#pimozide

[medicomunicare]

Aminoacids and fats meet for "malignant" purposes: reexploring antipsychotic drugs paving the way for metabolic wreck

Glioblastoma (GBM) is the most lethal brain tumor, with a median survival rate of merely 12-16 months after diagnosis. Despite surgical, radiation and chemotherapy treatments, the two-year survival rate for GBM patients is less than 10%. Two major challenges hinder effective treatment: the limited penetration of anti-tumor drugs into GBM tissues because of the blood-brain-barrier; and the rapid…

[000bachelor]

I feel like types of Tourette's, such as motor tics, or even tremors, should be discussed more in the art community.

Even when I'm graced by the Luvox, Topamax, and Pimozide gods, I sometimes find myself frustrated and depressed from how difficult and time-consuming it can be to draw with these damn shaky, jerky hands.

It's honestly ridiculous how many times the undo tool is pressed, or how many times I lift up an actual eraser, to delete the mistakes that such things have caused for me.

It's a disability that has progressively inhibited me from both sleep and the continuation of my biggest passion in life. It doesn't define me as a person, but it inhibits me from becoming the person that I have always wanted to become.

[summer-starry-dawn]

Pharmacie : Traitement de la dépression

L'âge moyen de la première dépression est de 20 ans, apparition du premier épisode dépressif entre 17 et 27 ans en moyenne. C'est le trouble psychiatrique le plus fréquent ; c'est 70% des PEC en médecine générale, à tous les âges de la vie. Elle est plus fréquente chez la femme.

N.B : En cas de syndrome dysphorique prémenstruel la pilule contraceptive est plus efficace qu'un antidépresseur

Pour parler d'épisode dépressif caractérisé (EDC) il faut :

Rupture avec un état antérieur ; le patient n'est pas dans son état habituel (capital sinon pas dans un EDC)

Symptômes évoluant depuis au moins 2 semaines.

Humeur triste ne fluctuant plus. C'est une tristesse pathologique ; - Souffrance morale, décrite pire que la souffrance physique par le patient - Anhédonie ; perte de la capacité à éprouver du plaisir - Perte d'intérêts - Anesthésie affective

- Ralentissement psychomoteur du patient dépressif

Ralentissement psychique - bradypsychie ; pensée qui vont lentement - discours lent, monotone, monothématique - troubles cognitifs de concentration/mémoire

Ralentissement moteur - asthénie permanente - clinophilie (rester allongé toute la journée) - incurie (pas prendre soin de soi) - apragmatisme (ne rien faire, absence d'activité) - présentation : patient figé, bradykinésie, hypomimie, Ω mélancolique (sourcils font la forme Ω)

Ralentissement somatique

- hyporexie ⇒ anorexie, amaigrissement (mais parfois hyperphagie)

- troubles du sommeils ; insomnie du petit matin

- troubles sexuels ; anorgasmie, impuissance, frigidité, dyspareunie (= douleur pendant les rapports)

Dépression iatrogène

Médicaments Pouvant Donner des Dépressions

Interféron α (IFN α) ;

Isotrétinoïne ;

Bêtabloquants ;

Diurétiques thiazidiques ;

Mefloquine ;

Fluoroquinolones et quinolones ;

Nitro-imidazolés ;

Glucocorticoïdes ;

Œstrogènes et oestroprogestatifs ;

Sulfamide

Prise en charge

Le plus souvent en ambulatoire avec le médecin généraliste (premier intervenant pour soigner la dépression)

Association : antidépresseur (6 à 12 mois) + psychothérapie

Le traitement par antidépresseur met environ 2/3 semaines pour montrer des effets positifs. Si le patient dépressif voit une amélioration de son état dépressif par la médication au bout d'un mois, il doit quand même continuer son traitement au moins 6 mois après la normothymie (= retour à l'état normal de l'humeur)

ISRS : Inhibiteurs sélectifs de la recapture de la sérotonine

Citalopram (Séropram®), Escitalopram (Séroplex®), Fluoxétine (Prozac®), Fluvoxamine (Floxyfral®), Paroxétine (Déroxat®, Divarius®), Sertraline (Zoloft®)

Propriétés : Psychostimulant, sédatif, anxiolytique

Indications :

Syndrome dépressif

Trouble obsessionnel compulsif

Trouble panique et phobie sociale

Trouble anxieux généralisé

État de stress post-traumatique

Contre-indications : Allongement de QT (Citalopram et Escitalopram), insuffisance rénale sévère (Citalopram)

Interactions médicamenteuses : Pimozide, Duloxétine, Agomélatine, Tramadol, IMAO sélectifs, Tamoxifène, Triptans

Effets indésirables

Levée de l’inhibition avec risque suicidaire

Gastralgies, nausées, vomissements, diarrhées

Allongement de QT pour le Citalopram et l’Escitalopram

Prise de poids

Perte d’appétit avec la Fluoxétine

Baisse de la libido, impuissance

Sueurs

Éruption cutanée

Hyponatrémie

IRSNa : Inhibiteurs de la recapture de la sérotonine et de la noradrénaline.

Duloxétine (Cymbalta®), Venlafaxine (Effexor®), Milnacipran (Ixel®)

Indications :

Syndrome dépressif

Trouble obsessionnel compulsif

Trouble panique et phobie sociale

Trouble anxieux généralisé

État de stress post-traumatique

Contre-indications : Insuffisance hépatique, insuffisance rénale sévère (Duloxétine), HTA non contrôlée, maladie coronarienne sévère ou instable (Milnacipran)

Interactions médicamenteuses : IMAO non sélectifs, Fluvoxamine, Tamoxifène

Effets indésirables

Levée de l’inhibition avec risque suicidaire

Nausées, vomissements, diarrhées

Hépatite

Baisse de la libido, impuissance

Hyponatrémie

Hypertension artérielle, tachycardie

Tricycliques (imipraminiques)

Ce sont des inhibiteurs de la recapture de la sérotonine, de la noradrénaline et de la dopamine

Amitriptyline (Laroxyl®, Elavil®), Amoxapine (Défanyl®), Clomipramine (Anafranil®), Dosulépine (Prothiaden®), Imipramine (Tofranil®), Maprotiline (Ludiomil®), Doxépine (Quitaxon®), Trimipramine (Surmontil®)

Propriétés : Psychostimulant, sédatif, anxiolytique

Indications : syndrome dépressif, douleur chronique, troubles anxieux

Contre-indications : glaucome à angle fermé, adénome de la prostate, IDM récent, épilepsie

Interactions médicamenteuses : IMAO, Sultopride, inhibiteurs sélectifs de la recapture de la sérotonine, alcool, Clonidine

Effets indésirables

Levée de l’inhibition avec risque suicidaire (en début de traitement)

Tremblements dose-dépendant

Troubles du rythme et de la conduction

Hypotension orthostatique

Baisse du seuil épileptique

Somnolence

Prise de poids

Effets anticholinergiques : sécheresse buccale, constipation, trouble de l’accommodation (flou visuel), rétention urinaire

IMAO : inhibiteurs de la monoamine oxydase

IMAO non sélectif (A et B) : Iproniazide (Marsilid®)

IMAO sélectif A : Moclobémide (Moclamine®)

Propriétés : psychostimulant, sédatif

Indications : syndrome dépressif

Contre-indications : hypertension artérielle, insuffisance hépatique, phéochromocytome, états confusionnels aigus, alcoolisme chronique

Interactions alimentaires : aliments riches en tyramine (poussées hypertensives) : alcool, chocolat, fèves, ginseng, abats, banane, figue, fromage fermenté, avocat, viandes et poissons fumés ou séchés, saucisson, soja, soupes en sachets ou boites, levure de bière

Interactions médicamenteuses : Buproprion, Midodrine, sympathomimétiques, Tétrabénazine, Triptans, ISRS, IRSNa, Tramadol, Péthidine, Réserpine, ICOMT, Tianeptine

Effets indésirables

Levée de l’inhibition avec risque suicidaire

Épisode maniaque

Insomnie, excitation

Effets anticholinergiques : sécheresse buccale, constipation, trouble de l’accommodation (flou visuel), rétention urinaire

Hypotension orthostatique

Crise hypertensive

Vertiges, sueurs, céphalées

Autres antidépresseurs

Ils ont des mécanismes variés.

Agomélatine (Valdoxan®), Miansérine (Athymil®), Mirtazapine (Norset®), Tianeptine (Stablon®)

Propriétés : psychostimulant, sédatif, antihistaminique

Indications : syndrome dépressif

Contre-indications : porphyrie, hypersensibilité ou antécédent d’agranulocytose due au produit

Interactions médicamenteuses : IMAO, inducteurs enzymatiques

Effets indésirables

Levée de l’inhibition avec risque suicidaire

Nausées, vomissements, diarrhée, constipation

Hypotension orthostatique

Prise de poids

Somnolence

Anxiété

Épisode maniaque

Effets anticholinergiques : sécheresse buccale, constipation, trouble de l’accommodation (flou visuel), rétention urinaire

Diminution du seuil épileptogène

Agranulocytose

Critères de choix

Chez l’Enfant et l’Adolescent

- Prise en charge psychothérapeutique en première intention.

- Les ISRS et leurs apparentés sont déconseillés (sauf Fluoxétine) car ils donnent un comportement suicidaire et/ou hostile.

- Les ATC sont contre-indiqués car effets secondaires psycho-comportementaux.

- En cas de troubles obsessionnels compulsifs (OCD), la Fluvoxamine et la Sertaline (ISRS) peuvent être utilisés chez l’enfant de plus de 6 ans.

Chez la Personne Âgée

- Les ISRS :

o Risque d’hyponatrémie, surtout si prise concomitante de diurétiques ;

o Risque hémorragique, surtout si prise concomitante d’anticoagulants.

- Les ATC ne sont pas prescrits en première intention car ils donnent des effets anticholinergiques risquant d’aggraver les fonctions cognitives en cas de démence.

=> Tous les antidépresseurs peuvent donner un risque de chute car ils donnent une hypotension et une sédation.

- La dose des ATC est réduite de moitié par rapport à celle donnée aux adultes.

Insuffisances Hépatique et Rénale

- Risque accru d’accumulation si IH.

- Risque d’accumulation de la Paroxétine et du Citalopram si IR

PK

Bonne absorption digestive ;

Effet de premier passage hépatique très important pour les ATC ;

Volume de distribution important pour les ATC et les ISRS ;

Liaison importante aux protéines plasmatiques ;

Les ATC, la Fluoxétine et le Citalopram donnent des métabolites actifs ;

Les ATC subissent un cycle entéro-hépatique ;

Ils sont éliminés par voie rénale et biliaire ;

Les ISRS sont des inhibiteurs enzymatiques du CYP450 2D6 et 3A4.

[nvrcmplt]

Hanazaki’s medication :: [ Source ]

fluphenazine & pimozide

( not a double dose; these are the drugs he can take; if he runs out of the drugs given to him at his local hospital. Fluphenazine; is his prescript-ed medication, however. )

What it does: Lessens / Blocks dopamine in the system.

What does it do for Hanazaki: Helps him control his more volatile tics.

Side effects: Weight Gain & Involuntary repetitive movements.

adhd medication - concerta

What it does: Aids Methylphenidate in the body to help increase attention and concentration.

What does it do for Hanazaki: Allows him to sit in his university classes without missing a thing due to his tics taking over. He doesn’t use this tablet every day but it at least once a week to help himself out during stressful times.

Side effects: Some ADHD medication can exacerbate his tics. So far, this one hasn’t made them any more worse than they are.

antidepressant - sarafem

What it does: Help control symptoms of sadness, anxiety and OCD

What it does for Hanazaki: Settles him down very fast; though he doesn’t like these meds since he feels very - hollow - after taking them. However, it is one of the best medications to give him when his system is near overdrive in outside stimulation and his tics are in control from other medication. These are the days when Hanazaki is very low; in his head and making things mentally worse for himself. Blaming himself for things in the past.

Hanazaki used to have; clonifine ( catapres ) though it usually treats high blood pressure; it also helps him have impulse control; however, the drug made him exhausted to the point he’d be asleep in a matter of hours after taking the pill. His parents and doctor deemed it an unnecessary drug to take; so he moved Ieji off the drug within the last few months.

Even though Hanazaki is on medication; it is his last resort. Having grown with those drugs are a child and now an adult; he has seen a huge difference in his symptoms. It was in a recent discussion with his GP and Therapist that he quits the medication. Feeling like he is becoming too dependent on them and out of fearing the worst; ‘of not ever being able to give them up to feel normal in society’, his GP and Therapist are currently looking into the possibility.

The worst that Hanazaki could go through is; withdraw symptoms from the medication he takes the other, Hanazaki’s tics come back worse. However, knowing of Hanazaki’s lifestyle, family support and current goal in life; they believe Hanazaki has a good chance of becoming medication independent; in terms that Hanazaki knows what to take when he needs to take it and not; take it when the clock strikes a certain hour.

Hanazaki will be reviewed again in a mouth; before he will take on the trial of not having to take medication for his Tourette. A trial period of two months; will be given to him, once his GP and Therapist sort things out on their end.

[bluebyrd-screaming]

Newmoonwerebat, idk how to tell you this but being sedated, especially heavily sedated, will fuck up your cognitive abilities

You aren't supposed to drive while taking these medications because of how drowsy they can make you. Driving while tired is known to be just as bad or worse as driving under the influence because your reaction times and abilities are greatly impaired, making you a hazard to yourself and other drivers

Being drowsy is inherently cognitive impairment

While I got out unscathed, the week that I was on an antipsychotic (pimozide to treat a tic disorder (note that tic disorders like Tourette's syndrome has no associated cognitive impairment so your whole "its not the antipsychotic, its the psychosis melting your brain" has no weight here, though its not like it really did in the first place)) was one of the worst of my life and I felt fundamentally broken every single day I took that medication. I was so tired that I couldn't focus, I almost crashed my car, I felt like I was moving through molasses, and almost fell asleep every thirty minutes. I genuinely loved my classes and regularly participated but that week I could barely process anything because i kept almost falling asleep at my desk, something that has never happened before or since. I also had jitteriness which felt like ants crawling under my skin alongside the drowsiness so I both couldn't move and felt like I needed to jump out of my skin

My reaction was more extreme. Not everyone will get that much drowsiness or the jitteriness and if pimozide works for them, more power to them

And while my reaction is extreme, it also shows the cognitive reaction to being sedated. Because the end goal of antipsychotic treatment for tourettes is to sedate the body just a little bit. And doing so will make you a little bit slower, and for some people that's worth it but for others it makes you feel like you've been turned into a zombie

Also it's like. Antipsychotics weren't made to "reduce psychosis" cause we don't have that kind of science in psychiatry. What they do and do well is reduce your cognitive function and all around sedate you to a point where you are unlikely to have the energy and ability to act out/cause trouble as a result of being mentally distressed. And while I am not saying that this can't be a relevant relief for a psychotic person in some cases, it sure isn't the straightforward biomedical solution to schizophrenia it's made out to be

[nursingwriter]

Zoloft is Pfizer's trademark name for Sertraline hydrochloride (HCl). Sertraline acts as a serotonin reuptake inhibitor (SSRI), thereby potentially decreasing the effects of clinical depression and certain anxiety disorders. Thus, Zoloft is typically classified as an antidepressant medication. Psychiatrists commonly prescribe Zoloft for various forms of depression, panic disorder, and obsessive-compulsive disorder (OCD) as well as for anxiety disorders such as social anxiety disorder. Additionally, Zoloft may be used to treat post-traumatic stress disorder (PTSD) and premenstrual dysphoric disorder (PMDD). Generally, doctors prescribe Zoloft to patients over the age of 18, but Zoloft has been approved for the purpose of treating OCD in patients between the ages of 6 and 17. Patients usually receive Zoloft in orally-administered pill form, but an oral liquid is also available. The liquid form of Zoloft comes highly concentrated and must be diluted with a half-cup of the following liquids: water, ginger ale, lemon/lime soda, lemonade, or orange juice ("Zoloft," 2006). Patients take one prescribed dose of the medication at the same time each day, without variance. A missed dose cannot be doubled on the following day. Pills can be taken with or without food. Most patients being treated for depression take 50 milligrams of Zoloft and are monitored closely by their doctors. If symptoms do not improve after at least one month of taking 50mg, doctors may increase the dose in regular intervals, to a maximum of 200mg per day. Prescribed as an antidepressant, Zoloft doses can be increased gradually in one-week intervals. For panic disorder, however, the initial dose of Zoloft may be only 25mg, to be increased at 50mg increments once per week up to the maximum allowable daily dose, which is 200mg. Patients being treated for OCD generally take 50mg each day of Zoloft, with the possibility of 50mg incremental dosage increases. The drug's effects may not be apparent for four weeks or more of treatment, which is why doctors must carefully monitor their patients' intake, symptoms, and side effects. Side effects of Zoloft include the following minor effects: nausea, nervousness, restlessness, diarrhea, loose stool, dyspepsia, vision problems, headaches, male sexual dysfunction, decreased sex drive, insomnia, fatigue, tremors, increased sweating, dry mouth, dizziness, abdominal pain, and changes in weight or appetite. However, more serious side-effects may occur as a result of taking Zoloft. One of the greatest risks with Sertraline HCl is the tendency for some patients, especially those under the age of 18, to develop suicidal thoughts during the first few weeks of taking the drug. Other potentially serious side-effects include seizures, convulsions, hallucinations, tremors, balance or coordination problems, and allergic reactions. Zoloft and other Sertraline hydrochloride compounds are contraindicated with MAO inhibitors (MAOIs) and patients taking MAOIs must cease their MAOI medication no less than 14 days before taking Zoloft. Similarly, patients who are prescribed MAOIs must wait at least two weeks after terminating their use of Zoloft. Other contraindicated medications include pimozide. Patients with a history of renal (kidney) or hepatic (liver) problems must use caution when taking Zoloft. Moreover, patients with a history of mania or bipolar disorder may not be candidates for Sartraline treatment. Pregnancy and lactation will also preclude a person from taking Zoloft. Zoloft should also be used minimally if at all with serotonergic drugs such as Prozac, and CNS-active drugs such as Serzone, both of which are also used to treat depression. Other medications may interfere with the effectiveness of Zoloft or cause unwanted side effects, so patients should alert doctors to any medications they may be taking including over-the-counter remedies. References Long, P. (2005). Sertraline. Internet Mental Health. Retrieved online Sept 20, 2006 at http://www.mentalhealth.com/drug/p30-z02.html Sertraline." Wikipedia. Retrieved online Sept 20, 2006 at http://en.wikipedia.org/wiki/Sertraline Treatment for Depression and Anxiety." Zoloft.com. Retrieved Sept 20, 2006 at http://www.zoloft.com/zoloft/zoloft.portal?_nfpb=true&_pageLabel=default_home Zoloft." (2006). Micromedex Physician's Desk Reference. Retrieved online Sept 20, 2006 at http://www.drugs.com/zoloft.html Zoloft." (nd). Health Square. Retrieved Sept 20, 2006 at http://www.healthsquare.com/newrx/ZOL1503.HTM Read the full article

[baekura]

Question for people with ADHD on antipsychotics (specifically orap/pimozide):

Does anyone else have issues hyperfixating/hyperfocusing while on this medication? Or have you found that it just generally affects your ADHD? I'm trying to figure out if its the medication or if there's something else going on in my life that's preventing me from hyperfixating.

[vijayanger12]

The global Pimozide market size is estimated to be worth US$ 11 million in 2021 and is forecast to a readjusted size of US$ 10 million by 2028 with a CAGR of -0.9% during the forecast period 2022-2030.

[its-ticsticstics]

Medications for Tourettes Syndrome

*This is not intended to be taken as medical advice. This is purely for educational purposes*

Goal of pharmaceutical treatment of TS

The goal of using medications in the treatment of Tourettes syndrome is not to completely remove tics but to help them become more managable along with any comorbid disorders.

Currently approved drugs for the treatment of TS

Neuroleptics: Haloperidol (Haldol), Pimozide (Orap), Aripiprazole (Abilify). Neuroleptics act to antagonize dopamine, through the blockade of type 2 dopamine receptors. In general, the higher the potency of dopamine blockade, the more effective a drug is in ameliorating tics.

Drugs used off-label for the treatment of TS

Atypical Antipsychotics: Risperidone (Risperdal), Clozapine, Olanzapine (Zyprexa), Quetiapine (Seroquel). Atypical antipsychotics are more selective dopamine receptor D2 blockers, although they can also affect serotonin. These drugs include risperidone, clozapine, olanzapine, quetiapine and the partial agonist aripiprazole. Atypical antipsychotics may be considered a safer treatment for tics due to the reduced risk of developing acute or subacute side effects. Risperidone may also treat comorbid aggression and obsessive-compulsive symptoms, and Olanzapine may help with morbid ADHD and aggression.

Experimental pharmalogical agents in the treatment of TS

Benzamides: Sulpiride, Tiapride; may also help treat echophenomena, aggression, tension, and obsessive-compulsive comorbidities.

Tetrabenazine: acts as dopamine antagonist, by reducing the presynaptic storage of monoamines and blocking postsynaptic DA receptors.

Alpha adrenergic agonists: Clonidine (Catapres), Guanfacine. These drugs may also help with comorbid oppositional defience, aggression, and obessive-compulsive symptoms.

Benzodiazepines: Clonazepam (Klonopin); addictive and generally best for transient use.

Anticonvulsants: Topiramate (Topamax), Levetiracetam (Keppra); better tolerated than neurleptics but conflicting evidence efficacy.

Dopamine Agonists: Pergolide (Permax), Apomorphine, Buspirone (Buspar), Ropinirole (Requip); typically medications that are used in the treatment of Parkinsonism, low doses may also treat tics.

Cannabinoids: THC in particular may also help with comorbid self-injurious behaviours, obsessive-compulsive symptoms, and ADHD.

*This is not an exhaustive list*

Sources: (x) (x)

[siglerprescriptiondrugcards]

Sertraline Hydrochloride

Brand Name: Zoloft

Generic Available

Common Dosage Forms:

Tablets: 25 mg, 50 mg, 100 mg

Oral Concentrate: 20 mg/mL (12% alcohol)

FDA Indications/Dosages:

Treatment of depression* and obsessive-compulsive disorder (OCD): Start with 50 mg once daily. Increase dosage as needed no sooner than weekly up to a maximum of 200 mg/day. Treatment for up to 16 weeks has shown as improvement in depressive states. Success in treatment for periods longer than 16 weeks is unknown.

Treatment of panic disorder, with or without agoraphobia and post-traumatic stress disorder (PTSD): Start with 25 mg once daily. Increase dosage as needed no sooner than weekly up to a maximum of 200 mg/day.

Treatment of premenstrual dysphoric disorder: Start with 50 mg/day, either daily throughout the menstrual cycle or limited to the luteal phase of the menstrual cycle. Changes in dose should be made at the start of the menstrual cycle up to a maximum of 150 mg/day.

Treatment of social anxiety disorder: Start with 25 mg once daily. After one week, the dose should be increase to 50 mg once daily.

*Depression is characterized by a depressed or dysphoric mood that lasts almost daily for an extended time (>2 weeks). 4 out of 8 of the following symptoms should be present to accurately diagnose the episode as depression: change in appetite, change in sleep patterns, psychomotor agitation, loss of interest in usual activities, increased fatigue, feelings of guilt or worthlessness, impaired concentration, and a suicide attempt or suicidal ideation.

Pharmacology/Pharmacokinetics: Sertraline is chemically unrelated to tricyclic or tetracyclic antidepressants. Its mechanism of action is thought to be due to its inhibition of CNS neuronal uptake of serotonin (5HT). It has very week actions on norepinephrine and dopamine neuronal reuptake. It has no significant affinity for adrenergic, cholinergic, GABA, dopaminergic, histaminergic, benzodiazepine, or serotonergic receptors. Terminal elimination half-life is 26 hours. Sertraline undergoes extensive first-pass metabolism (N-demethylation) to form a less active metabolite. Excretion occurs both through the urine and through feces. Sertraline is highly bound to plasma proteins (98%) and is a substrate for P450 hepatic isoenzyme CYP3A3/4.

Drug Interactions: Use in combination (within 14 days) with MONOAMINE OXIDASE INHIBITORS (MAOI) may cause serious or even fatal reactions. May increase PIMOZIDE levels. May be displaced by or displace other highly protein-bound drugs (warfarin, digitoxin). May decrease clearance of diazepam and tolbutamide. Variable effects may occur when used with other CYP3A3/4 substrates. Coadministration with aspirin or an NSAID may increase the risk of upper GI bleeding.

Contraindications/Precautions: Do not use pimozide or within 14 days of therapy with an MAOI. ANTIDEPRESSANTS INCREASE SUICIDAL THOUGHTS AND ACTIONS IN CHILDREN, ADOLESCENTS, AND YOUNG ADULTS. Suicide attempts are possible in depression and may continue until significant remission occurs. Only the smallest quantity possible should be dispensed. Use with caution in patients with renal or hepatic dysfunction. Although drowsiness is not a major adverse effect, patients should be careful when performing tasks which require alertness. Abrupt discontinuation of therapy may cause adverse effects including dysphoric mood, irritability, agitation, dizziness, anxiety, confusion, insomnia, and headache. Pregnancy Category B.

Adverse Effects: Nausea, diarrhea, dyspepsia, tremor, dizziness, insomnia, sweating, dry mouth, or male sexual dysfunction (ejaculatory delay).

Patient Consultation:

Continued therapy may be needed to show noticeable improvement. Do not stop therapy before consulting with a physician.

Sertraline oral concentrate must be diluted prior to use. Place the proper dose in 4 oz. of water, ginger ale, lemon/lime soda, lemonade, or orange juice ONLY. Do not mix in any other beverage. Take immediately after mixing. Do not premix doses.

Avoid alcohol while taking this medication.

Use caution when performing tasks that require mental alertness.

Consult with your physician or pharmacist before taking nonprescription medications.

Do not abruptly discontinue medication.

Store in a cool, dry place away from sunlight and children.

Contact a physician if the above side effects are severe or persistent.

If a dose is missed, skip it and return to normal dosing schedule.

Pay close attention to any changes, especially sudden changes, in mood behaviors, thoughts, or feelings. Antidepressants may increase suicidal thoughts and actions.

[writerthreads]

Writing characters with Tourette syndrome

By Writerthreads on Instagram

Disclaimer: I do not have Tourette’s so this post is based on Mayo Clinic’s article on this syndrome.

What is Tourette syndrome?

Tourette syndrome is a disorder that involves repetitive movements or unwanted sounds (tics) that can't be easily controlled. Tics typically show up between ages 2 and 15, showing up the most at the age of 6. Males are more likely to develop Tourette syndrome.

The are no cures to Tourette syndrome, but there are treatments. Many people with Tourette syndrome don't need treatment when symptoms aren't troublesome. Tics often lessen or become controlled after the teen years.

Symptoms

Tics can range from mild to severe. Severe symptoms might significantly interfere with communication, daily functioning and quality of life.

Tics are classified as simple or complex.

Simple: sudden, brief and repetitive, involving few muscle groups

Complex: coordinated patterns of movement involving several muscle groups

In addition, tics can:

Vary in type, frequency and severity

Worsen if the character is ill, stressed, anxious, tired or excited

Occur during sleep

Change over time

Worsen in the early teenage years and improve during the transition into adulthood

Characters experience an uncomfortable bodily sensation (premonitory urge) such as an itch, a tingle or tension. Expression of the tic brings relief. With great effort, some people with Tourette syndrome can temporarily stop or hold back a tic.

Causes

The exact cause of Tourette syndrome isn't known. It's a complex disorder likely caused by a combination of inherited and environmental factors.

Risk factors

Risk factors for Tourette syndrome include:

Family history. Having a family history of Tourette syndrome or other tic disorders might increase the risk of developing Tourette syndrome.

Sex. Males are about three to four times more likely than females to develop Tourette syndrome.

Complications

People with Tourette syndrome often lead healthy, active lives. However, Tourette syndrome frequently involves behavioral and social challenges that can harm your self-image.

Conditions often associated with Tourette syndrome include:

ADHD

OCD

Autism spectrum disorder

Learning disabilities

Sleep disorders

Depression

Anxiety disorders

Pain related to tics, especially headaches

Anger-management problems

Treatment

MEDICATION

Medication that reduces or blocks dopamine, eg. Fluphenazine, haloperidol (Haldol), risperidone (Risperdal) and pimozide (Orap)

Botox injections can relieve a simple or vocal tic

ADHD medications

Central adrenergic inhibitors, eg. clonidine (Catapres, Kapvay) and guanfacine (Intuniv) (all might cause sleepiness)

Antidepressants

Antiseizure medications

THERAPY

Behaviour therapy

Psychotherapy

Deep brain stimulation (DBS): For severe tics that don't respond to other treatment (still in early research stages

[bbybluues]

i have two empty bottles of pimozide just sitting on my dresser and i kinda want to make earrings out of them

idk how and my ears aren’t even pierced but i saw someone do it once and i thought it was cool

[hellocitalopramdiaries]

Citalopram Generic Name: citalopram (si TAL o pram) Brand Names: CeleXA

Medically reviewed by Sanjai Sinha, MD Last updated on Dec 19, 2018.

What is citalopram?

Citalopram is an antidepressant belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs).

Citalopram is used to treat depression.

Citalopram may also be used for purposes not listed in this medication guide.

Important information You should not use citalopram if you also take pimozide, or if you are being treated with methylene blue injection.

Do not use citalopram if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Report any new or worsening symptoms to your doctor, such as: mood or behaviour changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Do not give citalopram to anyone younger than 18 years old without the advice of a doctor. This medicine is not approved for use in children.

Before taking this medicine You should not use this medicine if you are allergic to citalopram or escitalopram (Lexapro), or if you also take pimozide.

Do not use citalopram if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure citalopram is safe for you, tell your doctor if you have:

a bleeding or blood clotting disorder;

liver or kidney disease;

narrow-angle glaucoma;

seizures or epilepsy;

heart disease, heart failure, a heart rhythm disorder, slow heartbeats, or recent history of heart attack;

personal or family history of Long QT syndrome;

an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

bipolar disorder (manic depression); or

a history of drug abuse or suicidal thoughts.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine during pregnancy without your doctor's advice.

Citalopram can pass into breast milk and may harm a nursing baby. You should discuss the risks and benefits of using citalopram if you are breast-feeding.

Do not give this medicine to anyone under 18 years old without medical advice. Citalopram is not approved for use in children.

How should I take citalopram? Take citalopram exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using citalopram suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

See also: Citalopram dosage information (in more detail)

What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking citalopram? Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with citalopram may cause you to bruise or bleed easily.

Drinking alcohol can increase certain side effects of citalopram.

Citalopram may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Citalopram side effects Get emergency medical help if you have signs of an allergic reaction to citalopram: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

a light-headed feeling, like you might pass out;

blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;

headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;

high levels of serotonin in the body--agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting; or

low levels of sodium in the body--headache, confusion, slurred speech, severe weakness, vomiting, feeling unsteady.

Common citalopram side effects may include:

problems with memory or concentration;

headache, drowsiness;

dry mouth, increased sweating;

numbness or tingling;

increased appetite, nausea, diarrhea, gas;

fast heartbeats, feeling shaky;

sleep problems (insomnia), feeling tired;

cold symptoms such as stuffy nose, sneezing, sore throat;

changes in weight; or

difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Citalopram side effects (in more detail)

What other drugs will affect citalopram? Taking citalopram with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with citalopram. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

cimetidine;

lithium;

St. John's wort;

tryptophan (sometimes called L-tryptophan);

a blood thinner (warfarin, Coumadin, Jantoven);

any other antidepressant;

heart medication;

medicine to treat a psychiatric disorder; or

"triptan" migraine headache medicine.

This list is not complete and many other drugs can interact with citalopram. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

See also: Citalopram drug interactions (in more detail)

Further information Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use citalopram only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 20.01.

Related questions What are some common side effects of antidepressants? SSRI’s vs SNRI’s - What's the difference between them? What is the difference between Celexa and Lexapro?

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