Psychotropic Medications Quick Reference
Counselors and social workers do not prescribe medications, but licensing exams test your knowledge of major medication classes, their uses, and common side effects. This cheat sheet covers the medications most frequently tested on the LCSW, NCE, and NCMHCE exams.
Antidepressants: SSRIs (First-Line for Depression and Anxiety)
| Generic Name | Brand Name | Common Uses | Key Side Effects |
|---|
| Fluoxetine | Prozac | MDD, OCD, Bulimia, Panic Disorder | Nausea, insomnia, sexual dysfunction, weight changes |
| Sertraline | Zoloft | MDD, PTSD, OCD, Social Anxiety, Panic | Nausea, diarrhea, sexual dysfunction |
| Escitalopram | Lexapro | MDD, GAD | Nausea, insomnia, sexual dysfunction |
| Paroxetine | Paxil | MDD, GAD, Social Anxiety, Panic, PTSD | Weight gain, sedation, sexual dysfunction; hardest to discontinue (withdrawal effects) |
| Citalopram | Celexa | MDD | Nausea, sexual dysfunction; QT prolongation at high doses |
Antidepressants: SNRIs, TCAs, MAOIs
| Class/Drug | Brand Name | Key Features |
|---|
| Venlafaxine (SNRI) | Effexor | Serotonin + norepinephrine; used for MDD, GAD, Social Anxiety; may increase blood pressure |
| Duloxetine (SNRI) | Cymbalta | MDD, GAD, fibromyalgia, neuropathic pain |
| Bupropion | Wellbutrin | Norepinephrine + dopamine; no sexual side effects; also used for smoking cessation; lowers seizure threshold |
| Amitriptyline (TCA) | Elavil | Older antidepressant; anticholinergic side effects (dry mouth, constipation, urinary retention); dangerous in overdose |
| Phenelzine (MAOI) | Nardil | Requires tyramine-free diet (no aged cheese, wine, cured meats); dangerous hypertensive crisis if diet violated; serotonin syndrome risk with SSRIs |
Anti-Anxiety Medications
| Drug/Class | Brand Name | Mechanism | Key Considerations |
|---|
| Alprazolam | Xanax | Benzodiazepine (GABA) | Fast-acting; high dependence/abuse risk; short-term use only |
| Lorazepam | Ativan | Benzodiazepine (GABA) | Used for acute anxiety, panic; dependence risk |
| Clonazepam | Klonopin | Benzodiazepine (GABA) | Longer-acting; also used for seizures |
| Buspirone | BuSpar | 5-HT1A partial agonist | No dependence risk; takes 2 to 4 weeks for effect; no sedation; preferred for long-term anxiety |
Mood Stabilizers
| Drug | Brand Name | Primary Use | Critical Information |
|---|
| Lithium | Lithobid, Eskalith | Bipolar I (gold standard) | Narrow therapeutic window; requires blood level monitoring; toxicity signs: tremor, confusion, seizures; monitor thyroid and kidney function |
| Valproic Acid | Depakote | Bipolar, seizures | Teratogenic (avoid in pregnancy); monitor liver function; weight gain |
| Lamotrigine | Lamictal | Bipolar depression | Risk of Stevens-Johnson Syndrome (serious rash); requires slow dose titration |
| Carbamazepine | Tegretol | Bipolar, seizures | Drug interactions (induces liver enzymes); monitor blood counts |
Antipsychotics
| Generation | Examples | Mechanism | Key Side Effects |
|---|
| Typical (First-Gen) | Haloperidol (Haldol), Chlorpromazine (Thorazine) | Dopamine D2 blockade | EPS (dystonia, akathisia, tardive dyskinesia), neuroleptic malignant syndrome (NMS) |
| Atypical (Second-Gen) | Risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (Seroquel), Aripiprazole (Abilify) | Serotonin + dopamine blockade | Metabolic syndrome (weight gain, diabetes risk, lipid changes); lower EPS risk |
ADHD Medications
| Type | Examples | Mechanism | Side Effects |
|---|
| Stimulants | Methylphenidate (Ritalin, Concerta), Amphetamine (Adderall, Vyvanse) | Increase dopamine and norepinephrine | Decreased appetite, insomnia, weight loss, cardiovascular effects, growth suppression in children |
| Non-Stimulants | Atomoxetine (Strattera), Guanfacine (Intuniv) | NE reuptake inhibitor / alpha-2 agonist | Lower abuse potential; slower onset; fatigue, nausea |
Key Exam Points
- Serotonin Syndrome: Caused by excess serotonin (e.g., combining SSRIs with MAOIs); symptoms include agitation, hyperthermia, tachycardia, clonus
- Neuroleptic Malignant Syndrome (NMS): Rare, life-threatening reaction to antipsychotics; symptoms include high fever, muscle rigidity, altered consciousness
- Tardive Dyskinesia: Involuntary movements (especially face/tongue) from long-term typical antipsychotic use; may be irreversible
- Black Box Warning: All antidepressants carry increased suicidality risk in children, adolescents, and young adults (ages 18 to 24)
- Counselor Role: Monitor for side effects, coordinate with prescriber, educate client; never advise starting/stopping/changing medication