35 Common Medications (Psychotropic, Non-Psychotropic, and Over-The-Counter)
Alexandria Lewis
Content Outline, Competency, and KSAs
II. Assessment and Intervention Planning
IIA. Biopsychosocial History and Collateral Data
KSA:
– Common psychotropic and non-psychotropic prescriptions and over-the-counter medications and their side effects
overview
Although social workers do not prescribe medications or give clients medical advice, having a foundational understanding of common psychotropic and non-psychotropic prescriptions, as well as over-the-counter (OTC) medications and their potential side effects, is important. Medications can significantly influence a client’s mood, behavior, and overall functioning. Side effects and adverse effects can significantly impact a client’s wellness and overall health condition.
Knowledge about medications allows social workers to recognize when a client may be experiencing medication-related issues, collaborate effectively with medical providers and other professionals, and provide accurate psychoeducation and support to clients navigating medication challenges.
Antipsychotic medications
Antipsychotic medications are used to treat psychotic disorders, severe depression, and mania.
Note: Click the drop down icons.
| Typical (Conventional) | Atypical |
| Haldol (haloperidol) | Abilify (aripiprazole) |
| Loxitane (loxapine) | Clozaril (clozapine) |
| Mellaril (thioridazine) | Fanapt (iloperidone) |
| Moban (molindone) | Geodon (ziprasidone) |
| Navane (thiothixene) | Invega (paliperidone) |
| Prolixin (fluphenazine) | Latuda (lurasidone) |
| Stelazine (trifluoperazine) | Risperdal (risperidone) |
| Thorazine (chlorpromazine) | Saphris (asenapine) |
| Trilafon (perphenazine) | Seroquel (quetiapine) |
| Zyprexa (olanzapine) |
Assessment Highlights:
- Since antipsychotic medications have side effects and adverse reactions, social workers should collaborate with other providers to monitor clients on these medications.
- Be aware of signs of side effects, such as involuntary movements or rapid weight gain, and recommend follow-up care.
- Encourage clients to communicate changes in their physical or mental state to their healthcare provider.
- Clients may struggle with adherence due to side effects or stigma. Use psychoeducation to explain the importance of medication for managing symptoms.
- Antipsychotics are associated with increased risks for falls, sedation, and cognitive impairments, especially in clients with dementia.
Exam Tips
- Rule Out Medical Causes: If a client is experiencing new symptoms, consider whether they might be related to medication side effects or an undiagnosed medical condition.
- Prioritize Safety: Look for answers that involve addressing serious side effects (e.g., signs of tardive dyskinesia or metabolic syndrome) or involving medical providers.
- Client-Centered Approach: Select options that emphasize empathy, psychoeducation, and collaborative care.
antidepressants
How Do Antidepressants Work? TED-Ed Video.
Types of Antidepressants:
Note: Click the drop down icons.
Antidepressant Side Effects:
-
- Nausea
- Increased appetite
- Weight gain
- Fatigue
- Drowsiness
- Insomnia
- Dry mouth
- Constipation
- Dizziness
- Agitation, restlessness, anxiety
- Sexual side effects
- Heart-related effects
Source: Mayo Clinic
mood-stabilizing medications
Lithium is used to treat mania and as maintenance treatment for Bipolar disorder. Common side effects of lithium: excessive urination, weight gain, nausea, vomiting, diarrhea, acne, and risk of diabetes. Serious side effects: coma, hypothyroidism, kidney problems, and confusion. Individuals on lithium should have lab tests to monitor kidney and thyroid functioning, including sodium, calcium, and creatinine (Wegmann, 2021).
Anticonvulsants is a class of mood stabilizers that is used for the treatment of bipolar disorder. Examples of anticonvulsants: Depakote (divalproex sodium, valproic acid), Lamictal (lamotrigine), Tegretol (carbamazepine), and Topamax (topiramate).
Side effects of Depakote, Lamictal, and Tegretol:
- Sedation
- Dizziness
- Drowsiness
- Blurred vision
- Coordination problems
Side effects of Topamax:
- Cognitive difficulties
- Cognitive fog
- Memory problems
- Difficulty finding words
(Wegmann, 2021)
Reference: Wegmann, J. (2021). Psychopharmacology: Straight talk on mental health medications (4th ed.). PESI Publishing.
Antianxiety medications and sleep agents
Benzodiazepines are used to treat anxiety disorders, insomnia, emergency treatment for seizures, muscle relaxation, and alcohol withdrawal.
Examples of benzodiazepines:
Short-Acting :
- Halcion (triazolam)
Intermediate-Acting:
- Xanax (alprazolam)
- Ativan (lorazepam
- Klonopin (clonazepam)
- Restoril (temazepam)
Long-Acting:
- Valium (diazepam)
- Librium (chlordiazepoxide)
- Dalmane (flurazepam)
Risk with the use of benzodiazepines:
- Misuse
- Habit-forming (long-term use)
- Interactions with alcohol and certain medications
- Prevents formation of new memories
- Causes sedation
- Slow down reflexes
Side effects:
- Common Side Effects:
- Drowsiness or sedation
- Dizziness or lightheadedness
- Impaired coordination or memory problems
- Serious Side Effects:
- Dependence and withdrawal symptoms with long-term use
- Risk of respiratory depression, especially when combined with other CNS depressants (e.g., alcohol, opioids)
- Cognitive impairment, especially in older adults
Source: Cleveland Clinic
Other antianxiety medications:
- Buspar (buspirone)
Assessment Highlights:
- Short-Term Use Recommended: Generally intended for short-term or intermittent use due to their risk of dependence and tolerance.
- Addiction Potential: Clients with a history of a substance use disorder are at greater risk of developing dependence. Social workers should monitor for misuse or over-reliance on these medications.
- Withdrawal Symptoms: Abrupt discontinuation can lead to severe withdrawal symptoms, including seizures, agitation, and rebound anxiety. Gradual tapering under medical supervision is important.
- Older Adults: Can increase the risk of falls, confusion, and memory issues in older adults, and alternative treatments are often preferred.
- Social workers should prioritize safety and assess any changes after a client has started taking benzodiazepines.
stimulants
Stimulants are a class of medications that increase activity in the central nervous system (CNS), enhancing alertness, attention, and energy. They are commonly prescribed for conditions like attention-deficit/hyperactivity disorder (ADHD) and narcolepsy but are also associated with potential misuse due to their energizing effects.
These stimulants fall under two categories:
- Methlyphenidate (e.g., Ritalin, Concerta)
- Amphetamine (e.g., Adderall, Vyvanse)
Side Effects:
- Loss of appetite
- Problems falling asleep
- Mood changes
Source: Child Mind Institute
common non-psychotropic medications
While social workers do not practice medicine/nursing, understanding common non-psychotropic medications is helpful because these medications often impact a client’s physical health, mental well-being, and overall quality of life. For instance, chronic conditions like diabetes, asthma, or GERD, and the medications used to manage them, can affect a client’s mood, energy levels, and ability to engage in treatment or daily activities. Also, ide effects or interactions with psychotropic medications can influence how clients feel and function. For example, fatigue from thyroid issues or mood changes from certain pain medications may mimic or exacerbate symptoms of mental health conditions, leading to challenges in assessment and intervention planning.
| Medication Class | Examples | Uses | Common Side Effects |
| Pain Relivers (non-opioid) | – Acetaminophen (Tylenol) – Ibuprofen (Advil, Motrin) – Naproxen (Aleve) |
Manage pain and inflammation. Commonly used for headaches, arthritis, or minor injuries. | – Acetaminophen: Liver damage with overdose or long-term use. – NSAIDs (Ibuprofen, Naproxen): Stomach upset, ulcers, increased risk of bleeding. |
| Opioid Pain Relievers | – Hydrocodone (Vicodin) – Oxycodone (OxyContin, Percocet) – Morphine |
Treat moderate to severe pain. High potential for dependence and misuse. | – Drowsiness, dizziness, constipation, nausea. – Risk of dependence, respiratory depression, and overdose with improper use. |
| Diabetes Medications | – Metformin (Glucophage) – Insulin |
Control blood sugar levels in individuals with diabetes. | – Metformin: Nausea, diarrhea, bloating, rare risk of lactic acidosis. – Insulin: Low blood sugar (hypoglycemia), weight gain, injection site irritation. |
| Hypertension Medications | – Lisinopril (Zestril) – Amlodipine (Norvasc) – Losartan (Cozaar) |
Manage high blood pressure to reduce risk of stroke or heart attack. | Lisinopril: Dry cough, dizziness, increased potassium levels. – Amlodipine: Swelling in legs/ankles, headache. – Losartan: Dizziness, fatigue. |
| Cholesterol Medications | – Atorvastatin (Lipitor) – Simvastatin (Zocor) |
Lower cholesterol levels to reduce risk of cardiovascular disease. | – Muscle pain or weakness, liver damage (rare), gastrointestinal upset. |
| Thyroid Medications | – Levothyroxine (Synthroid) | Treat hypothyroidism by replacing deficient thyroid hormone levels. | – Overmedication: Symptoms of hyperthyroidism (e.g., rapid heartbeat, weight loss, anxiety). – Undermedication: Persistent fatigue, weight gain. |
| Gastroesophageal reflux disease (GERD) | – Omeprazole (Prilosec) – Esomeprazole (Nexium) – Pantoprazole (Protonix) – Famotidine (Pepcid) – Calcium carbonate (Tums) – Magnesium hydroxide/aluminum hydroxide (Maalox, Mylanta) |
Relieve symptoms of heartburn and acid reflux. Heal and prevent damage to the esophagus caused by stomach acid (e.g., erosive esophagitis). Reduce stomach acid production to prevent symptoms. Manage complications of GERD, such as Barrett’s esophagus or ulcers. |
– Proton Pump Inhibitors (Prilosec, Nexium, Protonix): Headache, nausea, diarrhea, constipation. Long-term use: Risk of bone fractures, vitamin B12 deficiency, and kidney problems. – H2 Receptor Blockers (Pepcid): Headache, dizziness, diarrhea, constipation. – Antacids: Constipation, diarrhea. Long term use: Calcium or magnesium level issues (imbalances). |
| Asthma and COPD | – Albuterol (ProAir, Ventolin) – Fluticasone (Advair) |
Manage breathing difficulties, prevent asthma attacks, and improve lung functioning. | -Albuterol: Tremors, rapid heartbeat, nervousness. – Combination inhalers: Hoarseness, oral thrush (fungal infection of the mouth). |
| Anticoagulants (Blood Thinners) | – Warfarin (Coumadin) – Apixaban (Eliquis) – Rivaroxaban (Xarelto) |
Prevent blood clots, strokes, and heart attacks, especially in patients with atrial fibrillation or after certain surgeries. | – Increased risk of bleeding, bruising, and in rare cases, gastrointestinal issues. |
| Antibiotics | -Amoxicillin (Amoxil) – Ciprofloxacin (Cipro) |
Treat bacterial infections, such as respiratory infections, urinary tract infections, or skin infections. | -Nausea, diarrhea, allergic reactions, potential antibiotic resistance with misuse. |
| Allergy Medications | – Loratadine (Claritin) – Cetirizine (Zyrtec) – Diphenhydramine (Benadryl) |
Relieve symptoms of seasonal allergies, such as sneezing, runny nose, and itchy eyes. | – Non-drowsy types (e.g., Claritin): Rare side effects like headaches or dry mouth. – Sedating types (e.g., Benadryl): Drowsiness, confusion, or dry mouth. |
Exam Tips
- Prioritize Medical Referrals When Necessary: If a client presents with new or unexplained symptoms, such as dizziness, confusion, or mood changes, consider
whether a referral to a medical provider is appropriate to rule out medication-related issues. - Focus on the Biopsychosocial Perspective: Remember how physical health and medications impact mental health and social functioning. Consider medication
side effects or chronic conditions as potential contributors to client challenges. - Be Aware of Common Side Effects: Look for clues in the question about side effects (e.g., fatigue, nausea, mood changes) and consider whether they might
relate to specific medications like antidepressants, pain relievers, or blood pressure drugs. - Choose Answers That Support Collaboration: Select options that involve working with medical providers or educating clients about managing medication
side effects. Social workers often act as a bridge between clients and healthcare teams. - Don’t Overstep the Scope of Practice: Avoid answers suggesting that the social worker interprets lab results, prescribes, or adjusts medications.
The focus should always be on recognizing, referring, and supporting.
Self-Check
