SOMATIC TREATMENT

CLASSIFICATION OF PSYCHIATRIC DRUGS

ANTI – PSYCHOTICS

Antipsychotic drugs are used in the treatment of psychotic disorders and psychotic symptoms. These medicines are also known as major tranquilizers, neuroleptics, anti-schizophrenic drugs and D2 receptors. It is currently believed that these are the  most effective in the treatment of psychosis due to their action on D2 receptors. Major antipsychotic medicines are trifluoperazine, chlorpromazine, risperidone, clozapine, ziprasidone, aripiprazole, amisulpride, haloperidol, quitepine, paliperidol…etc.

These medicines can be administered orally, intra-venously (I/v) and intra-muscularly (I/m). The antipsychotic drugs are highly lipophilic and highly protein bound. They easily enter the areas of rich blood supply like the brain, kidneys, lungs and fetus. Half life periods of antipsychotics are long and a small dose per day can produce sustained therapeutic blood levels.

Most of the antipsychotic have one therapeutic window. If the blood level is below this ‘window’ the drug is ineffective. If it is higher than an upper limit, there is toxicity and it is equally ineffective.

Now, mostly, we use second generation antipsychotics, known as atypical anti-psychotics. These drugs are effective and do not produce undesirable extra pyramidal side effects [EPS], and do not cause fluctuation in the Serum Prolactin levels. Atypical anti-psychotics are effective on the positive symptoms, as well as it is believed to be effective in the treatment of negative symptoms.                                 

ANTI – DEPRESSANTS

These are used in the treatment of depressive disorders. These are also known as mood elevators and thymoleptics. Some studies say that its predominant action is to help to increase the catecholamine levels in the brain (Amine hypothesis). The tri-cyclic anti depressants are also called mono amine reuptake inhibitors. Its action is:

1.      Blocking the reuptake of Nor Epinephrine (NE), Serotonin (5HT) and/or Dopamine (DA) at the nerve terminals, thus increasing the NE, 5HT and DA levels at the receptors site.

2.      Down regulation of the beta- adrenergic receptors.                               

The antidepressants are amitryptiline, notriptyline, fluoxetine, fluoxamine, citalopram, escitalopram, sertaline, mirtazepine…etc.

The antidepressants are also like anti psychotics, highly lipophilic and highly protein bound. They tend to accumulate in areas with rich blood supply.

MOOD STABILIZING DRUGS

These drugs are effective as prophylactics in Recurrent Affective Disorders and in treating Acute Mania. The three main drugs used are Lithium, Carbamazepine and Sodium Valporate.

1.     Lithium

Lithium has been found useful in treating depression and bipolar mood disorders. The preparation mostly utilized is carbonate, though citrate and acetate are also equally effective. Lithium is absorbed rapidly after oral doses. Apart from acute mania and bipolar disorders, lithium is useful in other conditions like impulse control disorders, aggressive behavior and periodic drinking. Lithium along with anti depressants is better than either of them alone. During the treatment, it is essential to estimate blood lithium levels at regular intervals. The blood sample for estimation is taken 12 hours after the last lithium dose. If any changes are made in the dosage, the next blood level is estimated after at least 7 days of the last change. 

2.     Carbamazepine

This tri-cyclic compound was synthesized in 1953 by Schindler. The onset of action is faster as compared to lithium, but slower compared to valporate. The treatment is best monitored with repeated blood tests. The administration is oral.  Toxic blood levels are reached at more than 15 mg/ml.

3.     Valporate

Valporate and lithium have been widely used as the main drugs for the treatment of Mania and for the pophylaxis of bipolar mood disorder. Available forms of valporate are:

i.         Valporate Sodium

ii.       Divalproex (enteric-coated stable co-ordination compound composed of sodium valporate and valporic acid in a 1:1 molar relationship)

iii.     Chrono preparations (enteric-coated compound composed of sodium valporate and valporic acid in a 3:2 ratio)

It is administered orally. The usual dose of valporate is 1000-3000 mg/day, orally, in divided doses. Oral administration is effective in the management of acute mania.

Valporate is mainly used in the treatment of bipolar disorders, neurological disorders (migraine and pain syndromes, seizure disorders) and in disorders like Attention Deficit Hyperactivity Disorder (ADHD) and conduct disorders, several behavioral symptoms in mental retardation, Schizoaffective Disorders (bipolar type), alcohol withdrawal, tardive dyskinesia, impulse control disorders, panic disorders and border line personality disorders.

ANTI – ANXIETY DRUGS

These drugs are also known as Minor Tranquilizers and Anxiolytics. It is classified as:

1.     Barbiturates

Barbiturates are the derivatives of barbituric acid which was first synthesized in 1862. It is one of the old psychiatric drugs, but physical dependence and withdrawal symptoms made them unpopular. It can be divided into four main types:

a.       Long Acting: The duration of action is more than 8 hours.

b.      Intermediate Acting: The duration of action is 5-8 hours.

c.       Short Acting: The duration of action is 1-5 hours.

d.      Ultra-Short Acting: The duration of action is less than 1 hour.

Barbiturates can produce side-effects like excessive sedation, respiratory and circulatory depression, withdrawal symptoms, dependence… etc.

2. Non-barbiturate, Non- benzodiazepine Anti-anxiety Agents

3.  Benzodiazepines

Presently benzodiazepines are the drugs of first choice in the treatment of anxiety and for the treatment of insomnia. They are anxiolytic and sedative and in high dose act as hypnotics. They also have muscle relaxant and anti convulsive properties. Administration is through the oral route. Because of their lipophilic nature they readily pass into the brain resulting in a rapid onset of effects. They are mainly used in the treatment of anxiety disorders and where anxiety is a predominant symptom. They are also used in insomnia, phobias, panic disorders, akathesia, tardive dyskenesia and in withdrawal symptoms.

Physical and psychological dependence may develop along with withdrawal symptoms. High potency benzodiazepines can produce dependence and withdrawal symptoms. These can be reversed by the reintroduction of benzodiazepine in smaller doses.

4.  Buspirone

An antianxiolytic drug, it does not seem to act on the benzodiazepine receptors. It is anxioselective, with no sedative action, and no anticonvulsant or muscle relaxant properties. It is a non-diazepine, anti-anxiety drug. It is administered in a dose of 15-30 mg/day, in a thrice daily schedule due to a short half life. It is safe in the brain injured and elderly patients. The effects start after 2-4 weeks. Side effects are headache, nausea, dizziness and occasionally insomnia.  

5.  Zopiclone                       

Zopiclone belongs to a new class of non- benzodiazepine drugs. It is a short acting hypnotic compound which maintains sleep architecture better than benzodiazepine. Risk of dependence is low. Confusion, amnesia and depressed mood are some of its adverse symptoms.

ELECTRO – CONVULSIVE THERAPY (ECT)

Two Italian Psychiatrists, Cerletti and Bini first used ECT as an effective treatment for psychiatric disorders. In the present era, statistics reveal that it is an effective, specific and quick mode of management of serious psychiatric disorders.

E C T’s are Effective in the Case of:

Major Severe Depression

a.       with suicidal risk

b.      with stupor

c.       with poor intake of food and fluids

d.      with melancholia

e.       with psychotic features

f.        with unsatisfactory response to drug therapy

g.       where drugs are contraindicated, or have serious side effects

h.      where speedier recovery is needed

Severe Catatonia (Non-Organic)

a.       with stupor

b.      with poor intake of food

c.       with unsatisfactory response to drug therapy

d.      where drugs are contraindicated, or have serious side effects

e.       where speedier recovery is needed

Severe Psychosis (Schizophrenia or Mania)           

a.       with risk of suicide, homicide or danger of physical assault

b.      with unsatisfactory  response to drug therapy

c.       where drugs are contraindicated, or have serious side effects

d.      with prominent depressive features

E C T is usually administered in the morning after an overnight fast. No oral medication should be given in the morning. The bladder and bowel should be emptied just before the treatment, because incontinence can occur during the induced seizure. Tight clothing and metallic and sharp objects should be removed from the person’s body.  The total duration of treatment given depends on the diagnosis, presence of side effects and the response to the treatment. Usually 6-10 ECT’s are sufficient. Up to 15 can be given if required.

COMMON PSYCHIATRIC DRUGS USED IN THE TREATMENT OF VARIOUS MENTAL ILLNESSES

Anti Psychotics

Olanzapine = Oleanz, Olimelt, Meltolan

Risperidone = Risdone, Peridone

Risperidone 2 mg + Trihexyphenidyl 2mg = Risdone LS

Risperidone 3 mg + Trihexyphenidyl 2 mg= Risdone plus,

Risperidone 4 mg + Trihexyphenidyl 2 mg= Risdone Forte.

Haloperidol = Trancodol DT, Serenace, Halocer

Trifluoperazine =Trinicalm, Relicalm

Trifluoperazine 5 mg + Trihexyphenidyl 2 mg + Lacalm Plus, Neocalm Plus, Trazine –S

Trifluoperazine 5 mg + Trihexyphenidyl 2 mg + Chlorpromazine 50 mg=Neocalm Forte,

                                                                                                               Lacalm Forte, Trazine SC

Thioridazine = Tenzaril, Thioril

Pimozide = Mozep, Larap, Rzep

Chlorpromazine = Emetil, Zicot

Quetiapine = Qutan, Quel

Ziprasidone = Zipsydon

Aripiprazole = Aspirito, Arpizol

Clozapine = Skizoril, Sizopin

Amisulpride= Soltus, Sulpitac

Levosulpiride = Nexipride, Levipride

Paliperidone ER = Palido – OD 3

Flupenthixol Decanote – Fluanxol Depot, Spenzo Depot

Zuclopenthixol Decanote – Clopixol Depot

Haloperidol Decanote 50 mg = Senoram LA, Relinase LA

Fluphenazine Decanote = Prolinate, F-Tensil

S+P+C = Serenace5mg + Phenergan 50 mg + Calmese 4 mg = Trancodol + Phenergan   + Lopez

Anti Depressants

Sertaline = Sertima, Serta

Amitriptyline = Amitone, Sarotena.

Imipramine = Depsol, Depranil

Mirtazepine = Mirnite, Mirtaz                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            

Nortriptyline = Sensival, Primox.

Fluoxetine = Flunil, Fludac

Clomipramine = Clonil, Clomip

Trazodone = Trazonil, Trazaril

Escitalopram – Rexipra, Nexito

Paroxetine – Pexep CR, Pexidep

Duloxetine – Duvanta, Duzac

Etizolam = Etilam

Modafinil = Modafil, Modalert

Anti – MDP Drugs

Lithium Carbonate = Lithosun, Lithoril, Intalith

Oxcarbazepine = Oxetol, Zenoxa.

OCD Treatment

Fluvoxamine = Frext, Fluvoxine

Clomipramine = Clonil, Clomip

Buspirone = Buscalm, Buspin

Anti Convulsants

Sodium Valporate = Valprol CR, Valrate CR, Encorate Chrono

Carbamazepine = Oxetol, Zenoxa

Hydantoins = Eptoin (Phenytoin Sodium), Epsolin (Phenytoin Sodium)

Pregabalin = Pregabid

Clonazepam = Zapiz, Clonotril, Lonazep

Clobazam = Cloba, Frisium

Gabapenntin = Gabapin, Gabantin

Lamotrigine = Lamez and Lamepil, Lamosyn

Topiramate = Topaz, Topirol

Divalproex = Divaa (OD) Depakote, Valkem (OD)

Levetiracetam = Epictal

Sedatives and Tranquilizers

Diazepam = Valium, Calmpose

Alprazolam = Restyl, Zolax SR

Zolpidem = Zolway, Nitrest, Sove

Eszopiclone = Fulnite, Just sleep

Chlordiazepoxide = Librium, Calmtech

Oxazepam = Serepax

Buspirone = Buscalm, Buspin

Lorazepam = Lopez, Ativan, Lorel, Orazep

Zaleplon = Zaplon

Anxiolytics

Alprazolam = Restyl, Zolax

Lorazepam = Lopez, Ativan, Lorel, Orazep

Nitrazepam = Nitrosun, Nitravet

Hypnotics

Nitrazepam = Nitrosun, Nitravet

Diazepam = Valium, Calmpose

Zopiclone = Zona,

Drugs controlling Rigidity and Tremors

Lecodopa = Levopa

Carbidopa = Syndopa 110, Levopa – C

Tetrabenazine = Revocon

Ropinirole = Ropark, Ropitor

Bromocriptine = Encript

Amntadine = Amentrel

Drugs used for treating Migraine

Propranolol = Inderal, Provnol

Ergatomine = Vasograin

Sumitriptan = Suminat

Cerebral Activators

Piracetam = Ceracetam, Nootropil

Pyritinol = Encephabol

Donepezil = Alzil, Donecept (Treatment of Alzhemer’s disease)

Nimodipine = Nimotide

Galantamine = Galamer (Treatment of Alzhemer’s disease)

Atomoxetine Hydrocloride = Attentrol, Axepta (Treatment of ADHD)

Memantine = Nemeda, Admenta (Treatment of Dementia)

Anti Parkinsonism

Procyclidine = Dine

Trihexyphenidyl Hcl = Pacitane, Bexol, Dyskinil (Parkinsonism, Drug induced EPS, Spasticity)

Carbidopa = Syndopa 110, Levopa – C

Anti Emetics

Ondansetron = Emset

Promethazine = phenergan

Withdrawal Management

Stoppage of addictive substances produce mild to severe withdrawal symptoms  (depends on the drug, duration and amount) like tremors, sweating, tachycardia, Palpitations, Hyperplasia, high blood pressure, nausea and vomiting, sleeplessness, depression etc …. Withdrawal seizures also may occur in 5 to 10% of patients.

The drugs used for withdrawal management:

a.       Alcohol Withdrawal

Benzodiazepines:

Chlordiazepoxide = Librium

Diazepam = Valium

Lorazepam = Lopez

Clonazepam = Zapiz

Alprazolam = Restyl

b. Opioid Withdrawal

Benzodiazepines

Clonidine = Arkamin

Vitamin Tablets: Thiamine = Benalgis

Vitamin B 12: B complex with vitamin C = Cobadex Forte

IV Fluids = RL, DNS, NS

Vitamin injections: Inj. Opti neuron; Inj. Neurobion; Inj. MVI (Multi Vitamin Injections)

PSYCHIATRIC DRUGS AND THEIR INDICATION

ALPRASOLAM

Indication: Anxiety disorder, Agoraphobia, Panic disorder, Depression.

Brands: Alap, Albiz, Alcalm, Alep, Alltop, Alpra, Alprasolam, Alprose, Alprax, Alpronit, Alama, Alzolam, Anxit, Benzolam, Kalm, Loral, Procalm Restyl, Recalm, Zeprax, Zolax, Zolm X R, Zopic, Zozo.

AMISULPRIDE

Indication: Sulpitac is indicated in acute and chronic Schizophrenia disorders, in which positive symptoms (such as delusions, hallucinations, and thought disorders) and/or negative symptoms (such as blunted affect, emotional and social withdrawal) are prominent, including patients characterized by predominant negative symptoms.

Side-effect: The most commonly reported adverse effects with amisulpride include insomnia, anxiety and agitation. The other commonly reported adverse effects include somnolence, gastrointestinal disorders such as constipation, nausea, vomiting, dry mouth, weight gain.

Brands: Sulpitac, Soltus, Amazeo, Amival, Amigold.

AMITRIPTYLINE H C L

Indication: Major Depression. May be used in anxiety and sleep disorders and in case of migraine also.

Brands: Amit, Amitone, Amitryn, Tryptomer, Amixide, Limbival, Mitryp, Normaline, Serotena.

ARIPIPRAZOLE

Indication: Psychoses like Schizophrenia.

Side effect: The most commonly reported adverse effects are headache, asthenia, fever, nausea, vomiting, constipation, anxiety, insomnia, lightheadedness, somnolence, akathisia, tremor, rhinitis, coughing, rash and blurred vision.

Brands: Aria, Aridus, Arilan, Aripra, Aripra MT, Arrive, Arole, Arza, Arpizol, Asprito, Elrip, Pipra–A, Real one.

BUSPIRONE

Indication: Mild to moderate Anxiety disorders, not useful in severe anxiety.

Brands: Buscalm, Buson, Buspidac, Buspn, Tamspar.

CLOBAZAM

Indication: Used as an adjuvant in partial seizures secondary generalized tonic clonic seizures, absence, myoclonic seizure same cases of refractory epilepsy and Lennox gestaut. syndrome.

Brands: Aedon, Cloba, Clodus, Clozam, Gabaplus, Frisium, Lobazam, Zae.

CLONAZEPAM

Indication: Absence seizure, as an adjuvant in myoclonic and akinetic epilepsy acute mania, status epileptics and infatilespasmas.

Brands: Aspax, clonapx, Clonotril, Clozep, Epcan, Cerona, Zicam, Epizam, Lonazep, Lozep, Norep, Anza, Onzepam, Petril, Rivotril, Zozep.

CLOMIPRAMINE H C L

Indication: Depression, Panic states and Obsessive compulsive disorders.

Brands: Anafranil, Clofranil, Clomilent, Conil, Clamip, Clomizil, Depnil, Syconil.

CITALOPRAM

Indication: Depression. May be useful in Stress disorders and Panic disorders.

Brands: C - pram, C- tralo, C - talop, C itopam, Lopram, Zetalo.

CHLORDIAZEPOXIDE

Indication: Anxiety disorders, Management of Alcohol withdrawal, Psychosomatic disorders, Phobias.

Brands: Anxizide, Cloxide, Eelibrium, Librium, Amitryn, Amixide, Amixide–H, Andep, Chlozep, Libotryp, Libral, peacep, Raipex, Sidep, Spasrax, Tribs, Trisar, Trixia

CARBAMAZEPINE

Indication: It is the most effective drug for complex partial seizures also used in simple partial and generalized tonic; clonic seizure may be used in an alternative to lithium in bipolar and maniac disorder. Other uses trigeminal, post herpetic and related neurolgaos, painful diabetic neuropathy and withdrawal syndrome.

Brand: Acetol, Biocarb, carbatol, Epinil, Mezapin, Mazetol, Tegrital, Zen, Zen Retard, Zeptol,

CLOZAPIN

Indication: Schizophrenia refractory psychosis, bare live dyes kinesia.

Brands: Chrozap, Clomach, Ekloz, Korans, Losapin, Clocer, Lozine, Pyne, Sizopin, Skizoril, Syclop, Zepin, Zopizone.

CHLOPROMAZINE

Indication: Schizophrenia organic brain syndrome, Affective disorders, Paranoid states, a typical psychosis, Mania, Hypomania, Emesis and Intractable bicoug. Rarely used in tetanus.

Brand: Chlorpromazine, Colzine, Emetil, Korzine, Megatil, Reletil, Serectil, Sunparzin, Tranchlor, Clozine plus, Normazine plus, Normazine – H.

CLONIDINE H C L

Indication: Hypertension of all grades. Also used for symptomatic relief in Opioid withdrawals, Alcohol withdrawals and Smoking cessation.

Brand: Arakamine, Catapres, Clothalton.

DULOXETINE

Indication: Duloxetine is indicated for the treatment of Major Depressive Disorders in adults.

Brands: Duvanta

DIAZEPAM

Indication: Anxiety, Tension, Insomnia, Psychosomatic disorders, Behavioral disorders, Acute alcohol withdrawal syndrome, Psychoneurotic states, Preoperative medication adnunt for relief of muscle sprain, associated with cerebral palsy, spastic hemiplegia, athetosis, paraplegia, febrile convulsions in children.

Brands: Anxol, Calmoid, Calmpose, Camrelease-TR, Diaze, Direc, Diazep, Dizepax, Junix, Neone smar, Nupose, Paxum, Valium, Zeporos.

DIVALPROEX SODIUM (Extended Release tablets)

Indications: Diproex ER is indicated as monotherapy and adjunctive therapy in the treatment of adults and children 10 years of age and older with complex partial seizures that occur either in isolation or in association with other types of seizures. It is also indicated for use as sole and adjunctive therapy in the treatment of simple and complex absence seizure in adults and children 10 years of age and older and adjunctively in adults and children 10 years of age and older with multiple seizure types that include absence seizure.

Side-effect: Nausea, Dyspepsia, Diarrhoea, Vomiting, Abdominal pain, Respiratory infection, Somnolence, Infection, Increased appetite, Weight gain, Peripheral edema, dizziness, insomnia, nervousness, abdominal thinking, tremor, tinnitus, headache, asthenia, fever, anorexia, constipation, phryngits, rhinitis, dispenia, diplopia, bronchitis, alopepsia, weight loss, thrombocytopenia and depression.

BrandS: Diva, Divalpro, Depakote, Valkem (OD), Dayo Dilex Diproex

DONEPEZIL

Indication: Alzheimer’s disease.

Brand: Alzil, Donecept, Donep, Depezil.

ESCITALOPRAM

Indication: Cipralex is used for the treatment of depression. Depression is characterized by low/depressed mood, lack of energy, feeling low, feelings of little or no worth, disturbances in sleep, withdrawn and unable to cope with daily activities.  Depression may also be accompanied by suicidal thoughts.  Depressed patients may further suffer from symptoms of anxiety.

Side-effects: Commonly seen are nausea, Sinusitis (blocked or running nose) decreased appetite, difficulties falling as sleep, feeling sleepy, dizziness, yawning, diarrhea, constipation, increased sweating, sexual disturbances ejaculation, problems with erection, decreased sexual drive and women may experience fatigue and fever.

Brands: Celexeis, Deplam, Escitapax, EsdepEstomin, Rexipra, Ndexito, Stalopam, Zotalr, Cipralex, Feliz – s

FLVOXAMINE

Indication: Major depression, Anxiety states specially obsessive compulsive disorder and bulimia nervosa, also panic disorder and other which don’t require sedation catalepsy, narcolepsy.

Brands: Caddy, Depzac, Fadep, Faxtine, Fludac, Flood, Flunac, Flutine, Flunil, Flux, Fluxal, Mentol, Platin, Oxidep, S.R.B, Trizae, Xetine, Frext.

GBAPENTIN

Indication: Used in addiction to other drugs for treatment of partial seizure or without generalization. Especially in refractory cases. It is also being used in chronic pain, migraine and bipolar disorder.

Brands: Gabalept, Gabantin, Gabapin, Gabata, Gabatol Neuropin, Neurotin.

HALOPERIDOL

Indication: Psychosis like Schizophrenia, Acute mania, Gilles deia tourette syndrome and Huntington disease.

Brands: Halocer, Benzydol, Mindwel, Combidol, Depidol, Halo, Halopace, Halopidol, Hexidol, Mindol, Normadol, Peridol, Relinace, Schizol, Serenace, Senoram, Tendol, Trinace, Trinoram, Trancodol.

LOXAPINE

Indication: Schizophrenia

Brands -Loxapac, Loxabol

LITHIUM CARBONATE

Indication: Acute mania, Recurrent bipolar disorders, adjuvant to antidepressants in severe recurrent depression and in selected cases of hypothyroidism.  In appropriate ceoretion of ADH and drug induced leukopenias.

Brands: A-lith, Alkalith, Carbolith, Cylith, Elceb, Genlith, Hethium, Intalith, Licab, Lithium, Lithocep, Lithosun, Loponet, Manicarb, Monolith, Prolithium, Salith, Zecarb

LEVOSULPRIDE

Indication: Nexipride is indicated for the treatment of Schizophrenia.

Side effects: with prolonged administration of levosulpride, disturbances such as amenorrhea, gynecomastia, galactorrhea, hyperprolactinemia and changes in libido are observed; in particular cases, reversible effects of levosulpride on functioning hypothalamic pituitary gonadol axis are observed.

Brands: Nexipride.

LORAZEPAM

Indication: Anxiety disorders, Preanesthetic medication, Relief anxiety, (it is similar to diszepam in action)

Brands: Almazine, Anxipose, Antipam,Ativan, Benj, Biokalm, Biclar, Calmes, Lorpose, Lopez, Lorazine, Lerolel, Cerpam, Loripam, Lorivan, Olrav, Trapex, Zepnap.

MAGNESIUM VALPROATE Enteric-Coated Tablets

Indication: Epilepsy (generalized and partial seizures, as monotherapy or adjunctive therapy), Mania, Migraine

Brands: Macorate

METADOXINE

Indication: Peripheral, Drug induced, Diabetic and Alcoholic neuropathies.

Brand: Alcoliv, Atnuron, Cobalvit, Varnuron, Zonuron.

MIRTAZEPINE

Indication: Depression

Brands Maitz, Mirnite, Mirfe, Mirtaz, Mitazep-15, Nasdep, Zipdep

MODAFINIL

Indication: Modafil is indicated to improve wakefulness in patients with excessive daytime sleepiness associated with narcolepsy, obstructive sleep apnoea or hypopnoea syndrome.

Side effect: The most commonly reported adverse effect of modafinil is headache, chest pain, abdominal pain, tachycardia, palpitation, vasodilatation, dry mouth, diarrhea, decreased appetite, dyspepsia, constipation, dizziness, depression, abdominal thinking, confusion, paresthesia, hypertonia and blurred vision.

Brands: Modalert, Modafil,

NITRAZEPAM

Indication: short term treatment of Insomnia.

Brands: Baronite, Dormina, Hypnonexy, Hypnoril Hypnotex Insomin Forte, Nipam, Nigap, Nitravet, Nitraz SR, Nitrosun

NORTRIPTRYLINE H C L

Indication: All types of Depression, also used in phobias and panic disorders, noctomal enuresis in children, chronic pain and sleep disorders in adults.

Brands: Nordep, Nortin, Primox, Seemin, Sensival, Trip.

NALTREXONE

Indication: Opioid dependence as adjunct alcohol dependence.

Brands: Naltima

NEMDAA (MEMANTINE Hydrochloride Tablets)

Indications: Nemda is indicated for the treatment of moderate to severe dementia of the Alzheimer’s type.

Side effect: Urinary incontinence, diarrhea, insomnia, dizziness, headache, coughing, hallucination, fall, constipation, vomiting, back pain, dyspnea, confusion, urinary tract infection, hypertension, nausea and anorexia.

Brands: Admenta

OLANZAPINE (Mouth Dissolving tablet)

Indication: Schizophrenia, Mood disorders.

Brands: Biolance, Cansern, Joysol, Meltolam, Normapac, Olance, Ola, Olan, Olandus, Olanex, Olanz, Olanzep, Olapax, Olay, Oleanz, Olina, Ozap, Pitol, Schizol, Skyzol, Zepol, Zyolan, Zypine.

OXCARBAZEPINE

Indication: Used in an adjuvant in partial seizure in adults and children with or without secondary generalized toxic, clonic seizure.

Brands: Carbox, Mezalog, Oleptal, Oxana, Oxcarb, Oxeptal Oetol Zenoxa, Selzic.

PALIPERIDONE Extended Release Tablets

Indication: Acute and maintenance treatment of Schizophrenia

Adverse Reaction: Headache, increased appetite, drowsiness and sedation

Brands: Palido OD, Paliris

PROPRANOLOL HCL

Indication: prophylaxis of moderate to sever migraine.

Brands: Betacap – Tr Betabloc, Ciplax, Corbeta, Inderal, Propsr, Pral, Prop 40, Propal, Trilol, Migrabeta.

PROCYCLIDINE

Indication: They are synthetic anticholinergic drugs, having higher cerntral, peripheral, anticholinergic action.  Parkinson’s disease.

Brands: Dine, Kemadrni.

PROMETHAZINE HCL

Indication: Antimetic, antihistamine and sedative. It is prescribed in the treatment of mention sickness, nausearhinitis, Itching and skin rashes.  It can be used as preanesthetic medication in early stages of Parkinsonism and acute muscle dystonia.

Brands: Avamin, Emin, Emispar, Fevril, Metacef, Phena, Phenargan, Phenmol, Phenzee, Primozyn, Promogum.

PENFLURIDOE

Indication: Chronic Schizophrenia

Brands: Flumap, Sernap

PAROXETINE

Indication: Used in Depression, Obsessive compulsive disorders and Panic disorders.

Brands: Madofine, Parof, Panex, Pari, Parotin, Pexep, Raxip, Xef.

PIMOZIDE

Indication: Touretts syndrome severe tics and involuntary vocalization. Also in chronic Schizophrenia and Mania.

Brands: Larap, Medip, Monozide, Mozep, Nearap, Orap, Pimodac, R-Zep.

PREGABALIN Capsules

Indication: Neuropathic pain, postherpetic neuralgia and as adjunctive therapy in the treatment of Partial Seizures.

Brands: Pregabid

QUETIAPINE FUMARATE

Indication: Schizophrenia and other psychosis

Side-effect: Somnolence, hypotension, head ache, asthenia, abdominal pain, constipation, dry mouth, rash.

Brands: Qutipine, Q-minde, Placidine, Quel, Q-pin, Qutace, Qutan, Quticol, Qutipin, Sizoquit, Focalm.

QUETIAPINE S R (Sustained release)

Indication: Quetiapine fumarate sustained release tablets are indicated for the treatment of schizophrenia.

Side effect: Body as a whole Head ache pain, asthenia, abdominal pain, back pain and fever. Cardiovascular tachycardia and postural hypotension.

Digestive Dry mouth, constipation, vomiting, dyspepsia, gastroenteritis and increased gamma glut amyl transpeptidase.

Brands: Quel S R

REBOXETINE

Indication: Depression

Brands: Reboot, Rebotin, Reboxine

RESPERIDONE

Indication: Schizophrenia

Brands: Genrest, Neudon, Reridon, R-Don, Rasin, Respid, Respimed, Riscan, Respidon, Risper, Rize, Sizodon, Zisper, Peridone.

RIVASTIGMINE Capsules

Indications: Mild to moderate severe dementiaof the Alzheimer’s type

Side-effects: Nausea, vomiting, anorexia, dyspepsia, asthenia, dizziness, somnolence and weight loss.

Brands: Rivamer

SERTRALINE

Indication: Used in treatment and prophylaxis of depression. Also used in anxiety states like obsessive compulsive disorder and panic disorder.

Brands: Actiser, Episod, Inosert, Daxid, Depsert, Insert, Lindep, Normast, Serlift, Serve, Serline, Seron, Serta, Sertima, Setal, Setaline, Setex, Sertaline, Traline, Zolofit, Zotral, Lincer.

SODIUM VALPORATE

Indication: Absence of seizure and as an adjuvant drug for generalized and partial seizure, to prevent recurrent febrile seizure in children, same case of myoclonic, atonics seizure and petimal seizure

Brands: Valpro, Valrate, Valance, Valance-D, Cerval C R, Enchorate, Chorona.

TRYHEXYPHENIDYL

Indication: Parkinson’s disorders.

Brands: Bexol, Clonize, forte, cerexy, Lahexy, Manchexy, Pacetane , Parkine, Triphen.

TRIFLOPERAZINE

Indication: Psychosis like Schizophrenia, schizo – affective disorders and same case of mania.

Brand: Benzyzine, neocalmp, Arcane, Trazine, Sycot, Serentine

TRIFLUOPERAZINE

Indication Psychosis like schizophrenia, Schizo affective disorder and same case mania.

Brands: Arkan, Arkazine, Benzyzaine, Carekul, Dipicalm, Fist, Gastabid, Libronit, Neocalm, Trinicalm, Psycalm, Sycot, serentin, Trazine, Trizep Wipetri, Xypine.

TOPRAMETE

Indication: Used in refractory partial seizure or without secondary generalization, may be used in same case of generalized tonic-clonic seizure associated and lenox gastant syndrome.

Brands: Epimate, Epitop, Topamac, Topamate, Topex, Topican Topaz Topiram

AMITRYPTILINE

Brands: Amitone, Tryptomer

TRAZODONE HCL

Indication: Depression, Mild anxiety disorder. May be useful in Insomnia, Psychotic Depression, Chronic Alcoholism.

Brands: Depryl, Razocon, Trazonil, Trazolon, Trazaril, Traze.

VENILAFAXINE

Indication: Major depression

Brands: Dalium, Envilat, Flavix, Sentosa, Vendep X R, Ven O D, Ventax P R, Vanish, Venlift.

ZIPRASIDONE

Indication: Schizophrenia

Brands: Azona, Zipsydone.

ZOLPIDEM

Indication: Short term treatment of Insomnia.

Brands- Dactive, Dem, Nitrest, Pedo, Restem, Sobrium, Sove, Soza, Zanlop, Zen, Zeep, Zolpidem, Zolip, Zolpid, Zolway.

ZALEPLON

Indication: Short term treatment of Insomnia.  Zaplom has been shown to decrease the time to sleep onset and not increase total sleep time or decrease the number of awakening.

Side effect: Body as a whole – head ache, asthenia, back pain, chest pain.

Cardio vascular system: Migraine

Digestive system: Nausea, dyspepsia, constipation dry mouth.

Musculo skeletal system: Myalgia, arthritis

Nervous system: Somnlence, dizziness, depression, hypertonic, nervousness, thinking abnormal.

Respiratory system: Bronchitis

Urogenital system: Dysminorrhea

Brands: Siflnite, Zalep, Zalpil O, Zanlop, Zaplon, Zaso, Zolium.

INJECTIONS

CLOPIXOL DEPOT (Zuclopenthixol Decanoate Inj. BP)

Indication: For deep intra muscular inj. Acute and chronic schizophrenia and other psychoses, especially with symptoms such as hallucinations, delusions, thought disturbance, as well as agitation, restlessness, hostility and aggressiveness.

Side-effect: Drowsiness initially, dry mouth, disturbances of accommodation, urinary retention constipation tachycardia, orthostatic, hypotension and dizziness.

CLOPIXOL ACUPHASE (Zuclopenthixol Acetate Inj. BP)

Indications: Initial treatment of acute psychoses, including mania, and exacerbations of chronic psychoses.

SENORM LA (Haloperidol Inj.)

Indications: Senorm LA is a long acting Parenteral antipsychotic drug intended for use in the management of patients requiring prolonged Parenteral antipsychotic therapy (patients with chronic schizophrenia)

OLANZAPINE Inj.

Indications: Olanzapine Inj. is indicated for the rapid control of agitation and disturbed behaviors in patients with schizophrenia when oral therapy is not appropriate.  Treatment with the Inj. should be discontinued and the use of oral Olanzapine should be initiated as soon as clinically appropriate.

FLUANXOL DEPOT (Flupenthixol Inj. BP)

Indications: Schizophrenia and allied psychoses, especially with symptoms such as hallucinations, paranoid delusions and thought disturbances along with apathy, energy and withdrawal.