Medications for Mental Health Disorders — NCLEX-PN Review | Chapter 65: Saunders

Medications for Mental Health Disorders — NCLEX-PN Review | Chapter 65: Saunders

Chapter 65 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri offers an essential pharmacology guide to psychiatric medications used in treating mental health disorders. Covering antidepressants, mood stabilizers, antipsychotics, anxiolytics, sedative-hypnotics, and herbal therapies, this chapter equips NCLEX-PN candidates with critical safety protocols, side effect recognition, and patient education strategies.

Watch the lecture above for a complete NCLEX-focused breakdown of psychotropic drug classes, therapeutic ranges, adverse effects, and nursing interventions.

Saunders NCLEX-PN Examination Review book cover

Antidepressants

  • SSRIs: fluoxetine, sertraline — sexual dysfunction, serotonin syndrome risk, gradual tapering.
  • SNRIs: venlafaxine, duloxetine — nausea, insomnia, dry mouth.
  • TCAs: amitriptyline, imipramine — orthostatic hypotension, anticholinergic effects, ECG monitoring.
  • MAOIs: phenelzine, tranylcypromine — hypertensive crisis with tyramine foods, washout periods between meds.

Mood Stabilizers

  • Lithium: therapeutic range 0.6–1.2 mEq/L, toxicity signs (tremor, confusion, seizures), hydration and sodium balance education.
  • Anticonvulsants: valproic acid (hepatotoxicity risk), carbamazepine (agranulocytosis), lamotrigine (severe rash).

Antipsychotics

  • Typical: haloperidol, chlorpromazine — extrapyramidal symptoms (EPS), neuroleptic malignant syndrome (NMS), tardive dyskinesia.
  • Atypical: risperidone, olanzapine, quetiapine — metabolic syndrome, sedation.
  • EPS management: benztropine, diphenhydramine.

Anxiolytics

  • Benzodiazepines: lorazepam, diazepam — sedation, dependency, respiratory depression; short-term use only.
  • Buspirone: non-sedating, delayed onset, no dependency risk.
  • Beta blockers: propranolol — useful for performance anxiety.

Sedative-Hypnotics

  • Zolpidem, eszopiclone — short-term insomnia treatment, fall risk education, avoid alcohol.

Herbal Therapies

  • St. John’s wort: risk of serotonin syndrome with SSRIs, multiple drug interactions.
  • Kava: hepatotoxicity and sedation risk.

Client Education

  • Avoid alcohol and hazardous activities until drug effects are known.
  • Report serious side effects promptly (EPS, signs of lithium toxicity, serotonin syndrome).
  • Follow dosing schedules and do not stop medications abruptly without guidance.

NCLEX-Priority Focus Areas

  • Recognizing and managing serotonin syndrome, lithium toxicity, EPS, and NMS.
  • Implementing MAOI dietary restrictions to prevent hypertensive crisis.
  • Ensuring safe administration of sedatives and hypnotics to prevent injury.

Conclusion

Chapter 65 consolidates critical knowledge for safe psychiatric medication administration, enabling nurses to safeguard patients while optimizing therapeutic outcomes. Mastery of these pharmacologic principles is vital for NCLEX-PN success and safe clinical practice.

Subscribe to Last Minute Lecture for more NCLEX-focused lectures and nursing study resources.

View the complete Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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