Inhalant-Related Psychiatric Disorders Medication

Updated: Feb 19, 2019
  • Author: Guy E Brannon, MD; Chief Editor: Ana Hategan, MD, FRCPC  more...
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Medication

Medication Summary

If psychosis or delirium is present, use an antipsychotic such as risperidone or haloperidol and/or an anticonvulsant such as carbamazepine. Avoid benzodiazepines because they may worsen respiratory depression.

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Antipsychotics

Class Summary

Reduce psychosis and aggressive behavior. All antipsychotics may be equally efficacious, but their adverse effect profiles are different. The atypical antipsychotics such as risperidone, olanzapine, quetiapine, and ziprasidone have an advantage in the adverse effect profile, especially with their lower risk to cause adverse extrapyramidal effects and tardive dyskinesia.

Haloperidol (Haldol)

Indicated for psychosis, also to treat motor and vocal tics in children and adults.

Risperidone (Risperdal)

Binds to dopamine D2 receptor with 20-times lower affinity than 5-HT2–receptor affinity. Improves negative symptoms of psychoses and reduces incidence of adverse extrapyramidal effects.

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Anticonvulsants

Class Summary

Usually used to treat seizures but have been used for treatment of manic-depressive symptoms and behavioral agitation. Other anticonvulsants such as valproic acid (Depakene) or divalproex sodium (Depakote) may also be as effective as carbamazepine.

Carbamazepine (Tegretol)

Used to treat epilepsy and trigeminal neuralgia.

Valproic acid (Depakote, Depakene)

Although mechanism of action is not established, activity may be related to increased brain levels of GABA or enhanced GABA action. Valproate also may potentiate postsynaptic GABA responses, affect potassium channel, or have a direct membrane-stabilizing effect.

Has proven effectiveness in treating and preventing mania. Classified as a mood stabilizer and can be used alone or in combination with lithium. Useful in treating patients with rapid-cycling bipolar disorders and has been used to treat aggressive or behavioral disorders. A combination of valproic acid and valproate (ie, divalproex [Depakote]) has been effective in treating persons in manic phase, with a success rate of 49%.

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