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Emergency Psychiatry Medications

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Lorazepam

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Indications: Acute anxiety, agitation, seizure; Dosing: 2-4 mg IM/IV

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Haloperidol

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Indications: Acute psychosis, agitation; Dosing: 5-10 mg IM/IV

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Olanzapine

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Indications: Bipolar mania, psychosis; Dosing: 10 mg IM

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Diazepam

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Indications: Acute anxiety, seizures, alcohol withdrawal; Dosing: 5-10 mg IV

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Midazolam

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Indications: Seizures, preprocedure sedation; Dosing: 2-5 mg IM/IV

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Quetiapine

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Indications: Bipolar disorder, schizophrenia; Dosing: 25-50 mg PO/IM

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Risperidone

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Indications: Schizophrenia, Bipolar I disorder; Dosing: 1-2 mg PO/IM

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Ziprasidone

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Indications: Agitation associated with schizophrenia, bipolar mania; Dosing: 10-20 mg IM

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Aripiprazole

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Indications: Schizophrenia, acute manic and mixed episodes associated with Bipolar I; Dosing: 9.75 mg IM

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Chlorpromazine

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Indications: Severe behavioral disturbances, acute psychosis; Dosing: 25-50 mg IM/IV

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Flumazenil

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Indications: Benzodiazepine overdose; Dosing: Initial dose 0.2 mg IV, subsequent doses 0.3-0.5 mg IV if needed

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Naloxone

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Indications: Opioid overdose; Dosing: 0.04-2 mg IV/IM/IN, may repeat every 2-3 minutes as needed

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Lithium

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Indications: Acute mania; Dosing: 600-900 mg PO three times a day

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Valproate

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Indications: Mania, seizures; Dosing: 10-20 mg/kg IV loading dose then 1000-2500 mg daily divided doses

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Carbamazepine

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Indications: Acute mania, trigeminal neuralgia; Dosing: Initial 200 mg PO twice a day, may increase to 400 mg PO three times a day

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Dextroamphetamine

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Indications: ADHD, narcolepsy; Dosing: 5 mg PO once or twice daily, can be increased gradually

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Methylphenidate

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Indications: ADHD, narcolepsy; Dosing: 5-20 mg PO one to three times daily

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Clonidine

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Indications: ADHD (as an adjunct), hypertensive crisis; Dosing: 0.1-0.2 mg PO/IV

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