The Antipsychotic Algorithms for treatment of Schizophrenia Medication Dosing Table ATYPICAL Atypical First Dose Titration Schedule
Day 15: 100 mg bidDay 18: 125 mg bidDay 21: 150 mg bidDay 24: 100 mg am 200 mg hs
Antipsychotic Dosages out of range, or of significantly different starting dosages, require an explanation on the Clinical
The Antipsychotic Algorithms for treatment of Schizophrenia
Side Effects Sedation Anticholinergic Dysfunction Side Effects/Co-existing Symptoms Anti-EPS Starting Dose Range (daily dose) The Antipsychotic Algorithms for treatment of Schizophrenia Switching Antipsychotics Out-patients
1. Institute new antipsychotic at usual rate.
2. Overlap old antipsychotic with new antipsychotic with new antipsychotic by 1-3 weeks, clozapine
3. Consider having patient bring both old and new medications in and set up 7 day pill boxes to get
4. Assess the patient’s ability to follow complicated instructions and enlist family members to help if
***Refer to instructions for Using the Algorithm for detailed explanation of switching drugs.*** Problems Associated with Switching Antipsychotic Agents
Possible decompensation, particularly in early
Slow transition, overlap use of typical and
stages of treatment (may take > six weeks for
atypicals to become effective), with abrupt
associated with depression, suicidiality. Monitor closely.
New side effects; e.g. hypersalivation rather than
dry mouth with change to clozapine; weight gain
more with clozapine than with some conventional
agents that was being given with large doses of
discontinuation of high-potency agents.
anticholinergic agent that were not “carried
forward.” Withdrawal dyskinesia or akathisia
limited, but can be treated by adding back
possible whenever typical agent stopped abruptly
(dyskinesia especially after abrupt cessation of
Possible loss of antipsychotic efficacy.
Depending on anticholinergic effects of previous
after a few weeks; if not, consider dosage
agent and abruptness of switch, patient may
experience either new onset anticholinergic side
dietary counseling and increased exercise.
effects or cholinergic rebound symptoms. EPSmay also follow abrupt conversion to high (>5mg/day) doses of risperidone. Weight gain,
The Antipsychotic Algorithms for treatment of Schizophrenia Recommended Doses of Antidepressants Type/Class Usual target Recommended dose mg/day to administration Medication achieve in weeks 1-3 recommended schedule The Antipsychotic Algorithms for treatment of Schizophrenia Antidepressant/Antipsychotic Interactions venlafaxine (Effexor) increases haloperidol levels, but not by Cytochrome P450 interaction) *=Minor pathway
PORFIRIAS Diagnóstico Laboratorial 1. INTRODUÇ‹O 2.1.1. Porfirias Neuropsiquiátricas agudas neurológicas e cutâneas associadas a deficiênciashereditárias e adquiridas na via de biossíntese do(PIA), a Coproporfiria Hereditária (CH) e aheme. Embora as desordens primárias sejamPorfiria Variegata (PV) que freqüentementerelativamente incomuns, diversas condiçõesmani
In an effort to promote the appropriate use of certain drugs and to help better manage the cost of expensive drugs, the ConnectiCare Pharmacy & Therapeutics Committee has developed a list of prescription drugs that require prior authorization. Prior authorization requests must be faxed to ConnectiCare’s Pharmacy Services department at 860-674-2851 or toll free 800-249-1367 by the prescribin