Mental Health Drugs_Contra-indications/Side effects/withdrawal

If physical dependence exists then abrupt withdrawal may result in benzodiazepine withdrawal

Addison's disease Cardiac insufficiency Dehydration Family/personal history of brugada's syndrome Low sodium diet Rhythm disorder Untreated hypothyroidism

Not recommended If lithium is to be discontinued, the dose should be reduced gradually over a period of at least 4 weeks (preferably over a period of up to 3 months). If stopped abruptly consider switch to antipsychotic or valproate

Acute pulmonary insufficieny Marked Neuromuscular weakness Sleep apnoea Syndrome Unstable myasthenia Gravis Not for use alone to treat chronic psychoses Not for use alone to treat chronic depression (or associated anxiety) Respiratory Depression

Not recommended

Not recommended On planned withdrawal reduce dose over 1-2 weeks to avoid risk of rebound psychosis

Abdo pain constipation diarrhoea GI effects Nausea Vomiting

Amnesia Ataxia Confusion Dependence Drowsiness next day lightheadedness next day Muscle weakness Paradoxical increase in aggression

Poor controlled epilepsy Patients in manic phase

Alcohol and Drug Psychosis Bone Marrow disorders Coma History of Agranulocytosis History of circulatory collapse History of neutropenia Paralytic Ileus Severe Cardiac Disorders Severe CNS depression Uncontrolled Epilepsy

Anorexia; constipation; hypersalivation; malaise; speech disorders; urinary incontinence

Sleep problems Headache nausea diarrhoea tiredness

anorexia weight loss akathisia decreased libido/erectile dysfunction Sleep disturbances diaphoresis tremor rapid/irregular heartbeat flushing