameteli, DZ, dislipidemie, ameteli, tahicardie !!!fumatul scade conc OLZ
ZYPADHERA 1ml=150mg (210, 300, 405 mg)

10 mg/zi -> 210mg/2 sapt sau 405 mg/4sapt --2luni--> 150 mg/2 sapt sau 300 mg la 4 sapt

15 mg/zi -> 300mg/2sapt--2luni--> 210mg/2sapt sau 405 mg la 4 sapt

20 mg/zi -> 300mg/2sapt

Amisulprid 50/100/200/400 mg, T1/2=12h

I: SCH, distimie

DZ 400-800 mg/zi in 2 dz

s-: 50-300mg/zi, distimie 50mg/zi, dz <400mg intr-o singura prize

E.a.: EPS, +PRL, insomnia, sedare anx, agitatie, +QTc !!!scade pragul conv

Clozapina 12,5/25/50/100mg T1/2=5-16h

I: SCH, risc suicidar, violenta, agresivitate, TAB

Dz 300-450mg/zi max 900mg/zi;

zI=12,5mg; zII=12, 5mgx2/zi; zIII-IV=25mgx2/zi; zV-VI=25+50mg; zVII= +25mg/zi

!!!in primele 6 luni se prescrie pt 1 sapt, in urm 6 luni pt 2 sapt, apoi lunar

E.a.: +G, crize convulsive, sedare, ameteli, DZ, dislipidemie, hiperglicemie, miocardita, agranulocitoza

!!nu det disknezie tardiva

Paliperidona (Invega) 3/6/9/mg

3-6 ,max 12mg/zi; zI=6mg, +3mg/zi la 5 zile

Antipsihotice clasice

Haloperidol 1/2/5/20mg; sol 1mg/ml; IR 5mg/ml; decanoate 50/100mg (dz zilnica x 10-20 la 4 sapt) T1/2 12-38h

I: psihoze, ticuri, delirium, tulb de comportam, dementa

Dz 1-40mg/zi po max 100mg/zi;

E.a.: ESP, +PRL, sedare, hTA, tahicardie,+G, constipatie, retentive urinara, agravarea s neg si cognitive

Timostabilizatoare

Valproat 300/500mg

I: epilepsie, TAB-eo maniacale si mixte

DZ Zi=300mg/zi, max 1200-1500mg/zi

E.a.: sedare, tremor, vertij, ataxie, astenie, cefalee, greata, varsaturi, +G, +enz hepatice, ovar polichistic !!!scade cu 40%
metabolizarea lorazepamului => dz mai mici
Carbamazepina 600-1200mg mg/zi, initial 200mgx2/zi, dupa care se creste cu 200mg/zi la 1 sapt

Gabapentin initial 300x2, apoi 300mgx3/zi, max 2400mg/zi

Lamotrigina 100-200mg/zi in TAB; msaptI-II=25mg/zi; saptII-IV=50mg/zi; saptV=100mg/zi; sapt VI= 200mg/zi !rash la
initiere

Antidementiale

Donepezil 5-10mg/zi S, initial I-luna 5mg/zi

Rivastigmina 6-12 mg/zi in 2 dz , cu alimentatia; initial 1,5 mgx2/zi, apoi +3mg/zi la 2 sapt

Galantamina 16-24 mg/zi; I-luna 8mg/zi D, II-luna 16 mg/zi D, III-luna 24mg/zi D (IR se adm in 2 prize)

Memantina 10 mg x 2/zi (!sau intr-o singura dz); initial 5 mg/zi, + 5 mg/zi la 1 sapt !!!Nu are CI in AB si UG ca inhibitorii
de colinesteraze

Antidepresive

Trazodona 50/100/150/300 mg (Trittico XR 150/300mg) T1/2=3-6h/5-9h

I: depresie, insomnia primare/sec, anx

Dz: 150-400-600 mg/zi XR 150-375 mg/zi (initial 150 mg/zi, apoi +75mg/zi la 3 zile)

Insomnia/adjuvant in depresie: initial 25-50mg/zi, apoi 100mg/zi seara inainte de culcare

Depresie-monoterapie: initial 150 mgx2/zi, apoi +50mg la 3-4 zile

E.a.: sedare, ameteli, hTA, priapism, !!!poate bloca efectul antihipertensivelor

+: pac ingrijorati de e.a. dpdv sexual sau +G; nu are actiune pe Ach

Mirtazapina 15/30/45 mg T1/2=20-40h

I: MDD, AP, TAG , TSPT

Dz: 15-45 mg/zi S

E.a.: +G, sedare, hTA, ameteli, constipatie

+: act rapia pe insomnia si anx, nu det e.a. sexuale

Mianserina 10/30/60 mg T1/2=12-29h

30-60 mg/zi, max 90 mg/zi in 1-2 prize

Clomipramina (Anafranil) 100-250 mg/zi

Doxepina 100-300mg/zi

Tianeptina 12,5 mgx3/zi

I: TDR, distimie, anx+depresie, dep alcoolica


E.a.: cefalee, vertij, insomnia, sedare, tahicardie

Escitalopram 5/10/20 mg 10-20 mg/zi D/S, initial 10 mg/zi

I: TDR, TAG, AP, TOC, TSPT

E.a.: disf sexuale, g-I, insomnia, sedare, agitatie

+: insuf cardiac, toleranta buna, disf sexuale mai putine comparative cu celelalte SSRI

Sertralina 25/50/100 mg T1/2=30h 50-200 mg/zi D/S; initial 50 mg/zi, titrare la 1 sapt

I: TDR, AP, TSPT, TOC, TAG, Fobie sociala

Agomelatina 25-50 mg/zi , initial 25/zi, titrare la 2 sapt daca e cazul

CI: hipersensib, insuf hepatica

+: tulb ale ritmului somn-veghe; pacienti preocupati de +G ori de e.a. sexuale

Bupropion (Wellbutrin) XL (extended release) 150-450 mg/zi, initial 150 mg/zi D, apoi dupa 4 sapt? 300 mg/zi

E.a.: crize convulsive, HTA, anx, ameteli, cefalee, -G, gura uscata

I: MDD, adictie la nicotina, depresie bipolara, ADHD, disf sexuale

Venlafaxina XR 37,5/75/ 150/225 mg T1/2=3-7h

I: depresie, TAG, fobie sociala, TPanica, TSPT,

E.a.: cefalee, insomnia, greata, disf sexuale, HTA, hiponatremie, sedare/activare

75-223mg/zi -> act preponderant 5HT, la altii duala

225-375 mg/zi -> act duala la majoritatea pac

Initial 37,5 mg/zi 1 sapt, apoi se poate +cu 75 mg la 4 zile

Duloxetina 20/30/60 mg 40-60 mg/zi in 1-2 dz, max 120 mg/zi; initial 20mgx2/zi

NU SSRI in UG, UD, gastrita

Varstnicii cu importante comorbiditati somatice nu duc mai mult de 2mg haloperidol care in aceasta dz nu
are effect antipsihotic, ci mai degraba anxiolytic

CZP necesita + dz de antipsihotic

NU OLZ in DZ

In sevrajul alcoholic NL rapida trebuie evitata deoarece poate sa scada pragul convulsivant

RSP este influentata mai putin decat celelalte AP de fumat dar este..!

Milgamma 100mg B1 + 50 mg B6 -> 1f/zi im; intretinere 1-2 f/sapt