Every nurse must understand mental health medications. This topic shows up on almost every NCLEX exam and is a must-have in any nursing bundle. Whether you’re a new RN nurse or a seasoned registered nurse, this quick guide will help you remember key facts about antidepressants, antipsychotics, and mood stabilizers — plus what to watch for in patient care.
📌 Why Mental Health Meds Matter in Nursing
Mental health conditions like depression, schizophrenia, and bipolar disorder can’t be managed by therapy alone. Medications help balance brain chemicals so patients can think clearly, manage emotions, and live healthier lives.
As a registered nurse, you’re responsible for giving these meds safely, watching for side effects, and teaching patients how to take them properly.
🧠 1️⃣ Antidepressants
Use: Treat depression, anxiety, PTSD, OCD.
Common Types:
✅ SSRIs (Selective Serotonin Reuptake Inhibitors)
- Examples: Fluoxetine (Prozac), Sertraline (Zoloft), Escitalopram (Lexapro)
- Key points: Fewer side effects than older drugs. Takes 4–6 weeks to work.
- Side effects: Nausea, insomnia, sexual problems. Watch for serotonin syndrome!
✅ SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
- Examples: Venlafaxine (Effexor), Duloxetine (Cymbalta)
- Key points: Good for depression with pain. Similar warnings as SSRIs.
✅ Tricyclic Antidepressants (TCAs)
- Examples: Amitriptyline, Nortriptyline
- Key points: More side effects: dry mouth, sedation, heart issues. Overdose risk!
✅ MAOIs (Monoamine Oxidase Inhibitors)
- Examples: Phenelzine (Nardil), Tranylcypromine (Parnate)
- Key points: Rarely used. Dangerous food interactions (tyramine = hypertensive crisis!). Teach patients to avoid aged cheese, wine, cured meats.
📝 NCLEX Tip: Know serotonin syndrome signs — confusion, high BP, fever, tremors.
🧠 2️⃣ Antipsychotics
Use: Treat schizophrenia, bipolar mania, severe agitation.
Types:
✅ Typical (First Generation)
- Examples: Haloperidol (Haldol), Chlorpromazine (Thorazine)
- Key points: Good for positive symptoms (hallucinations, delusions).
- Side effects: EPS (tremors, muscle stiffness), tardive dyskinesia, neuroleptic malignant syndrome (NMS).
✅ Atypical (Second Generation)
- Examples: Risperidone (Risperdal), Olanzapine (Zyprexa), Clozapine (Clozaril)
- Key points: Fewer movement side effects, treats positive & negative symptoms.
- Side effects: Weight gain, diabetes risk, sedation. Clozapine needs WBC monitoring (risk of agranulocytosis).
📝 NCLEX Tip: Watch for NMS — sudden high fever, muscle rigidity, confusion. It’s an emergency!
🧠 3️⃣ Mood Stabilizers
Use: Manage bipolar disorder, especially manic episodes.
✅ Lithium
- Key points: Classic mood stabilizer.
- Check levels: 0.6–1.2 mEq/L — toxic if higher!
- Toxicity signs: Tremor, confusion, vomiting, diarrhea.
- Teaching: Keep salt intake steady, drink fluids, avoid dehydration.
✅ Anticonvulsants (used as mood stabilizers)
- Examples: Valproic acid (Depakote), Carbamazepine (Tegretol), Lamotrigine (Lamictal)
- Key points: Good for mood swings, also treat seizures.
- Side effects: Liver problems, low platelets, rash (Lamotrigine can cause Steven-Johnson Syndrome — severe rash).
📝 NCLEX Tip: For Lithium, monitor kidney function and teach patients signs of toxicity.
📚 Nursing Bundle Cheat Sheet: Quick Dos & Don’ts
✅ DO:
- Double-check drug interactions.
- Educate patients about side effects.
- Monitor vital signs and lab levels.
- Stay alert for suicide risk, especially when starting antidepressants.
❌ DON’T:
- Stop meds suddenly.
- Ignore patient complaints of tremors, fever, or sudden mood changes.
- Overlook diet restrictions for MAOIs or Lithium.
✅ Key Takeaway
Mental health meds can save lives — but only if given safely. Knowing the basics of antidepressants, antipsychotics, and mood stabilizers will help any nurse pass the NCLEX, build a stronger nursing bundle, and support patients better. Every RN nurse should keep this cheat sheet handy!