Antipsychotics and Antidepressants

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Antipsychotics and Antidepressants LKT Laboratories offers a variety of bioactive anti- serotonin available to interact with serotonin psychotic and antidepressant compounds for use in receptors. Fluoxetine Hydrochloride (F4780) and research models. Many of these compounds alter Paroxetine Hydrochloride Hemihydrate (P0297) dopamine signaling, inhibiting one of several are SSRIs used in many research applications. dopamine receptor subtypes or dopamine transporters. LKT Laboratories carries typical first Monoamine oxidase inhibitors (MAOIs) are generation antipsychotics such as Chlorpromazine another category of antidepressants that inhibit Hydrochloride (C2947) and Haloperidol (H0142) monoamine oxidase, an enzyme responsible as well as atypical second generation antipsychotics for degradation of serotonin and dopamine. Clozapine (C4757) and Risperidone (R3475). Inhibition of this enzyme increases levels of these neurotransmitters, allowing them to bind A second category of neuroactive compounds receptors and transmit signals involved in includes antidepressants, which typically act to reward, reinforcement, learning, and memory. prolong the activity of neurotransmitters in the Tranylcypromine Hydrochloride (T6903) and brain. These compounds often act on serotonin Moclobemide (M5610) are two of several MAOIs receptors, dopamine receptors, ion channels, carried by LKT Laboratories. and neurotransmitter transporters. Selective serotonin reuptake inhibitors (SSRIs) inhibit Additional representative antipsychotics and presynaptic reuptake of serotonin from the antidepressants from our product library can be synapse back into the neuron, increasing levels of found in the listing below. A5234 Amisulpride K1678 Ketanserin A5235 Amitriptyline Hydrochloride M0262 Maprotiline Hydrochloride A5059 Amoxapine M1845 Melitracen Hydrochloride A7034 Aripiprazole M3368 Mirtazapine A9801 Azaperone N1822 Nefazodone Hydrochloride B9363 Bupropion Hydrochloride O4400 Olanzapine B8274 Buspirone Hydrochloride P0144 Paliperidone C3477 Citalopram Hydrobromide Q8019 Quetiapine Fumarate C4457 Clomipramine Hydrochloride S1971 Sertraline Hydrochloride D1874 Desvenlafaxine Succinate T2936 Thioridazine Hydrochloride D5994 Doxepin Hydrochloride T7003 Trazodone Hydrochloride D8145 Duloxetine Hydrochloride T7033 Trifluoperazine Hydrochloride E7209 Escitalopram Oxalate V1854 Venlafaxine Hydrochloride F4584 Fluphenazine V3444 Vilazodone F4783 Fluvoxamine Maleate V5870 Vortioxetine I4659 Iloperidone Z3463 Ziprasidone Specialty Chemicals for Life Science Research LKT Laboratories, Inc. • lktlabs.com • Phone: 651-644-8424 • Fax: 651-644-8357 .

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Association of Selective Serotonin Reuptake Inhibitors with the Risk for Spontaneous Intracranial Hemorrhage
Supplementary Online Content Renoux C, Vahey S, Dell’Aniello S, Boivin J-F. Association of selective serotonin reuptake inhibitors with the risk for spontaneous intracranial hemorrhage. JAMA Neurol. Published online December 5, 2016. doi:10.1001/jamaneurol.2016.4529 eMethods 1. List of Antidepressants for Cohort Entry eMethods 2. List of Antidepressants According to the Degree of Serotonin Reuptake Inhibition eMethods 3. Potential Confounding Variables Included in Multivariate Models eMethods 4. Sensitivity Analyses eFigure. Flowchart of Incident Antidepressant (AD) Cohort Definition and Case- Control Selection eTable 1. Crude and Adjusted Rate Ratios of Intracerebral Hemorrhage Associated With Current Use of SSRIs Relative to TCAs eTable 2. Crude and Adjusted Rate Ratios of Subarachnoid Hemorrhage Associated With Current Use of SSRIs Relative to TCAs eTable 3. Crude and Adjusted Rate Ratios of Intracranial Extracerebral Hemorrhage Associated With Current Use of SSRIs Relative to TCAs. eTable 4. Crude and Adjusted Rate Ratios of Intracerebral Hemorrhage Associated With Current Use of Antidepressants With Strong Degree of Inhibition of Serotonin Reuptake Relative to Weak eTable 5. Crude and Adjusted Rate Ratios of Subarachnoid Hemorrhage Associated With Current Use of Antidepressants With Strong Degree of Inhibition of Serotonin Reuptake Relative to Weak eTable 6. Crude and Adjusted Rate Ratios of Intracranial Extracerebral Hemorrhage Associated With Current Use of Antidepressants With Strong Degree of Inhibition of Serotonin Reuptake Relative to Weak This supplementary material has been provided by the authors to give readers additional information about their work. © 2016 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 10/02/2021 eMethods 1.
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Report and Evidence Tables
Drug Class Review on Second Generation Antidepressants Final Report Update 1 July 2005 The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports. Gerald Gartlehner, M.D., M.P.H. Richard A. Hansen, Ph.D. Leila Kahwati, M.D., M.P.H. Kathleen N. Lohr, Ph.D. Bradley Gaynes, M.D., M.P.H. Tim Carey, M.D., M.P.H. RTI-UNC Evidence-based Practice Center Cecil G. Sheps Center for Health Services Research University of North Carolina at Chapel Hill 725 Airport Road, CB# 7590 Chapel Hill, NC 27599-7590 Tim Carey, M.D., M.P.H., Director Copyright © 2005 by Oregon Health & Science University Portland, Oregon 97201. All rights reserved Final Report Update 1 Drug Effectiveness Review Project Table of Contents Introduction........................................................................................................................ 4 Overview................................................................................................................. 4 Scope and Key Questions ....................................................................................... 7 Methods..............................................................................................................................
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Changing Medications Usually Is Not Complicated, but Problems Can Arise
Changing medications usually is not complicated, but problems can arise— especially with shorter half-life agents Discontinuing an antidepressant? Tapering tips to ease distressing symptoms David J. Muzina, MD ost psychiatrists have encountered patients who report dis- Vice president and national practice leader tressing symptoms when they have forgotten to take their for neurosciences Medco Health Solutions Mantidepressant for a few days or during changes in the medi- Fort Worth, TX cation regimen. A discontinuation syndrome can occur with almost any antidepressant, highlighting the need to slowly taper these medi- cations when discontinuation is part of a treatment plan. This article discusses antidepressant discontinuation syndrome (ADS) in a patient who experienced substantial distress after a rapid anti- depressant taper in preparation for electroconvulsive therapy (ECT). My goal is to raise awareness of ADS, promote early detection of the syn- drome, and address proper prevention and management strategies. CASE REPORT Feeling ‘worse than ever’ Mr. J, a 32-year-old tax accountant, is hospitalized for a major depressive episode (MDE) associated with deteriorating function and suicidal ide- ation. This second lifetime MDE started 8 months before his admission to an inpatient mood disorders unit. Mr. J initially was treated with fluoxetine, up to 40 mg/d across 14 weeks, with good tolerability but no significant benefit. His psychiatrist switched Mr. J to bupropion but stopped it after 4 weeks because of side effects— including headaches, insomnia, and tremor—and limited antidepressant benefit. Venlafaxine XR was initiated next, at 150 mg/d within the first 2 ES ag weeks, increased to 225 mg/d at week 6, then titrated to 300 mg/d at week 10.
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Psychedelic Drugs
108 PSYCHEDELIC DRUGS HENRY DAVID ABRAHAM UNA D. MCCANN GEORGE A. RICAURTE As defined in this chapter, the term psychedelic drugs includes 14.1%, and 7.2% of Danes reported the use of hallucino- both classic hallucinogens [i.e., indolalkylamines and phe- genic mushrooms (3). nylalkylamines, such as lysergic acid diethylamide (LSD) and In the United States, a survey of 633 undergraduates mescaline, respectively], ‘‘dissociative’’ drugs [i.e., arylcyclo- found that 23.8% had experimented with hallucinogenic hexamines, such as phencyclidine (PCP) and ketamine], and mushrooms, and 16.3% had had experience with LSD. substituted amphetamine analogues [i.e., phenylpropano- Among LSD users, 6.6% reported problems associated with lamines, such as 3,4-methylenedioxymethamphetamine LSD (Abraham and Koob, unpublished data). Of this group, (MDMA, ‘‘ecstasy’’)]. The use of psychedelic drugs dates 46.9% reported symptoms of hallucinogen persisting per- from the dawn of recorded history and continues today. ception disorder (HPPD), 37.5% described alcohol depen- Indeed, in Western culture, their use appears to be on the dence, 25% major depression, 18.8% persisting delusions, rise. Despite the longstanding popularity of psychedelic 15.6% panic attacks, and 12.5% auditory hallucinations. drugs, controlled research evaluating their effects in humans LSD use is most likely to occur between the ages of 18 and has been surprisingly scant, and data from preclinical studies 25. Use is more common in male Caucasians and Hispanics. have been largely limited to the last several decades. This Of note is that although the parents of LSD users tend to chapter reviews preclinical and clinical research involving be of a higher socioeconomic status, the users themselves indolalkylamines, arylcyclohexamines, and substituted am- exhibit an inverse relationship between LSD use and educa- phetamines, for which LSD, PCP, and MDMA are used as tional achievement (4).
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Tcas Versus Placebo - New Studies in the Guideline Update
TCAs versus placebo - new studies in the guideline update Comparisons Included in this Clinical Question Amitriptyline vs placebo Clomipramine vs placebo Dosulepin (dothiepin) vs placebo AMSTERDAM2003A LARSEN1989 FERGUSON1994B BAKISH1992B PECKNOLD1976B ITIL1993 BAKISH1992C RAMPELLO1991 MINDHAM1991 BREMNER1995 THOMPSON2001B CLAGHORN1983 CLAGHORN1983B FEIGHNER1979 GELENBERG1990 GEORGOTAS1982A GOLDBERG1980 HICKS1988 HOLLYMAN1988 HORMAZABAL1985 HOSCHL1989 KLIESER1988 LAAKMAN1995 LAPIERRE1991 LYDIARD1997 MYNORSWALLIS1995 MYNORSWALLIS1997 REIMHERR1990 RICKELS1982D RICKELS1985 RICKELS1991 ROFFMAN1982 ROWAN1982 SMITH1990 SPRING1992 STASSEN1993 WILCOX1994 16 Imipramine vs placebo BARGESCHAAPVELD2002 BEASLEY1991B BOYER1996A BYERLEY1988 CASSANO1986 CASSANO1996 CLAGHORN1996A COHN1984 COHN1985 COHN1990A COHN1992 COHN1996 DOMINGUEZ1981 DOMINGUEZ1985 DUNBAR1991 ELKIN1989 ENTSUAH1994 ESCOBAR1980 FABRE1980 FABRE1992 FABRE1996 FEIGER1996A FEIGHNER1980 FEIGHNER1982 FEIGHNER1983A FEIGHNER1983B FEIGHNER1989 FEIGHNER1989A FEIGHNER1989B FEIGHNER1989C FEIGHNER1992B FEIGHNER1993 FONTAINE1994 GELENBERG2002 GERNER1980B HAYES1983 ITIL1983A KASPER1995B KELLAMS1979 LAIRD1993 LAPIERRE1987 LECRUBIER1997B LIPMAN1986 LYDIARD1989 MARCH1990 17 MARKOWITZ1985 MENDELS1986 MERIDETH1983 Nortriptyline vs placebo NANDI1976 GEORGOTAS1986A NORTON1984 KATZ1990 PEDERSEN2002 NAIR1995 PESELOW1989 WHITE1984A PESELOW1989B PHILIPP1999 QUITKIN1989 RICKELS1981 RICKELS1982A RICKELS1987 SCHWEIZER1994 SCHWEIZER1998 SHRIVASTAVA1992 SILVERSTONE1994 SMALL1981 UCHA1990 VERSIANI1989 VERSIANI1990
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1 Supplemental Figure 1: Illustration of Time-Varying
Supplemental Material Table of Contents Supplemental Table 1: List of classes and medications. Supplemental Table 2: Association between benzodiazepines and mortality in patients initiating hemodialysis (n=69,368) between 2013‐2014 stratified by age, sex, race, and opioid co‐dispensing. Supplemental Figure 1: Illustration of time‐varying exposure to benzodiazepine or opioid claims for one person. Several sensitivity analyses were performed wherein person‐day exposure was extended to +7 days, +14 days, and +28 days beyond the outlined periods above. 1 Supplemental Table 1: List of classes and medications. Class Medications Short‐acting benzodiazepines Alprazolam, estazolam, lorazepam, midazolam, oxazepam, temazepam, and triazolam Long‐acting benzodiazepines chlordiazepoxide, clobazam, clonazepam, clorazepate, diazepam, flurazepam Opioids alfentanil, buprenorphine, butorphanol, codeine, dihydrocodeine, fentanyl, hydrocodone, hydromorphine, meperidine, methadone, morphine, nalbuphine, nucynta, oxycodone, oxymorphone, pentazocine, propoxyphene, remifentanil, sufentanil, tapentadol, talwin, tramadol, carfentanil, pethidine, and etorphine Antidepressants citalopram, escitalopram, fluoxetine, fluvozamine, paroxetine, sertraline; desvenlafaxine, duloxetine, levomilnacipran, milnacipran, venlafaxine; vilazodone, vortioxetine; nefazodone, trazodone; atomoxetine, reboxetine, teniloxazine, viloxazine; bupropion; amitriptyline, amitriptylinoxide, clomipramine, desipramine, dibenzepin, dimetacrine, dosulepin, doxepin, imipramine, lofepramine, melitracen,
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Providers | Medications for Depression
Medications for Depression Antidepressants alter the concentrations of one or more key neurotransmitters in the brain, namely norepinephrine, serotonin, and dopamine. As depression may be a presenting symptom of a mixed manic episode, it is important to adequately screen patients with depressive symptoms to determine if they are at risk of bipolar disorder. All patients should also be monitored with regards to mental status for depression, suicidal ideation, anxiety, social functioning, mania, panic attacks, or other unusual changes in behavior. All antidepressants carry a black box warning of increased risk of suicidal thinking and behavior in children and adolescents, particularly in the first few months of therapy. MAOIs are contraindicated with all other classes of antidepressants and should not be used in combination. Common side effects often improve within the first two weeks of treatment. A low starting dose might help increase tolerance and adherence. DRUG CATEGORY MEDICATION COMMON SIDE EFFECTS MONITORING PARAMETERS ADDITIONAL COMMENTS Selective Serotonin .Citalopram (IR, Liq)* .GI: effects are common (nausea, xerostomia, diarrhea) .Weight and BMI .Comparable to TCAs in efficacy, but are markedly safer and better tolerated Reuptake Inhibitors .Escitalopram (IR, Liq) .Sexual dysfunction: in both men & women .Signs/symptoms of serotonin syndrome .SSRIs differ from each other with respect to their degree of selectivity for the serotonin (SSRIs) .Fluoxetine (IR, Liq ) .Hematologic: Impaired platelet aggregation/bleeding .Electrolytes,
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Incidence of and Risk Factors for Chronic Opioid Use Among Opioid-Naive Patients in the Postoperative Period
Supplementary Online Content Sun EC, Darnall BD, Baker LC, Mackey S. Incidence of and risk factors for chronic opioid use among opioid-naïve patients in the postoperative period. JAMA Intern Med. Published online July 11, 2016. doi:10.1001/jamainternmed.2016.3298. eTable 1. List of CPT Codes eFigure. Sample Construction Flow Chart eTable 2. List of Drug Classes eTable 3. List of Medical Comorbidities and ICD-9 Codes eTable 4. Sample Summary Characteristics, by procedure eTable 5. Risk Factors for Chronic Opioid Use Following Surgery Among Opioid Naïve Patients This supplementary material has been provided by the authors to give readers additional information about their work. © 2016 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 eTable 1. List of CPT codes CPT Codes Total Knee Arthroplasty1 27447 Total Hip Arthroplasty1 27130 Laparoscopic Cholecystectomy2 47562, 47563, 47564 Open Cholecystectomy3 47600, 47605, 47610 Laparoscopic Appendectomy4 44970, 44979 Open Appendectomy5 44950, 44960 Cesarean Section6 59510, 59514, 59515 FESS7 31237, 31240, 31254, 31255, 31256, 31267, 31276, 31287, 31288 Cataract Surgery8 66982, 66983, 66984 TURP9 52601, 52612, 52614 Simple Mastectomy10‐12 19301, 19302, 19303, 19180 © 2016 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 eFigure. Sample Construction Flow Chart © 2016 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 eTable 2.
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Antidepressant Medications: U.S. Food and Drug Administration
Antidepressant Medications: U.S. Food and Drug Administration-Approved Indications and Dosages for Use in Adults The therapeutic dosing recommendations for antidepressant medications are based on U.S. Food and Drug Administration (FDA)-approved product labeling. Nevertheless, the dosing regimen is adjusted according to a patient’s individual response to pharmacotherapy. The FDA-approved indications and dosages for the use of antidepressant medications in adults are provided in this table. Some of the antidepressant medications are FDA-approved for the treatment of or as adjunct therapy for Parkinson’s disease. This indication is not discussed in this document because of its very specific focus and individualized treatment regimens. All of the antidepressant medications listed are for oral administration unless otherwise stated. Information on the generic availability of antidepressant medications can be found by searching the Electronic Orange Book at https://www.accessdata.fda.gov/scripts/cder/ob/default.cfm on the FDA website. Generic Medication Indication Initial Dose Maximum Dose Other Information Availability amitriptyline[1] depression Outpatients: Outpatients: Outpatients may be initiated at 50 mg Yes 75 mg per day; 150 mg per day; to 100 mg once a day at bedtime. Dose Hospitalized patients: Hospitalized patients: increases should be made gradually by 100 mg per day 300 mg per day 25 mg to 50 mg as necessary, preferably in the late afternoon or evening. Lower doses are recommended for elderly patients. Take in divided doses. amoxapine[2] depression 50 mg 2 or 3 times a day 400 mg per day; May increase dose to 100 mg 2 to 3 times Yes Hospitalized patients a day by the end of the first week.
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Antidepressants: Mechanism of Action, Toxicity and Possible Amelioration
Journal of Applied Biotechnology & Bioengineering Research Article Open Access Antidepressants: mechanism of action, toxicity and possible amelioration Abstract Volume 3 Issue 5 - 2017 Depression being a state of sadness may be defined as a psychoneurotic disorder Khushboo, Sharma B characterised by mental and functional activity, sadness, reduction in activity, Department of Biochemistry, University of Allahabad, India difficulty in thinking, loss of concentration, perturbations in appetite, sleeping, and feelings of dejection, hopelessness and generation of suicidal tendencies. It Correspondence: B Sharma, Department of Biochemistry, is a common and recurrent disorder causing significant morbidity and mortality University of Allahabad, Allahabad 211002, UP, India, worldwide. The antidepressant compounds used against depression are reported to Email [email protected] be used also for treating pain, anxiety syndromes etc. They have been grouped in five different categories such as Received: June 29, 2017 | Published: September 01, 2017 i. Tricyclic antidepressants (TCAs) ii. Selective serotonin-reuptake inhibitors (SSRIs) iii. Monoamine oxidase inhibitors (MAOIs) iv. Serotonin-norepinephrine reuptake inhibitor (SNRI) and v. Non-TCA antidepressants based on their mode of action. Most of the antidepressants have been reported to possess adverse effects on the health of users. The present review article focuses on an updated current of antidepressants, their mechanism of actions, pathophysiology of these compounds, their side effects and
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Anafranil (Clomipramine Hydrochloride) Tablets 1 Name of the Medicine 2 Qualitative and Quant
AUSTRALIAN PRODUCT INFORMATION – ANAFRANIL (CLOMIPRAMINE HYDROCHLORIDE) TABLETS 1 NAME OF THE MEDICINE Clomipramine hydrochloride 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 25 mg clomipramine hydrochloride. Lactose and sucrose Anafranil tablets contain lactose and sucrose. Patients with rare hereditary problems of galactose intolerance, fructose intolerance, severe lactase deficiency, sucrase-isomaltase insufficiency or glucose-galactose malabsorption should not take Anafranil tablets. For the full list of excipients, see Section 6.1 List of excipients. 3 PHARMACEUTICAL FORM Tablet 4 CLINICAL PARTICULARS 4.1 THERAPEUTIC INDICATIONS • Major depression. • Obsessive-compulsive disorders and phobias in adults. • Cataplexy associated with narcolepsy. 4.2 DOSE AND METHOD OF ADMINISTRATION General The dosage should be determined individually and adapted to the patient's condition. Doses should be kept as low as possible and increased cautiously. Note that the plasma concentrations of the drug and active metabolite do not stabilise for 7 to 14 days after commencing treatment and after a dosage change. During treatment, the efficacy and tolerability of Anafranil must be judged by keeping the patients under close surveillance. Depression, obsessive-compulsive disorders and phobias: Start treatment with one tablet of 25 mg 2 or 3 times daily. Raise the daily dosage stepwise, e.g. 25 mg every few days, (depending on how the medication is tolerated) to 4 to 6 tablets of 25 mg. Once a distinct improvement has set in, adjust the daily dosage to a maintenance level averaging 2 to 4 tablets of 25 mg. 1 Cataplexy accompanying narcolepsy: Anafranil should be given orally in a daily dose of 25 to 75 mg.
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Currently Prescribed Psychotropic Medications
CURRENTLY PRESCRIBED PSYCHOTROPIC MEDICATIONS Schizophrenia Depression Anxiety Disorders 1st generation antipsychotics: Tricyclics: Atarax (hydroxyzine) Haldol (haloperidol), *Anafranil (clomipramine) Ativan (lorazepam) Haldol Decanoate Asendin (amoxapine) BuSpar (buspirone) Loxitane (loxapine) Elavil (amitriptyline) *Inderal (propranolol) Mellaril (thioridazine) Norpramin (desipramine) Keppra (levetiracetam) Navane (thiothixene) Pamelor (nortriptyline) *Klonopin (clonazepam) Prolixin (fluphenazine), Prolixin Sinequan (doxepin) Librium (chlordiazepoxide) Decanoate Spravato (esketamine) Serax (oxazepam) Stelazine (trifluoperazine) Surmontil (trimipramine) Thorazine (chlorpromazine) *Tenormin (atenolol) Tofranil (imipramine) MEDICATIONS PSYCHOTROPIC PRESCRIBED CURRENTLY Trilafon (perphenazine) Tranxene (clorazepate) Vivactil (protriptyline) Valium (diazepam) 2nd generation antipsychotics: Zulresso (brexanolone) Vistaril (hydroxyzine) Abilify (aripiprazole) Aristada (aripiprazole) SSRIs: Xanax (alprazolam) Clozaril (clozapine) Celexa (citalopram) *Antidepressants, especially SSRIs, are also used in the treatment of anxiety. Fanapt (iloperidone) Lexapro (escitalopram) Geodon (ziprasidone) *Luvox (fluvoxamine) Invega (paliperidone) Paxil (paroxetine) Stimulants Invega Sustenna (used in the treatment of ADD/ADHD) Prozac (fluoxetine) Perseris (Risperidone injectable) Zoloft (sertraline) Adderall (amphetamine and Latuda (lurasidone) dextroamphetamine) Rexulti (brexpiprazole) MAOIs: Dexedrine (dextroamphetamine) Risperdal (risperidone), Emsam
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