CuraRN

Drug Cards: Psychiatric Medications

Student study notes from paramedic coursework (2023 to 2024), not medical advice. Verify clinical values against current references and your local protocols.

Doses are general reference values recorded during paramedic training. They are not protocol: follow your local protocols and current drug references. New Jersey EMS doses and approved medications may differ.

EMS drug cards

Common medications in a Psychiatric ED context.

| psychiatric meds | . | . | | —– | —– | —– | | bupropion | depakote | risperidone | trazodone | venlafaxine | |

bupropion

Generic Name:

bupropion

Trade Name(s): Wellbutrin, Zyban

Actions:

Bupropion is an antidepressant medication that belongs to the class of drugs called aminoketones. It works by inhibiting the reuptake of dopamine and norepinephrine in the brain, which helps to increase their levels and improve mood.

Indications:

Bupropion is indicated for the treatment of major depressive disorder and seasonal affective disorder (SAD). It is also used as an aid to smoking cessation.

Contraindications:

Contraindicated in individuals who have hypersensitivity or allergy to the drug itself. It should also be avoided in patients with a seizure disorder, a history of bulimia or anorexia nervosa, or those who are taking or have recently taken monoamine oxidase inhibitors (MAOIs).

Dosage Range:

1xDay 150mg - Max: 300mg

Routes of Administration:

PO

Adverse Reactions:

*[top](#drug-cards-psychiatric-medications)*

depakote

Generic Name:

divalproex sodium

Trade Name(s): Depakote, Depakene.

Actions:

Depakote is an anticonvulsant medication primarily used to treat seizures and bipolar disorder. It works by increasing the levels of gamma-aminobutyric acid (GABA) in the brain, which helps to stabilize the electrical activity of neurons and reduce the occurrence of seizures or mood episodes.

Indications:

Depakote is indicated for the treatment of epilepsy and seizures. It is also used to treat manic episodes associated with bipolar disorder and to prevent migraine headaches.

Contraindications:

Known hypersensitivity or allergy; liver disease or a urea cycle disorder. It should also be avoided in pregnant women due to the increased risk of birth defects.

Dosage Range:

25 mg/kg/day MAX: 60 mg/kg/day

Routes of Administration:

PO

Adverse Reactions:

*[top](#drug-cards-psychiatric-medications)*

risperidone

Generic Name:

Risperidone

Trade Name(s): Risperdal

Actions:

Risperidone is an atypical antipsychotic medication that works by blocking the receptors for dopamine and serotonin in the brain. This helps to regulate the levels of these neurotransmitters, which can improve the symptoms of certain mental health disorders

Indications:

Risperidone is indicated for the treatment of schizophrenia, bipolar disorder, and irritability associated with autism in children and adolescents

Contraindications:

Contraindicated in individuals who have hypersensitivity or allergy to the drug itself. Patients with a history of breast cancer, blood dyscrasias, or a history of neuroleptic malignant syndrome

Dosage Range:

1 - 3 mg/day Max: 6mg/day

Routes of Administration:

PO, IM (long acting)

Adverse Reactions:

*[top](#drug-cards-psychiatric-medications)*

trazodone

Generic Name:

Trazodone

Trade Name(s): Desyrel

Actions:

Trazodone is an antidepressant medication that belongs to the class of drugs called serotonin antagonist and reuptake inhibitors (SARIs). It works by blocking the reuptake of serotonin in the brain, which helps to increase its levels and improve mood.

Indications:

Trazodone is indicated for the treatment of major depressive disorder, and insomnia.

Contraindications:

Contraindicated in individuals who have hypersensitivity or allergy to the drug itself. It should also be avoided in patients with a history of priapism, as well as those taking monoamine oxidase inhibitors (MAOIs) due to the risk of serotonin syndrome.

Dosage Range:

The dosage of trazodone may vary depending on the condition being treated and the individual’s response to the medication. For major depressive disorder, the initial dose is typically 150 mg per day, which may be increased gradually up to 600 mg per day. For insomnia, the recommended starting dose is 25 to 50 mg at bedtime, which may be increased to a maximum of 150 mg per day.

Routes of Administration:

PO

Adverse Reactions:

*[top](#drug-cards-psychiatric-medications)*

venlafaxine

Generic Name:

Venlafaxine

Trade Name(s): Effexor

Actions:

Venlafaxine is an antidepressant medication primarily used to treat major depressive disorder (MDD), anxiety disorders, and panic disorder. It belongs to the serotonin-norepinephrine reuptake inhibitors (SNRIs) class, which work by increasing the levels of serotonin and norepinephrine in the brain.

Indications:

Venlafaxine is indicated for the treatment of major depressive disorder, anxiety disorders, and panic disorder. It is also commonly used as a smoking cessation aid.

Contraindications:

Contraindicated in individuals who have hypersensitivity or allergy to the drug itself. It should also be avoided in patients with uncontrolled narrow-angle glaucoma, and it is not recommended for use in children and adolescents under 18 years of age.

Dosage Range:

BID/TID - 150-225 mg/day Max: 375 mg/day

Routes of Administration:

PO

Adverse Reactions:

nausea, headache, dry mouth, dizziness, insomnia, nervousness, constipation, sexual dysfunction, decreased appetite, increased blood pressure, abnormal bleeding, seizures, serotonin syndrome, and suicidal thoughts or behaviors.