Psychopharmacology in Couple and Family Therapy

Name of Intervention

Psychopharmacology.

Synonyms

Psychiatric medication meds

Introduction

Often a family member engaged in couples or family therapy will also be treated with psychiatric medication or might raise the question of a need for medication. At times, the therapist may notice or learn about problematic behavior of a family member and wonder if medication might be helpful in addressing that concern. At times also discussions about medication may be a source of conflict in couples or family treatment. This entry will review indications for using psychiatric medications and approaches for responding to discussion about medications. Couples and family therapy may be conducted by psychiatrists or licensed nurse practitioners who are able to prescribe medication. This entry will be directed primarily to nonphysicians conducting couples and family therapy, and will not address situations where the same professional both conducts couples or family therapy and prescribes medication....

Appendix: List of Commonly Used Psychiatric Medications

Stimulants	Generic name	Use	Common side effects
Concerta	Methylphenidate	ADHD	Appetite suppression, irritability occasionally
Focalin	Methylphenidate	ADHD	Irritability occasionally
Ritalin	Methylphenidate	ADHD	“........”
Metadate	Methylphenidate	ADHD	“........”
Methylin	Methylphenidate	ADHD	“........”
Adderall	Dextroamphetamine	ADHD	“........”
Vyvanse	Dextroamphetamine	ADHD	“........”
Strattera	Atomoxetine	ADHD	Less effective/sedation
Atypical antipsychotics
Risperdal	Risperidone	Psychosis emotion dysregulation	Appetite increase, metabolic changes, muscle stiffness
Seroquel	Quetiapine	Aggressiveness (at times)	“........”
Geodon	Ziprasidone	Aggressiveness (at times)	“........”
Zyprexa	Olanzapine	Aggressiveness (at times)	“........”
Abilify	Aripiprazole	Aggressiveness (at times)	“........”
Clozaril	Clozapine	Aggressiveness (at times)	Appetite increase, metabolic changes, muscle stiffness, and blood abnormalities
Antidepressants (SSRI’s)
Prozac	Fluoxetine	Depression and anxiety	Suicidal ideation (very occasionally)
Lexapro	Escitalopram	Depression and anxiety	“........”
Celexa	Citalopram	Depression and anxiety	“........”
Zoloft	Sertraline	Depression and anxiety (and OCD)	“........”
Paxil	Paroxetine	Depression and anxiety	Not used for children and adolescents
Other antidepressants
Effexor	Venlafaxine	Depression and anxiety	Suicidal ideation (very occasionally)
Luvox	Fluvoxamine	Depression and anxiety	“........”
Wellbutrin	Bupropion	Depression and anxiety	Seizures in overdose
Antianxiety (in addition to SSRI’s)
Ativan	Lorazepam	Acute panic severe anxiety	Can be addictive
Klonopin	Clonazepam	Acute panic severe anxiety	“........”
Xanax	Alprazolam	Generally not used	“........”
Alpha agonists
Tenex	Guanfacine	Aggressiveness ADHD	Sedation
Catapres	Clonidine	Aggressiveness insomnia	“........”
Mood stabilizers
Lithium	Lithium	Bipolar disorder	Kidney and CNS toxicity/tremor
Depakote	Divalproex	Bipolar disorder	Weight gain, rash
Trileptal	Oxcarbazepine	Bipolar disorder	Sedation
Topomax	Topiramate	Bipolar disorder	“........”
Neurontin	Gabapentin	Bipolar disorder, pain	“........”
Lamictal	Lamotrigine	Bipolar disorder, depression	Rash
Insomnia
Melatonin		Sleep induction
Trazodone	Trazodone	Sleep induction	Some sleepiness in AM
Remeron	Mirtazapine	Sleep induction	“........”