CENTRAL NERVOUS SYSTEM
Mood disorders 3D
sugar). Pre-existing low WBCs or history of leukopenia/
neutropenia; monitor CBCs during 1st few months of
treatment; discontinue if WBCs decline. Exposure to
extreme heat. Dehydration. Reevaluate periodically.
Monitor for hyperglycemia. Exclude neuroleptic
malignant syndrome if fever occurs. Suicidal tendencies.
Write ; for smallest practical amount. Elderly (not
for dementia-related psychosis). Labor & delivery.
Pregnancy (Cat.C). Nursing mothers: not recommended.
Interactions: Avoid alcohol. Caution with other
centrally-acting drugs. Potentiates antihypertensives.
Levels may be reduced by CYP3A4 inducers (eg,
carbamazepine). Levels may be increased by CYP3A4
inhibitors (eg, ketoconazole) or CYP2D6 inhibitors
(eg, quinidine, fluoxetine, paroxetine). Caution with
drugs that interfere with temperature regulation (eg,
anticholinergics).
Adverse reactions: Headache, anxiety, insomnia,
GI upset, somnolence, fatigue, akathisia, orthostatic
hypotension, asthenia, blurred vision, tremor, pyrexia,
salivary hypersecretion, neuroleptic malignant
syndrome, tardive dyskinesia, weight gain, others. Inj:
local reactions.
How supplied: Tabs 2mg– 30; 5mg, 10mg,
15mg, 20mg, 30mg– 30, 100; Oral soln (w. dosing
cup)–150mL; Discmelt– 30; Single use vials– 1
;BUPROPION
BUDEPRION XL Teva
WELLBUTRIN XL GlaxoSmithKline
Aminoketone. Bupropion HCl 150mg, 300mg; ext-rel
tabs.
Indications: Depression. Seasonal affective disorder.
Adults: Swallow whole. Avoid bedtime dosing.
;18yrs: Depression: initially 150mg once daily in
the AM for at least 3 days; if tolerated, increase
to 300mg once daily at least 24 hrs apart. May
increase after several weeks to max 450mg once
daily. Seasonal affective disorder: start in autumn,
taper and stop in early spring. 150mg once daily in
AM; if tolerated, increase to 300mg once daily after
1 week. Max 300mg/day. Severe hepatic cirrhosis:
max 150mg every other day. Mild-moderate hepatic
cirrhosis, or renal impairment: consider reduced dose
and/or dose frequency.
Children: ;18yrs: not recommended.
; Also: Bupropion
BUDEPRION SR Teva
WELLBUTRIN SR GlaxoSmithKline
Bupropion HCl 100mg, 150mg, 200mg; sust-rel tabs.
Indications: Depression.
Adults: Swallow whole. Avoid bedtime dosing.
;18yrs: initially 150mg once daily in the AM for at
least 3 days; if tolerated, increase to 150mg twice
daily at least 8 hrs apart. May increase after several
weeks to max 200mg twice daily at least 8 hrs apart.
Severe hepatic cirrhosis: max 100mg/day or 150mg
every other day. Mild-moderate hepatic cirrhosis,
or renal impairment: consider reduced dose and/or
dose frequency.
Children: ;18yrs: not recommended.
;
Also: Bupropion
WELLBUTRIN GlaxoSmithKline
Bupropion HCl 75mg, 100mg; immediate-rel tabs.
Adults: Avoid bedtime dosing. ;18yrs: initially
100mg twice daily for at least 3 days; if tolerated,
increase to 100mg 3 times daily at least 6 hrs apart;
max increase 100mg/day per 3-day period. May
increase after several weeks to max 450mg/day
in 3 divided doses; max single dose: 150mg (give
400mg/day as 100mg 4 times daily at least 4 hrs
apart). Severe hepatic cirrhosis: max 75mg once daily.
Mild-moderate hepatic cirrhosis, or renal impairment:
consider reduced dose and/or dose frequency.
Children: ;18yrs: not recommended.
Contraindications: Seizure disorders. Bulimia.
Anorexia nervosa. Within 14 days of MAOIs. Abrupt
withdrawal of sedatives or alcohol. Other forms of
bupropion (eg, Zyban).
Warnings/Precautions: History or risk of seizures;
discontinue if seizure occurs: do not restart. Hepatic or
renal impairment (monitor closely). Depression: clinical
worsening or suicidal risk (monitor). Bipolar disorder.
Psychosis. Unstable heart disease. CHF. Recent MI.
Maintain at lowest effective dose. Write ; for smallest
practical amount. Elderly. Labor & delivery. Pregnancy
(Cat.C). Nursing mothers: not recommended.
Interactions: See Contraindications. Avoid alcohol.
Levodopa, amantadine may increase toxicity.
Caution with drugs that lower seizure threshold
(eg, quinolones, theophylline, antidiabetics, anorectics,
CNS stimulants, systemic steroids, antidepressants,
antipsychotics) or factors that lower seizure threshold
(eg, opiate or cocaine addiction, excessive use of
alcohol or sedatives). Caution with drugs metabolized
by CYP2B6 (eg, orphenadrine, cyclophosphamide) or
CYP2D6 including tricyclic antidepressants, SSRIs
(eg, paroxetine, fluoxetine, sertraline), antipsychotics
(eg, haloperidol, risperidone, thioridazine), ;-blockers
(eg, metoprolol), Class 1C antiarrhythmics
(eg, propafenone, flecainide); consider dose
reduction. May be affected by metabolic enzyme
inducers (eg, carbamazepine, phenobarbital,
phenytoin), or inhibitors (eg, cimetidine). Monitor for
hypertension with nicotine replacement.
Adverse reactions: CNS stimulation (eg, agitation,
insomnia, seizures, tremor, dizziness), mania/
hypomania, psychosis, weight change, dry mouth,
headache, migraine, GI effects, edema, rash (rarely
may be serious, eg, erythema multiforme, Stevens-Johnson syndrome), palpitations, urinary frequency,
sweating, tinnitus, myalgia, hypertension.
How supplied: XL tabs– 30, 90; SR tabs– 60;
Immediate-rel tabs– 100
;CITALOPRAM
CELEXA Forest
SSRI. Citalopram (as HBr) 10mg, 20mg;, 40mg;;
tabs (;scored).
Also: Citalopram
CELEXA ORAL SOLUTION
Citalopram (as HBr) 2mg/mL; sugar- and alcohol-free;
peppermint flavor; contains parabens.
;
