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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by SLS on March 9, 2003, at 10:52:06
Hi.
I've added information about drug half-life and metabolotic route of elimination.
This is a chart displaying the trade-names and generic-names of drugs used in psychiatry. For each drug is listed its therapeutic uses, dosage, half-life, and pharmacological properties. The abbreviations used can be found at the bottom of the chart or can be opened up in a separate window.
I hope you find it useful.
http://sl.schofield3.home.att.net/medicine/psychiatric_drugs_chart.html
- Scott
Posted by laurarn on March 9, 2003, at 11:33:10
In reply to Psychiatric Drugs Chart - now includes half-life, posted by SLS on March 9, 2003, at 10:52:06
Hi Scott. Once again, thank you for the wonderful information. The only discouraging thing to me in the half-life of Abilify.
I know it is good to stay on a med for at least 2-3 months in order to truly evaluate it's usefulness. But, in this case I have stopped the Abilify until I see my pdoc on Wednesday. I know there are meds to counteract the akathesia and stiff muscles that I have been experiencing, but if I don't get sleep and a bit of stillness I'll go crazy!
This past week has been just horrible. I've been on Abilify 2 weeks now at a low dose and the side effects have been horrible. So, as you can see, the half-life info isn't so great for me. But at least I have that information in a nifty chart. Back to my Seroquel again. Should have never left it.
Thanks again for a great link. Best wishes to you.
Posted by SLS on March 9, 2003, at 12:37:17
In reply to Re: Psychiatric Drugs Chart - now includes half-life » SLS, posted by laurarn on March 9, 2003, at 11:33:10
Hi Laura.
I'm sorry you've had such a tough time with Abilify. What are you taking it for? Is it helping?
> I know it is good to stay on a med for at least 2-3 months in order to truly evaluate it's usefulness.
I think that depends on what condition you are trying to treat it with. For instance, it can take 3 or 4 months for an antipsychotic (neuroleptic) to stabilize someone with schizophrenia. I would guess the same is probably true for schizoaffective disorder, although I think using an effective mood stabilizer along with the antipsychotic could stop the induction of episodes somewhat sooner. If one is using a neuroleptic to produce an improvement in unipolar or bipolar depression without psychotic features, I believe that if it is going to provide benefit, it will do so within the first 10-14 days. Of course, this is dependent upon proper dosing.
My doctor started me out on 20mg of Abilify, and I've been taking it for a little over 3 weeks. It has given me minor improvements in energy, motivation, and thought clarity. Unfortunately, it is wholly inadequate, even though it is being used in combination with Lamictal and desipramine. I don't think neuroleptics work very often when used as monotherapy to treat depression. In any event, I am happy to take every little bit I can get. When I see my doctor on Tuesday, I'm not sure what we will be doing with Abilify. My biggest problem with Abilify (aside from its not helping very much) is some serious constipation. The only thing that seems to help are laxatives. I'd like to know if perhaps the degree of constipation is dose-dependent. If it is, I'll want to try reducing it to 10mg.
My next big decision is as to which antidepressant to move on to. I would prefer to try duloxetine (an Effexor-like drug) next, but it has still not been approved. That leaves Lexapro and Strattera as the two for me to consider. I'll leave that up to my doctor.
> But, in this case I have stopped the Abilify until I see my pdoc on Wednesday. I know there are meds to counteract the akathesia and stiff muscles that I have been experiencing, but if I don't get sleep and a bit of stillness I'll go crazy!
I think you are doing the right thing.
> This past week has been just horrible. I've been on Abilify 2 weeks now at a low dose and the side effects have been horrible.
I am still suspicious that taking very low dosages of Abilify might be counterproductive in that it might cause someone to feel sedated and sleepy all day long, yet still cause insomnia and agitation. If it weren't for the akathisia and dystonia (muscle stiffness), I would encourage you to increase the dosage. I guess what it boils down to for you is: Are the benefits significant enough to try to work with the side effects?
> So, as you can see, the half-life info isn't so great for me. But at least I have that information in a nifty chart. Back to my Seroquel again. Should have never left it.
20/20 hindsight.
Be well and thanks for the encouragement.
- Scott
Posted by AndrewB on March 9, 2003, at 13:36:20
In reply to Psychiatric Drugs Chart - now includes half-life, posted by SLS on March 9, 2003, at 10:52:06
Scott,
I expect to get a lot of use out of this reference chart, as I was already referring frequently to the previous version. I believe the chart to be exceptional in its accuracy, inclusiveness, and utility.Sincerest thanks,
Andrew
Posted by laurarn on March 9, 2003, at 14:57:35
In reply to Psychiatric Drugs Chart - now includes half-life, posted by SLS on March 9, 2003, at 10:52:06
Posted by SLS on March 9, 2003, at 19:31:07
In reply to Re: Psychiatric Drugs Chart - now includes half-li, posted by AndrewB on March 9, 2003, at 13:36:20
Posted by Shawn. T. on March 9, 2003, at 20:32:24
In reply to Psychiatric Drugs Chart - now includes half-life, posted by SLS on March 9, 2003, at 10:52:06
I appreciate all of the time that you seem to have spent on this page. I strongly suggest that you consider adding references. I think that it is unfair for the researchers who have uncovered drug mechanisms to not receive credit for their work. In addition, visitors to the page have no means of confirming all of the information unless they spend a great deal of time doing research; this should not be necessary. I find several of your descriptions to be inaccurate. You've left out a very large amount of important information and included several mechanisms that are indirect. Would it be fair for me to describe a drug like Celexa as one that works by desensitizing 5-HT1A receptors? That may be a true fact, but does that really tell me anything about how Celexa actually works? A plus sign tells me nothing about how much of a certain drug is actually necessary to induce a response at a receptor; I should not have to guess what your interpretation might be. How am I to interpret your information on half-lifes? Is this data from rats or humans; what was the average age of the subjects studied? I'm not mocking your efforts; I'm simply suggesting that you need to properly reference and more thoroughly research your information. People unfamiliar with drug mechanisms are likely to accept your comments without reservation; you need to take this into account and provide a more accountable resource.
Shawn
Posted by SLS on March 9, 2003, at 22:45:09
In reply to Re: Psychiatric Drugs Chart - now includes half-life, posted by Shawn. T. on March 9, 2003, at 20:32:24
Hi Shawn.
I'll give some consideration to the points you have made. If I should decide to go back and reference all of sources I used, I would need to take the page down for a few months. I doubt I would invest the time necessary. I find it fascinating that you should falt me for doing exactly the same thing that the vast majority of the "professional" pages posted on the Web demonstrate. Have you written letters to them too? What's the big deal?
> In addition, visitors to the page have no means of confirming all of the information...
Sure they do.
> ...unless they spend a great deal of time doing research; this should not be necessary.
It was for me.
If you were so concerned with inaccuracies, then why did you not submit them to me via the e-mail address listed at the bottom of the page dedicated for precisely that purpose. I should hope you made it down that far in your attempt to identify references.
Please do.
In the meantime, I'll consider placing some wording at the top of the page qualifying its limitations and post an appropriate disclaimer.
Thanks for the input.
- Scott
Posted by jrbecker on March 9, 2003, at 23:29:43
In reply to Re: Psychiatric Drugs Chart - now includes half-life » Shawn. T., posted by SLS on March 9, 2003, at 22:45:09
uh...perhaps you can petition for an NIMH grant to help you with all the proposed changes.
Posted by jodeye on March 10, 2003, at 2:06:38
In reply to Re: Psychiatric Drugs Chart - now includes half-li, posted by AndrewB on March 9, 2003, at 13:36:20
Hi Andrew,
I have heard magnesium referred to as "natures calcium channel blocker". What are your thoughts on high-dose magnesium having effects similar to that of memantine or acamprosate?
Aloha,
--jodeye
Posted by Shawn. T. on March 10, 2003, at 3:01:07
In reply to Re: Psychiatric Drugs Chart - now includes half-life » Shawn. T., posted by SLS on March 9, 2003, at 22:45:09
I should reiterate that I'm not bashing your efforts; I think that the page is a very useful resource. I'm bothered by all sites that don't properly reference material; I have contacted a few large sites about this issue. I posted a reply here because people should understand that they need to be somewhat careful about unreferenced information on the internet. I don't suggest that you take your site down; a small note would suffice. I'll send you a list of suggestions at some point in the future. At some distant point in the future, I could send you a large list of references for your information; of course, you would have to be willing to take the time to post them to your page. I doubt that it would require more than a couple hours of work on your part.
Shawn
Posted by SLS on March 10, 2003, at 7:15:06
In reply to Re: Psychiatric Drugs Chart - now includes half-life » SLS, posted by Shawn. T. on March 10, 2003, at 3:01:07
Hi Shawn.
> I posted a reply here because people should understand that they need to be somewhat careful about unreferenced information on the internet.
I think that this should be well-understood and emphasized with respect to all sources of information both on and off the Internet. The caveats the Dr. Bob has placed at the top of this page goes a long way to accomplishing this. Not everyone reads them, though. I didn't before I got started here.
> I don't suggest that you take your site down; a small note would suffice. I'll send you a list of suggestions at some point in the future.
That would be very helpful and much appreciated.
Thanks, Shawn.
- Scott
Posted by jay on March 10, 2003, at 10:16:44
In reply to Psychiatric Drugs Chart - now includes half-life, posted by SLS on March 9, 2003, at 10:52:06
Hey Scott:Awesome job, info that EVERY psychiatrist should know. (Which many don't it seems!) I of course don't have much pharmacological knowledge, but just some questions about the SRI's.
I was wondering about various effects beyond serotonin of some of the SRI's. I noticed you have with Prozac (fluoxetine) and Zoloft (sertraline), but was curious about Celexa (citalopram), Paxil (paroxetine) and Luvox (fluoxetine). Maybe these others aren't really significant. I think that both Paxil and Celexa may have norepinephrine reuptake properties, as well as anticholinergic properties. I also am sure that Luvox has pro-melatonin properties. I've picked one abstract on each, but there are a large number of others from a Medline search. Please let me know what you think, and honestly I am not trying to stir up *anything*..ok? :-):
Here is one of many on Paxil..and I hope I have this right:
Am J Psychiatry 2002 Oct;159(10):1702-10
Inhibition of norepinephrine uptake in patients with major depression treated with paroxetine.One that implicates anticholinergic properties of Celexa:
Psychopharmacology (Berl) 2001 Apr;154(4):343-9
The effects of amitriptyline, citalopram and reboxetine on autonomic nervous system. A randomised placebo-controlled study on healthy volunteers.And one on melatonin and Luvox:
J Clin Psychopharmacol 2001 Apr;21(2):167-74
Differential effects of fluvoxamine and other antidepressants on the biotransformation of melatonin.Thanks again...
Jay
Posted by Ron Hill on March 10, 2003, at 11:46:15
In reply to Psychiatric Drugs Chart - now includes half-life, posted by SLS on March 9, 2003, at 10:52:06
Scott,
Thank you for all the hard work and long hours you have invested over the years in the Psychiatric Drugs Chart. For some time now I have had it bookmarked in the reference section of my medication e-folder.
I clicked through the rest of your web site today and it confirmed what I already knew; you are a good person.
-- Ron
Posted by Questionmark on March 11, 2003, at 1:46:02
In reply to Psychiatric Drugs Chart - now includes half-life, posted by SLS on March 9, 2003, at 10:52:06
This is the end of the thread.
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