MEDICATIONS FOR DEPRESSION, ANXIETY,
AND OBSESSIVE-COMPULSIVE DISORDER (Part I)

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Group Main Use	Medication Brand/Generic	Form	Dose Schedule	Dose Range	Most Common Side Effects for Group	Pros for Group	Cautions for Group
SRI Serotonin Reuptake Inhibitors (depression, anxiety,OCD, panic)	Prozac (fluoxetine)	capsule 10 mg, 20 mg, 40 mg, 90 mg/weekly tablet, scored 10, 20 mg liquid 20 mg/5cc	usually a.m.	Child: 5-20 mg Adoles: 10-40 mg Adults: 20-80 mg	Increased energy which may be pleasant or feel like anxiety, agitation or irritabliity. Zoloft and Paxil may sedate (rarely Prozac), Luvox most likely to sedate. Celexa and Lexapro are the most neutral, regarding energy. Decreased appetite, sometimes with nausea. Less if taken with food. With time, weight may increase. 25-40% experience decreased sex drive or response. Less common for group: increased urinary frequency, dry mouth or sweating, vivid dreams.	Once a day. Very good safety profile. No labs, no EKG typically needed. No, or few, heart side-effects. Few significant interactions except increases tricyclic antidepressant blood levels. Zoloft and Celexa lowest interactions. Excellent for mild, moderate and severe depressions and anxiety disorders including panic, mixed, obsessive compulsive, post traumatic stress and atypical types. May help temper and impulsivity. Very low risk in overdose. Reportedly, low risk in pregnancy and breast feeding. SRI side effects (as with most meds) often lessen with time. All SRI's  are available as generic and are very inexpensive. Prozac available in once a week form. All SRI help PMS and perimenopausal symptoms. Lexapro is a refined isomer version of Celexa.	Any SRI, especially Prozac, may agitate or disinhibit if excess energy occurs. Switch to evening if sedation occurs. Takes 1-3 weeks to begin to help and 1-3 months for maximum effect. Avoid combination or overlap with MAOI as with all antidepressants. Discontinuation syndrome (nausea, dizziness, "flu-ish," "out of sorts") may occur if stopped suddenly without taper or skip one or several days. Not dangerous, but unpleasant. More likely with Paxil or Effexor, not with Prozac because it lasts longest. Can occur with any SRI, SNRI, or TCA. FDA Caution: advise monitor for rare increased suicidal thoughts or behavior especially in kids when first starting medicine (age 24 and under).. Celexa max dose now 40 mg to avoid possible heart rhythm effect.
	Zoloft (sertraline)	tablet, scored 25 mg, 50 mg, 100 mg liquid 20mg/cc (100mg=5cc)	usually a.m.; evening if sedation	Child: 25-50 mg Adoles: 50-200 mg Adult: 50-200 mg
	Paxil (paroxetine) Paxil CR	tablet, scored 10 mg, 20 mg, 30 mg, 40 mg  liquid 10mg/5cc 12.5, 25, 37.5 mg	usually a.m.,evening if sedation	Child: 5-30 mg Adoles: 10-40 mg Adult: 10-60 mg
	Luvox (fluvoxamine) Luvox CR	tablet, scored 25, 50, 100 mg Extended release capsules 100, 150 mg	often twice a day evening if sedation once a day	Child: 25-200 mg Adoles: 50-200 mg Adult: 100-300 mg 100-300 mg
	Celexa (citalopram) Lexapro (escitalopram)	tablet, scored 10, 20, 40mg liquid 10mg/5cc tablet, scored 5, 10, 20 mg liquid 5mg/5ml	usually evening if sedation morning or evening	Child: 5-20mg Adoles: 10-40mg Adult: 10-40mg Child: 5-10mg Adoles: 10-20mg Adult: 10-30mg
Viibryd (depression)	vilazodone	Tablets 10, 20, 40mg	Usually evenings or AM with food	Adoles: 10-20mg Adult: 10-40mg	diarrhea, nausea, similar to SRI, sedation	Has SRI and 5HT-1A actions. Thus may have slightly broader action. Brand only	Unclear, if any better than other SRI options. Newer and thus shorter track record
Trintellix (depression)	Trintellix vortioxetine	Tablets 5, 10, 15, 20mg	Usually once a day start 5-10 mg	Adult: 10-20mg	Nausea, GI, similar to SRI	Has SRI, 5HT-1A and additional serotonin actions. Thus slightly broader actions. Brand only. Was known as Brintellix.	Unclear, if any better than other SRI options. Newest and thus less experience.