Handy charts
Handy charts to help people compare the medications for mental health conditions
Contents:
1. Acute Psychiatric Emergency
2. ADHD (Attention Deficit Hyperactivity
Disorder)
3. Alcohol Dependence
4. Alcohol Withdrawal
5. Alzheimers Disease
6. Anxiety (Generalised Anxiety Disorder)
7. Bipolar depression
8. Bipolar mania
9. Bipolar mood disorder
10. Depression
11. Insomnia
12. OCD (Obsessive Compulsive Disorder)
13. Panic Disorder
14. Psychosis and schizophrenia
15. PTSD (Post Traumatic Stress Disorder)
16. Seasonal Affective Disorder
17. Social anxiety (Social Phobia)
Please telephone the helpline for a large
print version of any of these charts
Each comparison chart has 2 pages; the first page
explains the background and the second page has a
summary of the important comparative information.
The charts can only be a summary, and have thus
been designed to be used in conjunction with
www.choiceandmedication.org.uk or
www.southstaffsandshropshealthcareft.nhs.uk/,
where more explanations, details and information
can be found.
Hospital Pharmacy Departments:
Stafford - 01785 221326
Tamworth - 01827 263800 ext 8327
Lichfield - 01543 412904
Burton Upon Trent - 01283 566333 Ext 5638
Shelton Pharmacy, Shrewsbury - 01743 492150
Also available: Ask About Your Medicines
For additional copies, please contact the
Medicines Management & Pharmacy Team
Tel. 01785 221141
Produced by Medicines Management &
Pharmacy, St Chads House, Stafford,
ST16 3AG
In addition,
www.choiceandmedication.org.uk has
further details about each of the conditions
listed e.g.
What is the condition?
What are the symptoms?
What are the alternatives to treat it?
(including non-medication treatments)
What are the main medications?
Is there an easy way to compare the main
medications? (ie these charts on-line)
If the medication is working, for how long
will I need to keep taking it?
If the medication is not working, how long
will it be before a change is considered?
How many medicines should I be taking for
my symptoms?
Are there any guidelines I can look at?
Where can I find out more information?
Edition 2, October 2011
 Acute Psychiatric Emergency
A handy chart to help you compare the medicines to help the symptoms of an acute emergency
Please note: Everyone is unique and this is only a guide!
This guide is different from the others in the series as it is not designed to
help people choose their medication, as in an acute emergency this will not
be appropriate. We have put this together to help relatives and carers to
know what the choices are, why certain medicines might be used, the usual
doses and what might then happen. There are many other ways that
someone can be helped in an emergency and medication should be used to
help, not just to be the only treatment. It might also help if you putting
together an Advance Directive.
We hope you take this guide in the way in which it is intended i.e. an honest
attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines used to help manage an acute
psychiatric emergency, and a few others that are sometimes used.
These first medicines are those that NICE (National institute for Clinical
Excellence) in England has included in their most recent guidelines
We have listed them as their generic name (the name of the actual
drug). We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more
details
What it does some medicines are more useful for psychosis, some for
agitation and mania, and some for both. Some are better just at calming
and reducing aggression or distress.
How we think it might work this is how we think the medicine works in
the brain to help an acute emergency. There is more about this on the
website. Taking two medicines with the same way of working doesnt help
much. However, in an emergency, using two medicines that work in
different ways often works much better e.g. quicker and with less side
effects. An antipsychotic and a benzodiazepine together often give a
quicker and better effect, and usually means lower doses of both can be
used.
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How it can be given these are the different forms of a medicine e.g. plain tablets, melt-
in-the-mouth tablets, syrups or liquids, injections (this is almost always into the muscles;
IM), suppositories or rectal tubules.
Top dose in 24hrs this is the most that should usually be given to an adult in any 24
hours. This is not necessarily the same as in a day, because you could get lots one
evening and then more the next morning. Some people need higher doses, some need
lower doses. Sometimes people need more than these doses, but this should only be done
carefully. The dose should usually be lower in older and younger people.
How long for it to start to work this is just a guide to how soon an effect from the
medicine starts to take an effect. This is usually quicker if given by injection.
Peak effect this is the time when the effect from a dose will be at its greatest.
How long it lasts for this is how long the main effect of each dose often lasts for,
although this will be different in different people.
Some of the main side effects these are just two of the main side effects. They are
more marked at higher doses, and most wear off after a few days.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy, sedated or doped up
Muscle problems can include muscle stiffness, muscles tightening up or going
into a spasm, restlessness (akathisia)
There are many other possible side effects.
Please see the website for more details of each of the medicines and side effects.
Tips on how to get the best out of medication:
Read the website to make sure you know what each medicine is for, when and how it is
taken or given
Although medicines can help some of the symptoms, they are not always the only answer.
In emergencies medication has to be the last resort ways of calming (de-escalation)
should be used all the time.
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms in an acute emergency
Main medicines What it does How we think it How it can be given Top dose in How long Peak effect How long it Main side effects * Comment
probably works 24 hours before it lasts for Drowsi- Muscle
works ness problems
NICE recommended
Haloperidol Antipsychotic & Blocks dopamine Tablets, syrup 30mg 1hr 2-6hrs 20hrs Often given with a
antimanic Injection 18mg 30mins 15-60mins 4-6hrs
benzodiazepine
Olanzapine Antipsychotic & Blocks dopamine Tablets, melt-in-the- A benzodiazepine
20mg 4hrs 5-8hrs 24hrs
(Zyprexa) antimanic and calms mouth tabs must not be given
Injection 20mg 15mins 15-45mins 6-8hrs within an hour
Risperidone (e.g. Antipsychotic & Blocks dopamine Tablets, melt-in-the- Often given with a
Risperdal) antimanic mouth tablets, syrup
16mg 1hr 1-2hr 20hrs benzodiazepine
Benzodiazepines
Lorazepam Sedative and Tablets 4mg (up to 10mg) 30-45mins 2hrs 4-6hrs
calming Boosts GABA, the
Injection IM 8mg 30-45mins 60-90mins 4hrs
o
brains natural Often given with an
Diazepam Sedative and Tablets, syrup 30mg 30mins 1hr 4-8hrs
calming chemical antipsychotic
calming Injection IM 20mg? 15mins 15-30mins 4-8hrs o
messenger
Rectal 30mg 5-10mins 15mins 4-8hrs
Other medicines (usually only used where main medicines have not worked, or as an add-on)
Aripiprazole (Abilify) Antipsychotic & Regulates Tablets, melt-in-the-
30mg 1-2hrs? 3-5hrs About 24hrs
antimanic dopamine mouth tablets, syrup
Injection 30mg 1hr 1-3hrs 24hrs
Quetiapine Antipsychotic & Blocks dopamine
(Seroquel XL) antimanic and calms
Tablets 800mg 3-4hrs XL 6hrs About 12hrs
Often given with a
Chlorpromazine Antipsychotic Tablets, syrup 1000mg 1-2hrs 3hrs 6-8hrs benzodiazepine
Block dopamine
Injection 200mg 1hr? 1-4hrs 6-8hrs

and calms
Trifluoperazine Antipsychotic Tablets, syrup (20mg) 1hr 2-4hrs 24hrs
Zuclopenthixol Antipsychotic Blocks dopamine 400mg over 2
acetate (Acuphase)
Injection
weeks
12hrs? 36hrs 2-3 days
Valproate Antimanic Calms, boosts
(e.g. Depakote) GABA Tablets, syrup 2000mg or more 2hrs 3-5hrs 12hrs o Better for mania

Carbamazepine (e.g. Antimanic Calms Tablets 2000mg 6hrs 12hrs 24hrs

Tegretol) Syrup or chewtabs 2000mg 1-2hrs 2-6hrs 24hrs o Better for mania
Suppositories 1000mg 3-6hrs 6hrs 24hrs
Promethazine Sedative and Antihistamine, Tablets, syrup 25mg 15-30mins 2-3hrs 6-12hrs
calming sedates Injection 100mg ? ? ?
Clonazepam Tablets 20mg 1hr 1-4hrs 30hrs
Boost GABA, the o
Sedative and Often given with an
brains natural Injection NK NK NK NK
calming antipsychotic
Midazolam calming agent Injection or mouth spray 5mg 15-30mins 30mins 2hrs o
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about these side effects.
 ADHD (attention deficit hyperactivity disorder)
A handy chart to help you compare the medicines to help the symptoms of ADHD
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes. However,
this guide should help you to be able to choose between the many medicines.
There are many other ways you can be helped e.g. talking therapies, art therapy,
help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of ADHD,
and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual drug).
We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side effects
you get. Some people need higher, some need lower doses. It is usually best
to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide, as some people may get
better quicker or slower. But dont give up too early.
V04 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Agitation feeling tense, under pressure, fidgeting, anxious
Headache can be mild
Nausea feeling sick, but not usually being sick
Muscle stiffness can be stiffness or a slight shake or tremor
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to compare the medicines to help the symptoms of ADHD
Medicine Usual dose per
How we think it How long it Some of the main side effects * How long you How to stop it
day might work takes to work Drowsiness Agitation Head- Nausea Muscle could or should
(probably) ache stiffness take it for
Main medicines (licensed or which are proven to help)
Methylphenidate Up to about Boosts Within a few Usually for several Should be
(Ritalin, 40mg a day dopamine in hours or days.
o o years. Short gaps stopped slowly
Medikinet, (depends on areas of the May take a may help. Often over several
Concerta, your weight). brain that few weeks for helps adults too weeks if taken for
Equasym) Can be up to 60- control the full effect more than a few
100mg a day or concentration months
more in adults
Atomoxetine 40-80mg a day Boosts Takes about 4- Usually for several No problems
(Strattera) in children. Can noradrenaline 8 weeks to
o o years. Short gaps known
be higher in start working may help. Often
adults helps adults too
Dexamfetamine Usually up to Boosts Within a few o o Usually for several Should be
(Dexadrine) 20mg a day, a dopamine in hours or days. years. Short gaps stopped slowly
bit higher in areas of the May take a may help. Often over several
adults brain that few weeks for helps adults too weeks if taken for
control the full effect more than a few
concentration months
Other medicines (usually only used when the main medicines have not worked or as an add-on)
Antipsychotics Risperidone up Decreases In a few days Can be regular Should be no
such as to about 4mg a dopamine in the for agitation
o o but may also be problems
risperidone or day. alerting parts of useful if taken
olanzapine Olanzapine up to the brain and so when needed for
about 10mg a helps to calm agitation
day the brain
Clonidine 50-300mcg Boosts the About 4 weeks o o Sometimes for Should be
(Dixarit, (0.05-0.3mg) a regulation of several years. stopped slowly

Catapres ) day, usually attention and Short gaps may over several
given 3-4 times behaviour help. Often helps weeks if taken for
a day. adults too more than a few
months
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Indemnity applies only to subscribing organisations. about these side effects.
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 Alcohol dependence
A handy chart to help you compare the medicines to help the symptoms of alcohol dependence
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes.
However, this guide should help you to be able to choose between the many
medicines. There are many other ways you can be helped e.g. talking therapies,
art therapy, help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat alcohol dependence,
and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual
drug). We have also mentioned the trade name where possible
This is only short guide please see the rest of our website for more details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side
effects you get. Some people need higher, some need lower doses. It is
usually best to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get
better quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Nausea feeling sick, but not usually being sick
Headache - where your head hurts
Stomach upset and diarrhoea
Others because these medicines are all quite different
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of alcohol dependence
Medicine Usual What it does How we think How long it Some of the main side effects * How long you How to stop it
dose per it might work takes to Drowsiness Headache Nausea Stomach Other could or should
day (probably) work upset & side take it for
the runs effects
Main medicines (licensed or which are proven to help)
Acamprosate 666mg Reduces Blocks the A week or O o Diarrhoea 1 year No problems
three reward and effect of so but
times a craving glutamate and builds over
day boosts GABA the next
month
Disulfiram 200- Adversive
Blocks the A few hours o o Halitosis For as long as No problems
500mg a makes you
enzyme that Being you need,
day ill if you
breaks down short of probably for at
drink alcohol
alcohol breath least 6 months
dehydrogenase
Thiamine and 50- Protects the Replaces Can be O o o o About a month to No problems
other vitamins 100mg a brain from missing fairly quick start with, can be
day damage vitamins longer if needed
Other medicines (usually only where the main medicines have not worked or as an add-on)
Naltrexone 50mg Reduces Blocks reward About an O Poor For as long as No problems
reward and receptors hour but sleep you need, maybe
craving the effect Thirst 3 months or
will build for Sweating longer
days and
weeks
Antidepressants, See other Help treat some of the May take For as long as Depends on the
anxiolytics Handy reasons people may drink too several needed treatment
See other handy charts
Charts much e.g. anxiety, social weeks or
phobia, depression longer

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(www.choiceandmedication.org) about these side effects.
Indemnity applies only to subscribing organisations.

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 Alcohol withdrawal
A handy chart to help you compare the medicines to help the symptoms of alcohol withdrawal
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes.
However, this guide should help you to be able to choose between the many
medicines. There are many other ways you can be helped e.g. talking therapies,
art therapy, help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of
alcohol withdrawal, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual
drug). We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more
details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side
effects you get. Some people need higher, some need lower doses. It is
usually best to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get
better quicker or slower. But dont give up too early.
V04 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many are
worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Weight gain feeling more hungry and putting on weight
Nausea feeling sick, but not usually being sick
Dry mouth etc plus blurred vision, constipation, poor memory, difficulty passing
urine (sometimes called anticholinergic side effects)
Sexual problems lack of desire, performance or pleasure
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will be
up to you. Taking a medicine means remembering every day and may be also getting
some side effects. It also often means you get well and stay well. You will need to
decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to take
it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for you,
try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your toothbrush,
in your car if you have one, next to the TV or computer, but dont forget to keep them out of the
sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of alcohol withdrawal
Medicine Usual dose What it does
How we think How long it Some of the main side effects * How long you How to stop it
per day it might work takes to work Drowsiness Weight Nausea Dry Sexual could or should
(probably) gain mouth etc problems take it for
Main medicines (licensed or which are proven to help)
Chlordiazepoxide Starting at Anticonvulsant, A couple of o o o Usually no more Gradually over
high dose stops fits or hours than 9 days a week or so
Boosts GABA,
Diazepam (e.g. up to seizures o o o Usually no more Gradually over
the brains
about than 9 days a week or so
natural
150mg a
calming
day) then
messenger
slowly
reducing
Clomethiazole Starting at Anticonvulsant, Calms the A couple of o Usually no more Gradually over
(Heminevrin) high dose stops fits or spread of hours than 9 days a week or so
then seizures stimulating
reducing messages in
brain
Thiamine (and 50-100mg Protects brain Replaces Over a few o o o o For as long as No problem
other vitamins) from damage missing days or needed
vitamins weeks
Pabrinex 2 Protects the Quickly Over a few o o o o o Usually 3 days No problem
ampoules brain from replaces vital week or so,
a day for 3 more damage vitamins can be
days quicker
Other medicines (usually only where the main medicines have not worked or as an add-on)
Carbamazepine 400- Anticonvulsant, Calms the A couple of Usually only a Gradually over
1000mg stops fits or spread of hours week or so a week or so
seizures stimulating
messages in
brain

V04 2011 Mistura Enterprise Ltd (www.choiceandmedication.org) * See other page for more advice
Indemnity applies only to subscribing organisations. about these side effects.

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 Alzheimers Disease and dementia
A handy chart to help you compare the medicines to help the symptoms of Alzheimers Disease
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes.
However, this guide should help you to be able to choose between the many
medicines. There are many other ways you can be helped e.g. art therapy, and
help with coping with the symptoms.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of
Alzheimers Disease, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual
drug). We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more
details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side
effects you get. Some people need higher, some need lower doses. It is
usually best to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get
better quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Nausea feeling sick, but not usually being sick
Headache can be mild
Muscle stiffness can be stiffness of the legs or arms
Tremor a slight shake, usually the hands
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of Alzheimers Disease
Medicine Usual dose per How we think it How long it Some of the main side effects * How long you How to stop it
day might work takes to work Drowsiness Nausea Headache Muscle Tremor could or should
(probably) stiffness take it for
Main medicines (licensed or which are proven to help)
Donepezil 5-10mg a day o o
Stops the
(Aricept) May get some
breakdown of
Galantamine Up to 24mg a day improvement, o o
acetylcholine, the Should be no
(Reminyl, or the person
brains chemical problem but the
Reminyl XL) may stop
messenger for Usually life-long person usually gets
Rivastigmine 6-12mg a day getting worse, o o
memory worse when
(Exelon) over several
stopped
Memantine Up to 20mg a day Improves the weeks or a

o o
(Ebixa ) flow of messages month or so
around the brain
Others (these can help with some symptoms of dementia e.g. being
aggressive, irritable or not sleeping)
Risperidone 0.5mg to 2mg a May cause some o o There should be
(licensed) day for up to 6 sedation and can
no problem.
weeks reduce agitation. Within a few
Quetiapine Up to about May cause some days. Usually o o o o
(Seroquel, 100mg a day sedation and only used if They should be
Seroquel XL) reduces agitation. required or stopped every
Other Pericyazine up to These are usually regularly at a o o few weeks to
antipsychotics about 5mg a day. only used when low dose to check they are
There should be
Sulpiride up to required or help with not making
no problem
200mg a day. regularly at low behaviour things worse
Amisulpride up to dose to help with problems or
200mg a day behaviour agitation.
problems or
agitation.

Quetiapine or other antipsychotics should only be used with great care

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 Anxiety: a handy chart to help you compare the main medicines to help the symptoms of anxiety
As anxiety and depression often occur together, you might also want to look at the Handy Chart for depression
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes.
However, this guide should help you to be able to choose between the many
medicines. There are many other ways you can be helped e.g. talking therapies,
art therapy, help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of
anxiety, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual
drug). We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more
details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side
effects you get. Some people need higher, some need lower doses. It is
usually best to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get
better quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Feeling strange just not feeling right
Nausea feeling sick, but not usually being sick
Dizziness feeling a bit unsteady
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the main medicines to help the symptoms of anxiety
Medicine Usual dose per
How we think it How long it takes to Some of the main side effects * How long you How to stop it
day
might work work Drowsiness Nausea Feeling Dizziness could or should
(probably) strange take it for
Main medicines (licensed or which are proven to help)
SSRIs e.g. escitalopram Escitalopram Boosts serotonin o O
Takes about 3-4
(Cipralex), 10mg a day.
weeks. The Stop gradually
Paroxetine. Other Paroxetine
symptoms may get a over a few weeks
SSRIs may also work 20mg a day As long as you
bit worse in the first if taken for more
Venlafaxine 75mg a day o O want. Taking for
Boosts serotonin couple of weeks than a few
(e.g. Efexor XL) at least 6
and before then getting months
Duloxetine 60mg a day o O months reduces
noradrenaline better
(Cymbalta) the chances of
Pregabalin Around 300mg Slows down A week or so, builds getting unwell No problem, best
(Lyrica) excitatory over 3-4 weeks again stopped over a
messages few days though
Buspirone 30mg Boosts serotonin 4 weeks at full dose o No problem
(e.g. Buspar)
Benzodiazepines Lorazepam up Boosts the A few hours o O
(shorter-acting e.g. to 4mg. effect of GABA,
lorazepam, oxazepam, Oxazepam up to the brains Usually for up to Should be done
clonazepam) 30mg natural a month or so, slowly if taken for
Benzodiazepines Up to about inhibitory or A few hours to a few but can be more than a few
calming
o O longer months
(longer-acting e.g. 15mg days
diazepam, chemical
chlordiazepoxide) messenger
Beta-blockers e.g. Up to 120mg a Stops the heart A few hours o o As long as you Should be done
propranolol or day maximum beating too fast feel you want or slowly if taken for
oxprenolol and reduces need to more than a few
tremor months
Unlicensed (usually only where the main treatments have failed or as an add-on)
Other SSRIs (e.g. Fluoxetine & Boosts serotonin As paroxetine/ o O As SSRIs above As SSRIs above
fluoxetine, citalopram, citalopram 20mg escitalopram above
sertraline) a day
Antipsychotics e.g. Pericyazine Sedative and Within a few hours o o Usually when No problem
pericyazine around 5-30mg calming required
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org) * See other page for more advice
Indemnity applies only to subscribing organisations. about these side effects.
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 Bipolar Depression
A handy chart to help you compare the medicines to help the symptoms of bipolar depression
You might also want to look at the Handy Charts for bipolar mood disorder and bipolar mania
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes. However,
this guide should help you to be able to choose between the many medicines.
There are many other ways you can be helped e.g. talking therapies, art therapy,
help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of bipolar
depression, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual drug).
We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side effects
you get. Some people need higher, some need lower doses. It is usually best
to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get better
quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Weight gain feeling more hungry and putting on weight
Nausea feeling sick, but not usually being sick
Postural hypotension can be stiffness or a slight shake or tremor
Sexual problems lack of desire or pleasure
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of bipolar depression
Medicine Usual dose per
How we think it How long it Some of the main side effects * How long you How to stop it
day might work takes to work Drowsi- Weight Nausea Postural Sexual could or should
(probably) ness gain hypotension problems take it for
Main medicines (licensed or which are proven to help)
Quetiapine 300mg a day We dont really Probably up to o As long as you Should be no
(Seroquel XL) know, but it about 4 weeks want, probably problem
Can help bipolar blocks dopamine for several years
depression when it
happens
Lamotrigine 50-200mg a day We dont really May take many o o As long as you Should be no
(e.g. Lamictal) know weeks, and want, probably problem
Can help stop must be started for several years
bipolar depression slowly
coming back
Other medicines (usually only where main medicines have not worked or as an add-on)
Antidepressants Fluoxetine, May take at o It is best if all
e.g. SSRIs citalopram and Best stopped
Boosts serotonin least 4 weeks antidepressants are
Low chance of paroxetine slowly after a
for the full effect stopped slowly.
sending you high 20mg a day few months
but you may Paroxetine should
Mirtazapine 30mg a day when the
Boosts serotonin
feel a bit better o o o depression has
be stopped
(e.g. Zispin) after a few gradually over
Lowest chance of and noradrenaline gone
weeks several weeks
sending you high
Lithium Around 400- We dont really o o Often many Must be done
(e.g. Camcolit, 1000mg a day, know, but it does May take several years, two years slowly over at least
Priadel) depending on a lot of different months is a minimum 4 weeks, if not over
your blood level things in the brain a longer time
Olanzapine Around 10mg a We dont really o o As long as you
May take several
(Zyprexa) day know, although it want, probably
months
blocks dopamine for several years Should be no
Valproate Around 400- o o As long as you problem
Boosts GABA and May take several
(e.g. Depakote, 1000mg a day want, probably
others months
Epilim) for several years
Antidepressants may help bipolar depression in the short-term but may not be a good idea if taken for a long time. Please see our website for more help.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org) * See other page for more advice
Indemnity applies only to subscribing organisations.
about these side effects.
www.choiceandmedication.org/south-staffs www.southstaffshealthcare.nhs.uk
 Bipolar Mania
A handy chart to help you compare the medicines to help bipolar mania
You might also want to look at the pages for bipolar
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes. However,
this guide should help you to be able to choose between the many medicines.
There are many other ways you can be helped but medicines are usually the first
choice.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of bipolar
mania, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual drug).
We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side effects
you get. Some people need higher, some need lower doses. It is usually best
to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get better
quicker or slower. But dont give up too early.
V04 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
www.choiceandmedication.org/south-staffs
Indemnity applies only to subscribing organisations.
mood disorder, acute psychiatric emergency and insomnia
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy, sedated or doped up
Muscle stiffness can be stiffness or a slight shake or tremor
Weight gain feeling more hungry and putting on weight
Dry mouth, blurred vision plus constipation, poor memory, difficulty passing
urine (sometimes called anticholinergic side effects)
Sexual problems lack of desire or pleasure
There are many other possible side effects.
Please see the website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see the website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help bipolar mania
Medicine Usual dose How we think it How long it takes Some of the main side effects * How long you How to
per day might work to work Drowsi- Muscle Weight Dry mouth, Sexual could or should stop it
(probably) ness stiffness gain blurred vision problems take it for
Main medicines (licensed or which are proven to help)
Valproate Up to Boosts the effect of Can be a couple of O O O
semisodium 2000mg a GABA, the brains days at high dose
(e.g. day natural calming
Depakote) chemical messenger
Risperidone 4-6mg a
day
All reduce the effect
Olanzapine Up to 20mg Can have a quick
of dopamine
(Zyprexa) a day effect in a few
Should be
Quetiapine 600mg a hours but the effect Can be many
slowly over
(Seroquel XL) day should build over a years, as they can
a few
Aripiprazole 15-30mg a Regulates dopamine few days or week O O help stop you
weeks. If
(Abilify) day receptors or so becoming ill again
you stop
Asenapine 5-10mg Reduces the effect of O any
(Sycrest) twice a day dopamine quicker, it
Carbamazepine Up to 1600 Calms the spread of Can take a few O O O might make
(eg Tegretol) mg a day stimulating messages days you less
Lithium Can be up We dont really Can take a week or O stable.
(e.g. to 1000mg known for sure as it two
Camcolit, a day or does lots of things in
Priadel) higher the brain
Haloperidol Up to 18mg Reduces the effect of Can have an effect As above, but not
a day by dopamine in a few hours but usually used long-
injection or the effect should term
30mg by build over a few
mouth days or weeks
Benzodiazepines Lorazepam Boosts the effect of Should be quick o o o o Are usually used Slowly over
4mg a day GABA, the brains e.g. about an hour only for a few a week or
or higher natural calming days or until you so
messenger are stable
V04 2011 Mistura Enterprise Ltd (www.choiceandmedication.org) * See other page for more advice
Indemnity applies only to subscribing organisations. about these side effects.

www.choiceandmedication.org/south-staffs www.southstaffshealthcare.nhs.uk
 Bipolar Mood Disorder (manic-depression)
A handy chart to help you compare the medicines to help the symptoms of bipolar mood disorder
You might also want to look at the Handy Charts for bipolar depression and bipolar mania
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people may
get better but some may stay the same. Some may improve quicker than other
people. Some may get all the side effects in the book, others none at all. What
happens to you will depend on your unique brain and your genes. However, this
guide should help you to be able to choose between the many medicines. There are
many other ways you can be helped e.g. talking therapies, art therapy, help with
coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts about
medicines. We hope you take this guide in the way in which it is intended i.e. an
honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of bipolar
mood disorder, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual drug).
We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side effects
you get. Some people need higher, some need lower doses. It is usually best to
start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get better
quicker or slower. But dont give up too early.
V04 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Weight gain feeling more hungry and putting on weight
Stomach upset feeling sick, but not usually being sick
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for
will be up to you. Taking a medicine means remembering every day and may be
also getting some side effects. It also often means you get well and stay well. You
will need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of bipolar mood disorder
Medicine Usual dose per How we think it How long it Some of the main side effects * How long How to stop it
day might work takes to work Drowsi- Weight Stomach Other main side you could or
(probably) ness gain upset effects should take it
for
Main medicines (licensed or which are proven to help)
Lithium Around 400- We dont really May take several Tremor, passing lots Often many Must be done
(e.g. Camcolit, 1000mg a day, know, but it does months for the of urine, feeling years, and at slowly over at least
Priadel) depends on a lot of different full effect thirsty. You will need least two 4 weeks. It is
blood level things in the brain a blood test every 3 years better stopped over
months or so. several months
Olanzapine * 10-20mg a day We dont really May take several o Diabetes
(Zyprexa) know but it blocks months
[for stopping mania the effect of
coming back] dopamine Should be no
Aripiprazole * 15-30mg a day Regulates May take several o Constipation, problem
(Abilify) dopamine months headache, poor sleep,
[for stopping mania tremor, feeling
coming back] restless
Quetiapine 300-600mg a We dont really May take several Hypotension (feeling Should be no
(Seroquel, day know but it blocks months dizzy when you stand Often for problem
Seroquel XL) dopamine up) many years
receptors
Lamotrigine 50-200mg a We dont really May take many o Headache, feeling Should be no
(e.g. Lamictal) day know months. It also dizzy or sick, skin problem
[for stopping needs to be rashes.
bipolar depression started slowly
coming back]
Carbamazepine 400-1000mg a Calms the spread May take several o Blurred vision, Best stopped slowly
(e.g. Tegretol) day of stimulating months dizziness over several weeks
messages in brain
Valproate * Around 400- Boosts the action May take several Nausea Often for Should be no
(Depakote, 1000mg a day of GABA and months many years problem
Epilim) others
* These medicines are only licensed to prevent mania coming back, if you got better with that medicine when you were high.
V04 2011 Mistura Enterprise Ltd (www.choiceandmedication.org) * See other page for more advice
Indemnity applies only to subscribing organisations. about these side effects.
www.choiceandmedication.org/south-staffs www.southstaffshealthcare.nhs.uk

A handy chart to help you compare the medicines to help the symptoms of depression
Anxiety and depression often occur together, you might also want to look at the Handy Chart for anxiety
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some
people may get better but some may stay the same. Some may improve
quicker than other people. Some may get all the side effects in the book,
others none at all. What happens to you will depend on your unique brain
and your genes. However, this guide should help you to be able to choose
between the many medicines. There are many other ways you can be helped
e.g. talking therapies, art therapy, help with coping with the symptoms,
relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is
intended i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of
depression, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual
drug). We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more
details
Not all these medicines work as well as each other. Your clinician may
be able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side
effects you get. Some people need higher, some need lower doses. It is
usually best to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in
the brain. There is more on this on the website. Taking two medicines
with the same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get
better quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Depression
Some of the main side effects these are just a few of the main side effects. Many are
worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Weight gain feeling more hungry and putting on weight
Nausea feeling sick, but not usually being sick
Dry mouth etc plus blurred vision, constipation, poor memory, difficulty passing
urine (sometimes called anticholinergic side effects)
Sexual problems lack of desire or pleasure
Sleep problems sleep not being as refreshing as usual
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will be
up to you. Taking a medicine means remembering every day and may be also getting
some side effects. It also often means you get well and stay well. You will need to decide
what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped slowly.
It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to take
it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for you,
try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your toothbrush, in
your car if you have one, next to the TV or computer, but dont forget to keep them out of the sight
and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of depression
Medicine Usual dose per How we think How long it Some of the main side effects * How long you How to stop it
day it might work takes to Drowsi Weight Nausea Dry Sexual Sleep could or should
(probably) work -ness gain mouth problems problems take it for
SSRIs : citalopram, Citalopram, parox-
etine and fluoxetine
Stop paroxetine
escitalopram slowly over
(Cipralex), fluvox- 20mg a day. Taking an
Boost serotonin several weeks.
amine, paroxetine, Sertraline 50-100mg
antidepressant No big problems
a day. Escitalopram
sertraline, fluoxetine for 6 months with the others
10mg a day.
Venlafaxine 75-225mg each after a first bout Stop slowly over
of depression
(e.g. Efexor XL) morning at least 4 weeks
Mirtazapine 30mg at bedtime will really Should be no
O O O reduce the
(e.g. Zispin) (15mg is too low) Boost the problems
chances of
Tricyclics e.g. dosulepin, Usually 125- amount of
lofepramine, becoming
150mg a day. serotonin and They take
clomipramine, nor-adrenaline depressed
Lofepramine 140- about 4 Stop slowly over
imipramine, amitrip- again.
tyline, trimipramine 280mg a day weeks for about 4 weeks
For a second
Duloxetine 60-120mg each the full episode, 1-2
(Cymbalta) morning effect. But years seems
Agomelatine 25-50mg at Regulates you should O O O O O O best. No known
(Valdoxan) bedtime melatonin, start to feel problems
boosts nor- a bit better For a third
adrenaline and after a episode or more
dopamine of depression,
week or
Trazodone 100-300mg at Boosts serotonin Stop slowly over
two. O O taking an
bedtime antidepressant about 4 weeks
Reboxetine 8-12mg each Boosts Should be no
noradrenaline
O O O O for at least 3-5
(Edronax) morning years reduces problems
MAOIs e.g. Tranylcypromine the chance of Stop slowly over
tranylcypromine, and isocarboxazid Stop the relapse. You about 4 weeks
phenelzine, 30mg a day. breakdown of might want to
isocarboxazid (needs Phenelzine 45- serotonin and think about
special diet) 90mg a day. nor-adrenaline taking an
Moclobemide 300-600mg a day antidepressant
Tryptophan 3-6g a day Increases life-long. Should be no
O O O O O O
(Optimax)only for serotonin problems
resistant depression production
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org) * See other page for more advice
Indemnity applies only to subscribing organisations. www.choiceandmedication.org/south-staffs www.southstaffshealthcare.nhs.uk about these side effects.
 Insomnia: a handy chart to help you compare the medicines to help insomnia
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes.
However, this guide should help you to be able to choose between the many
medicines. There are many other ways you can be helped e.g. relaxation, sleep
hygiene and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of
insomnia, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual
drug). We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more
details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side
effects you get. Some people need higher, some need lower doses. It is
usually best to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get
better quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Hangover feeling sleepy the next morning
Stomach upset feeling a bit sick
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help insomnia (poor sleep)
Medicine Usual dose atHow we think it How long it Duration of effect Some main side effects * How long you How to stop it
night might work takes to work Hangover Stomach could or should
(probably) upset take it for
Main medicines (licensed or which are proven to help)
Zopiclone 7.5mg About an hour Lasts about 4-8 hours O
(e.g. Zimovane) or so
Zolpidem 5mg About 15- Lasts about 2 hours O O
(e.g. Stilnoct) Boost the effect 20mins
Zaleplon (e.g. Sonata) 10mg of GABA, the 15-20mins Lasts about 2-4 hours O O These medicines
Benzodiazepines, Loprazolam 1-2mg brains natural About an hour Lasts about 4-6 hours, can sometimes A low dose for a few
Lormetazepam calming O
shorter-acting or so but may be longer in tend to lose their days may help, as
(e.g. loprazolam, temaz- 0.5-1.5mg chemical
older people effect in some you can get rebound
pam, lormetazepam) Temazepam10mg messenger
people over a few insomnia (ie sleep
Benzodiazepines, Nitrazepam 5mg About an hour Lasts about 6-8 hours, O months. So, it is gets worse for a few
longer-acting or so but may be longer in best not to take days) if you stop
(e.g. nitrazepam) older people them every night suddenly
Promethazine 10-25mg Antihistamine About an hour Lasts about 4-8 hours O for a long time.
(e.g. Phenergan) and sedative
Chloral hydrate and Chloral hydrate Sedative About an hour Lasts about 4-8 hours
cloral betaine up to 1g
Clomethiazole 192mg (resistant Sedative About an hour Lasts about 4-8 hours
(Heminevrin) insomnia only)
Melatonin 2mg at night in Boosts About an hour Lasts for a few hours O 3-13 weeks can There should be no
(Circadin PR) people aged 55 melatonin, the help get a sleep problems at the end
or over, for up brains natural pattern back to of the course
to 13 weeks sleep regulator normal
Other medicines (usually only where the main medicines have not worked or as an add-on)
Sedative Mirtazapine 15- O These may lose A lower dose for a
antidepressants (e.g. 30mg Antihistamine some of their few days may help,
mirtazapine, Trazodone 50- and sedative effect over as you can get
trazodone) 150mg About an hour Lasts about 4-8 hours several months. rebound insomnia
Antipsychotics or Promethazine Antihistamine Best not to take (i.e. sleep gets worse
O
antihistamines at low 10-25mg and sedative them every night for a few days) if you
dose for a long time. stop suddenly
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org) * See other page for more advice
Indemnity applies only to subscribing organisations.
about these side effects.

www.choiceandmedication.org/south-staffs www.southstaffshealthcare.nhs.uk
 OCD (obsessive-compulsive disorder)
A handy chart to help you compare the medicines to help the symptoms of OCD
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes.
However, this guide should help you to be able to choose between the many
medicines. There are many other ways you can be helped e.g. talking therapies,
art therapy, help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of OCD,
and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual
drug). We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more
details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side
effects you get. Some people need higher, some need lower doses. It is
usually best to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get
better quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many are
worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Weight gain feeling more hungry and putting on weight
Nausea feeling sick, but not usually being sick
Dry mouth etc plus blurred vision, constipation, poor memory, difficulty passing
urine (sometimes called anticholinergic side effects)
Sexual problems lack of desire, performance or pleasure
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will be
up to you. Taking a medicine means remembering every day and may be also getting
some side effects. It also often means you get well and stay well. You will need to
decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to take
it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for you,
try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your toothbrush,
in your car if you have one, next to the TV or computer, but dont forget to keep them out of the
sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of obsessive-compulsive disorder
Medicine Usual dose per
How we think How long it Some of the main side effects * How long you could How to stop it
day it might work takes to work Drowsiness Weight Nausea Dry mouth Sexual or should take it for
(probably) gain etc problems
Main medicines (licensed or which are proven to help)
SSRIs e.g. Citalopram, Boost These should best be
citalopram, fluoxetine and serotonin stopped slowly over at
escitalopram, paroxetine 20- least 4 weeks,
Takes about If the medicine has
fluvoxamine, 60mg a day. especially with higher
10-12 weeks helped, it seems
paroxetine, Sertraline 50- doses. Paroxetine
for full effect. that if you keep
sertraline, 200mg a day. should be stopped
Some taking it for at least
fluoxetine Escitalopram gradually over at least
symptoms may 1-2 years it will
10-20mg a 4 weeks or more
begin to reduce the chances
day.
improve after a of the symptoms
Tricyclics e.g. May need Boosts Should be slowly over
few weeks coming back
clomipramine higher doses serotonin at least 4 weeks
(other tricyclics e.g. 150-
do not work) 300mg a day
Other medicines (usually only where the main medicines have not worked or as an add-on)
Venlafaxine Usually 75- Boosts the Takes about If the medicine has Should be slowly over
(e.g. Efexor 225mg a day amount of 10-12 weeks helped, it seems at least 4 weeks,
XL) or possibly serotonin and for full effect. that keeping taking possibly longer
higher noradrenaline Some it for at least 1-2
symptoms may years will reduce
begin to the chances of the
improve after a symptoms coming
few weeks back
Antipsychotics Risperidone up Partly Within a few o Often for a few
e.g. risperidone to about 1- sedation and days, but takes
months just to help Should be no problems
used with SSRIs 4mg a day partly a bit longer for
the worst but over a few weeks
Antipsychotics Olanzapine up calming the the full effect to o o symptoms, but can is a good idea
e.g. olanzapine to about 10mg mind kick in
be longer.
used with SSRIs a day
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Indemnity applies only to subscribing organisations. about these side effects.

www.choiceandmedication.org/south-staffs www.southstaffshealthcare.nhs.uk
 Panic Disorder
A handy chart to help you compare the medicines to help the symptoms of panic disorder
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes. However,
this guide should help you to be able to choose between the many medicines.
There are many other ways you can be helped e.g. talking therapies, art therapy,
help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of panic
disorder, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual drug).
We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side effects
you get. Some people need higher, some need lower doses. It is usually best
to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get better
quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Weight gain feeling more hungry and putting on weight
Nausea feeling sick, but not usually being sick
Dry mouth, blurred vision plus constipation, poor memory, difficulty
passing urine (sometimes called anticholinergic side effects)
Sexual problems lack of desire, performance or pleasure
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of panic disorder
Medicine Usual dose per How we think How long it Some of the main side effects * How long you could How to stop it
day it might work takes to work Drowsiness Weight Nausea Dry mouth, Sexual or should take it for
(probably) gain blurred problems
vision
Main medicines (licensed or which are proven to help)
SSRIs e.g. Paroxetine Boost Stop paroxetine
citalopram, 20mg a day. serotonin slowly over several
escitalopram, Sertraline 50- weeks. Usually no
paroxetine 100mg a day. If the medicine has problems with others
Take about 8-
Escitalopram helped, it seems
12 weeks for
10mg a day that keeping taking
the full effect
Tricyclics Usually 125- Boost it for 6-12 months at Should be slowly over
but you may least will reduce the
e.g. amitriptyline, 150mg a day serotonin and start to feel about 4 weeks
clomipramine, Lofepramine noradrenaline chances of the
better after a
dosulepin, 140-210mg a symptoms coming
few weeks
doxepin,
day back
imipramine,
lofepramine,
trimipramine
Benzodiazepines Clonazepam Boost GABA, Should get o o o o Usually only for a Should be slowly over
e.g. 0.5-2mg a day. the brains some effect in few weeks or a few weeks
clonazepam, Diazepam 2- natural a few days months, or longer if
diazepam, 10mg a day. calming only taken if
lorazepam Lorazepam 1- messenger needed
4mg a day.
Other medicines (usually only where main medicines have not worked or as an add-on)
Beta-blockers Up to 120mg a Stops the Should get o o o o o Often just used as Should be stopped
e.g. day heart beating some effect in an if needed slowly if taken for
propranolol or too fast and a few hours medicine more than a few
oxprenolol reduces months
tremor
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Indemnity applies only to subscribing organisations. about these side effects.

www.choiceandmedication.org/south-staffs www.southstaffshealthcare.nhs.uk
 Psychosis
A handy chart to help you compare the medicines to help the symptoms of psychosis and schizophrenia
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes. However,
this guide should help you to be able to choose between the many medicines.
There are many other ways you can be helped e.g. talking and family therapies,
art therapy, help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of
psychosis and schizophrenia, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual drug).
We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side effects
you get. Some people need higher, some need lower doses. It is usually best
to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get better
quicker or slower. But dont give up too early.
V04 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleep, sedated or doped up
Muscle stiffness can be stiffness or a slight shake or tremor
Weight gain feeling more hungry and putting on weight
Dry mouth etc plus blurred vision, constipation, poor memory, difficulty
passing urine (sometimes called anticholinergic side effects)
Sexual problems lack of desire, performance or pleasure
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also getting
some side effects. It also often means you get well and stay well. You will need to
decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of psychosis
Medicine Usual dose How we think How long it Some of the main side effects * How long you could How to stop it
per day it might work takes to work Drowsi- Muscle Weight Dry mouth Sexual or should take it for
(probably) ness stiffness gain etc problems
Newer ones (atypicals, second generation)
Risperidone 4-6mg a day Mainly blocks
(e.g. dopamine Usually there
Risperdal) receptors may be an effect
in a few days, If taking one of
Paliperidone 6mg a day
with the effect
(Invega) these medicines for
building over 3-4 a first episode of
Olanzapine 10-20mg a Blocks
weeks psychosis or possible
(Zyprexa) day dopamine
and other schizophrenia,
Quetiapine Around taking it for at least Should be no
(Seroquel XL) 600mg a day receptors
2 years will reduce problem but we
Aripiprazole 10-30mg a Regulates As above but O O O the chances of the suggest that
(Abilify) day dopamine you might get a symptoms coming stopping it gently
bit more back. over several
agitated before weeks or months
getting better If taking it for is the safest way
Clozapine Usually Blocks a wide Usually there schizophrenia that
(Clozaril, around 300- range of may be an effect keeps coming back,
Denzapine, 600mg a day receptors in a few days, then taking it for at
Zaponex) with the effect least 5 years will
- only for building over 3-4 much reduce the
resistant weeks. Can be chances of the
schizophrenia up to 6 months symptoms come
for clozapine back.
Other antipsychotics If for symptoms of
Haloperidol 5-20mg a day psychosis, then it
Usually there Should be no
Block may only be needed
Amisulpride 400-800mg/d may be an effect problem but
dopamine for a few weeks or
in a few days, stopping it gently
Sulpiride 400- receptors months
with the effect over several
1600mg/d
building over 3-4 weeks or months
Zuclopenthixol 10-25mg a
weeks is the safest way
day
* See other page for more advice
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Indemnity applies only to subscribing organisations.
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Medicine Usual dose How we How long it Some of the main side effects * How long you How to stop it
think it might takes to work Drowsi- Muscle Weight Dry mouth Sexual could or should
work ness stiffness gain etc problems take it for
(probably)
Phenothiazines
Chlorpromazine 75-300mg/d Blocks Should be no great
Levomepromazine 100-200mg/d dopamine Usually have an problem but we
receptors, effect in a few suggest that
Pericyazine 75-300mg/d some days, with the stopping it gently
Perphenazine 12-24mg a day serotonin and effect building over several weeks
many other over 3-4 weeks If taking one of
or months is the
Trifluoperazine 5-15mg a day these medicines
receptors for a first episode
safest way
Depot and longer-acting injections of psychosis or
Risperidone 25-50mg every Mainly blocks At least 4 possible Risperidone carries
(Risperdal Consta) two weeks dopamine weeks before
schizophrenia, on being released
receptors any effect, but taking it for at for another 5-7
will then build least 2 years will weeks after the
over several reduce the last injection
weeks chances of the
Paliperidone palm- 50-150mg once Mainly blocks symptoms coming
itate (Xeplion, a month dopamine
back.
Invega Sustenna) receptors If taking it for
Olanzapine pamoate 210-405mg schizophrenia that
keeps coming
(Zypadhera) every two or Because the
four weeks back, then taking it medicine is
Block for at least 5 years
Zuclopenthixol 200-500mg released from a
dopamine and will much reduce
decanoate (e.g. every two depot over
many other the chances of the
Clopixol) weeks Usually takes a several weeks,
receptors symptoms come
Flupentixol 20-200mg week or so stopping is not a
decanoate (e.g. every two before it begins back. problem as the
If for symptoms of
Depixol) weeks to work medication slowly
psychosis, then it
Haloperidol 50-200mg a Blocks reduces. The main
decanoate (e.g. four weeks dopamine
may only be
problem is
needed for a few symptoms coming
Haldol Decanoate ) receptors
weeks or months back.
Fluphenazine 25-100mg Block
decanoate (e.g. every two dopamine,
Modecate) weeks serotonin and
Pipothiazine 25-50mg every many other

palmitate (Piportil) two weeks receptors
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 PTSD (post-traumatic stress disorder)
A handy chart to help you compare the medicines to help the symptoms of PTSD
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes. However,
this guide should help you to be able to choose between the many medicines.
There are many other ways you can be helped e.g. talking therapies, art therapy,
help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of PTSD,
and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual drug).
We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side effects
you get. Some people need higher, some need lower doses. It is usually best
to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get better
quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many are
worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Weight gain feeling more hungry and putting on weight
Nausea feeling sick, but not usually being sick
Dry mouth etc plus blurred vision, constipation, poor memory, difficulty passing
urine (sometimes called anticholinergic side effects)
Sexual problems lack of desire, performance or pleasure
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will be
up to you. Taking a medicine means remembering every day and may be also getting
some side effects. It also often means you get well and stay well. You will need to
decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for you,
try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your toothbrush,
in your car if you have one, next to the TV or computer, but dont forget to keep them out of the
sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of post-traumatic stress disorder (PTSD)
Medicine Usual dose
How we think it How long it Some of the main side effects * How long you could How to stop it
per day might work takes to work Drowsiness Weight Nausea Dry Sexual or should take it for
(probably) gain mouth etc problems
Main medicines (licensed or which are proven to help)
SSRIs; Paroxetine Boost serotonin Takes about May need to be for a Should be slowly
paroxetine, and 40-50mg a 12 weeks for long time e.g. 1-2 over several
sertraline day. full effect years at least, as weeks,
(although Sertraline there is a high preferably
sertraline is only around chance of the longer
licensed for 150mg a day symptoms coming
women) back if you stop
Other medicines (usually only where the main medicines have not worked or as an add-on)
Other SSRIs e.g. Citalopram Boost serotonin Should be slowly
citalopram, and over several
escitalopram, fluoxetine weeks, better if
fluoxetine 20-60mg a May need to be for a even slower
day. Takes about long time e.g. 1-2
Escitalopram 12 weeks for years at least as
10-20mg a full effect there is a high
day. chance of the
Venlafaxine 150-225mg a Boosts serotonin symptoms coming Should be slowly
back if you stop
(e.g. Efexor day and over at least 4
XL) noradrenaline weeks, possibly
longer
Antipsychotics Risperidone Partly sedation o
e.g. risperidone 1-4mg a day and partly Takes a few Often for a few Should be no
used with SSRIs calming the weeks to help months just to help problems but
Antipsychotics Olanzapine mind if used some of the o o the worst symptoms, over a few
e.g. olanzapine about 10mg with the SSRIs symptoms but can be longer weeks is a good
used with SSRIs a day or venlafaxine. idea

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 SAD (Seasonal Affective Disorder)
A handy chart to help you compare the medicines to help the depressive symptoms of SAD
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes. However,
this guide should help you to be able to choose between the many medicines.
There are many other ways you can be helped e.g. talking therapies, art therapy,
help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of
Seasonal Affective Disorder, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual drug).
We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side effects
you get. Some people need higher, some need lower doses. It is usually best
to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get better
quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Weight gain feeling more hungry and putting on weight
Nausea feeling sick, but not usually being sick
Dry mouth, blurred vision plus constipation, poor memory, difficulty
passing urine (sometimes called anticholinergic side effects)
Sexual problems lack of desire or pleasure
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your
toothbrush, in your car if you have one, next to the TV or computer, but dont forget to keep
them out of the sight and reach of children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the depressive symptoms of seasonal affective disorder
Medicine Usual dose per How we think How long it Some of the main side effects * How long you How to stop it
day it might work takes to work Drowsiness Weight Nausea Dry mouth, Sexual could or should
(probably) gain blurred vision problems take it for
Unlicensed (there are no licensed treatments in the UK or RoI)
Sertraline, 50-200mg a Boosts Should be no
an SSRI day serotonin great problem but
slowly over a
Although other Takes about 4 week or so is a
SSRIs can be weeks for full Can be for good idea
used, the best
effect but you shorter courses
evidence is for
may feel e.g. 3 months
sertraline
better after a but may be
few weeks. better to take
Other SSRIs e.g. Citalopram, Boosts Stop paroxetine
Can be started for about 4-6
citalopram, paroxetine serotonin slowly over
for winter months
escitalopram and several weeks. No
depression in
(Cipralex), fluoxetine problems with
autumn before
paroxetine, 20mg a day. others
your mood
fluoxetine Escitalopram
drops
10mg a day
Bupropion 150-300mg a Boosts o o o Should be no
(Zyban) day dopamine great problem but
- licensed in slowly over a
USA week or so is a
good idea

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www.choiceandmedication.org/south-staffs www.southstaffshealthcare.nhs.uk
 Social Anxiety or Social Phobia
A handy chart to help you compare the medicine treatments to help the symptoms of social anxiety
You might also want to look at the Handy Chart for anxiety
Please note: You are unique and this is only a guide!
This guide will be about right for most people, but not everyone. Some people
may get better but some may stay the same. Some may improve quicker than
other people. Some may get all the side effects in the book, others none at all.
What happens to you will depend on your unique brain and your genes.
However, this guide should help you to be able to choose between the many
medicines. There are many other ways you can be helped e.g. talking therapies,
art therapy, help with coping with the symptoms, relaxation, and self-help.
No guide can be 100% unbiased, but we have tried hard to stick to the facts
about medicines. We hope you take this guide in the way in which it is intended
i.e. an honest attempt to inform, educate and help.
What the sections in the table mean:
Medicine these are the main medicines to help treat the symptoms of social
phobia, and a few others that are sometimes used.
These medicines are in no special order
We have listed them as their generic name (the name of the actual
drug). We have also mentioned the trade name where possible
This is only short guide. Please see the rest of our website for more
details
Not all these medicines work as well as each other. Your clinician may be
able to help you choose which one (or ones) might be best for you.
Some of these medicines might not be used in your area
Usual dose per day this will depend on how well you do and what side
effects you get. Some people need higher, some need lower doses. It is
usually best to start a drug slowly; its kinder to your brain.
How we think it might work this is how we think the medicine works in the
brain. There is more on this on the website. Taking two medicines with the
same way of working doesnt often help much.
How long it takes to work this is just a guide as some people may get
better quicker or slower. But dont give up too early.
V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org)
Indemnity applies only to subscribing organisations.
www.choiceandmedication.org/south-staffs
Some of the main side effects these are just a few of the main side effects. Many
are worse at higher doses, but most wear off after a few weeks.
= Most people will get this side effect
= Quite a few will get this side effect
= Only a few people will get this side effect
o = This is very rare or not known
The side effects here are:
Drowsiness feeling sleepy or doped up
Weight gain feeling more hungry and putting on weight
Nausea feeling sick, but not usually being sick
Dry mouth, blurred vision plus constipation, poor memory, difficulty passing
urine (sometimes called anticholinergic side effects)
Sexual problems lack of desire, performance or pleasure
There are many other possible side effects.
Please see our website for more details of each of the medicines and side effects.
How long you could or should take it for - how long you take any medicine for will
be up to you. Taking a medicine means remembering every day and may be also
getting some side effects. It also often means you get well and stay well. You will
need to decide what helps you best and what helps you get on with your life.
How to stop it some medicines can be stopped quickly. Others should be stopped
slowly. It is best to try to stop all medicines slowly its kinder on your brain.
Tips on how to get the best out of medication:
Read the website to make sure you know what the medicine is for, when and how to
take it and for how long to take it
Try to get the best out of one medicine before trying another. Get the right dose for
you, try taking it at different times, and try to cope with any side effects
Take it regularly every day, unless it is meant to be taken only when required
(find ways to remember e.g. leave the pack by your bed, in the kitchen, next to your toothbrush, in your car
if you have one, next to the TV or computer, but dont forget to keep them out of the sight and reach of
children)
Although medicines can help most peoples symptoms, they are not always the only
answer. Please see our website for ideas for self-help, and help from others
www.southstaffshealthcare.nhs.uk
 A handy chart to help you compare the medicines to help the symptoms of social anxiety
You might also want to look at the Handy Chart for anxiety
Medicine Usual dose per
How we think How long it Some of the main side effects * How long you How to stop it
day it might work takes to work Drows- Weight Nausea Dry mouth, Sexual could or should
(probably) iness gain blurred vision problems take it for
Main medicines (licensed or which are proven to help)
Escitalopram 10mg a day Should be no great
(Cipralex) Takes at least problem but slowly
- other SSRIs may 12 weeks for May need to over a week or so is
be effective, but full effect but take for at least a good idea
unlicensed Boosts six months or
may begin to
Paroxetine 20mg a day serotonin more or the Should be stopped
feel better
(e.g. Seroxat) after a few symptoms may slowly over several
- other SSRIs may be
weeks come back. weeks
effective, but are
not licensed
Other medicines (usually only where the main medicines have not worked or as an add-
on)
Venlafaxine (e.g. 75-150mg a Boosts Should be stopped
Takes up to 12
Efexor XL) day serotonin and May need to slowly over several
weeks for full
noradrenaline take for at least weeks
effect but you
Other SSRIs e.g. Fluoxetine & Boosts six months or Should be no great
may begin to
fluoxetine, citalopram serotonin more or the problem but slowly
feel better
citalopram and 20mg a day. symptoms may over a week or two
after a few
sertraline Sertraline come back. is a good idea
weeks
50mg a day
Benzodiazepines Lorazepam up Boosts GABA, Quick, can be o o O o Best just used If taken regularly
to 4mg a day the brains a few hours or for short-term every day should
natural less help when probably be
calming needed, rather stopped slowly over
messenger than regularly a couple of weeks
Beta-blockers e.g. Up to 120mg a Slows the Should get o o o o o Often just used Should be stopped
propranolol or day, usually heart, reduces some effect in as an if slowly if taken for
oxprenolol much less tremor a few hours or needed more than a few
so medicine months

V03 2011 Mistura Enterprise Ltd (www.choiceandmedication.org) * See other page for more advice
Indemnity applies only to subscribing organisations. about these side effects.

www.choiceandmedication.org/south-staffs www.southstaffshealthcare.nhs.uk
No such guide can be entirely bias-free. No matter how hard someone tries, training
and background will always influence your outlook. We have, however, tried to
eliminate bias, and we hope you take these charts in the spirit in which they are
provided i.e. a genuine attempt to inform, educate and support.
See also www.choiceandmedication.org.uk or
www.southstaffsandshropshealthcareft.nhs.uk/
Produced by Medicines Management & Pharmacy Team,
St Chads House, Stafford, ST16 3AG
October 2011