GEORGETTE REVIEW PMHNP 388 REVISION
HANDBOOK 2026 PSYCHOPHARMACOLOGY
AND CLINICAL MANAGEMENT
◉ Serotonin syndrome.
Answer: D/C med
cyproheptadine
◉ When switching antidepressenats.
Answer: wait 14 days when SSRI -> MAOI
wait 5-6 wks from fluoxetine to MAOI
wait 2 wks if switching from MAOI -> fluoxetine.
Due to fluoxetine (prozac) having longer halflife.
◉ Triptans
Sumatriptan (Imitrex).
,Answer: don't give w/ antidepressants- increased risk of serotonin
syndrome
◉ If cancer and depressed.
Answer: citalopram/escitalopram
least drug drug interactions
◉ NDRI.
Answer: NE and DA reuptake inhibitor
Wellbutrin
best for those that don't want sexual s/e
depressed, low energy, fatigue- wellbutrin best
contraindicated in hx of seizures or eating disorders (because
electrolyte levels being off can cause seizures)
◉ Chronic Pain and antidepressants.
Answer: SNRI
,Duloxetine (cymbalta)
◉ Fluoxetine (prozac).
Answer: can cause insomnia
take in morning, not evening.
many SSRIs can cause insomnia- take in morning, worst insomnia is
w/ prozac
◉ schizophrenia.
Answer: onset 18-25 M
25-35 F
highest of all mental illnesses to cause thoughts of self harm (SI)
◉ Which disorder causes the highest amount of homicidal ideation
(HI).
Answer: antisocial personality highest
◉ Brain PET scan of schizophrenia.
, Answer: everything decreased in size except ventricles (ventricles
are holes anyway, obviously they are bigger)
◉ Don't given stimulants to:.
Answer: schizophrenics- would exacerbate dopamine levels.
potentiates DA release
◉ What causes aggression/impulsivity/abstract thinking issues in
schizophrenia?.
Answer: abnormal prefrontal cortex, amygdala, basal ganglia,
hippocampus and limbic regions of brain
◉ What type of exercise is best for schizophrenia?.
Answer: aerobic- improves cognition, quality of life and long term
health.
ACT team- case management in the home
◉ High risk of relapse on oral haldol.
Answer: switch to deconate
deconate should be 20x the daily oral dose.
HANDBOOK 2026 PSYCHOPHARMACOLOGY
AND CLINICAL MANAGEMENT
◉ Serotonin syndrome.
Answer: D/C med
cyproheptadine
◉ When switching antidepressenats.
Answer: wait 14 days when SSRI -> MAOI
wait 5-6 wks from fluoxetine to MAOI
wait 2 wks if switching from MAOI -> fluoxetine.
Due to fluoxetine (prozac) having longer halflife.
◉ Triptans
Sumatriptan (Imitrex).
,Answer: don't give w/ antidepressants- increased risk of serotonin
syndrome
◉ If cancer and depressed.
Answer: citalopram/escitalopram
least drug drug interactions
◉ NDRI.
Answer: NE and DA reuptake inhibitor
Wellbutrin
best for those that don't want sexual s/e
depressed, low energy, fatigue- wellbutrin best
contraindicated in hx of seizures or eating disorders (because
electrolyte levels being off can cause seizures)
◉ Chronic Pain and antidepressants.
Answer: SNRI
,Duloxetine (cymbalta)
◉ Fluoxetine (prozac).
Answer: can cause insomnia
take in morning, not evening.
many SSRIs can cause insomnia- take in morning, worst insomnia is
w/ prozac
◉ schizophrenia.
Answer: onset 18-25 M
25-35 F
highest of all mental illnesses to cause thoughts of self harm (SI)
◉ Which disorder causes the highest amount of homicidal ideation
(HI).
Answer: antisocial personality highest
◉ Brain PET scan of schizophrenia.
, Answer: everything decreased in size except ventricles (ventricles
are holes anyway, obviously they are bigger)
◉ Don't given stimulants to:.
Answer: schizophrenics- would exacerbate dopamine levels.
potentiates DA release
◉ What causes aggression/impulsivity/abstract thinking issues in
schizophrenia?.
Answer: abnormal prefrontal cortex, amygdala, basal ganglia,
hippocampus and limbic regions of brain
◉ What type of exercise is best for schizophrenia?.
Answer: aerobic- improves cognition, quality of life and long term
health.
ACT team- case management in the home
◉ High risk of relapse on oral haldol.
Answer: switch to deconate
deconate should be 20x the daily oral dose.
