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Psychotropic Medications Consent Drug List (PDF)

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Psychotropic Medications Consent Drug List (PDF) Classes of Medications Frequently Used for Psychiatric Indications Consent is required for any medication that is used in the treatment of a psychiatric diagnosis or symptom, whether or not the medication is included in this list. Refer to physician order for determination of indication for use. The classification of psychotropic medication is fairly standard but medications can be used for treatment of illnesses that would be considered listed under a different classification. For example, some medications listed under antipsychotics maybe used as a mood stabilizer. The Executive Formulary Committee does not endorse the use of nonformulary drugs Antidepressants Antipsychotics amitriptyline (Elavil) aripiprazole (Abilify, Abilify Discmelt) amoxapine (Asendin) nonformulary aripiprazole (Abilify Maintena) bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin aripiprazole lauroxil (Aristada) XL) aripiprazole lauroxil (Aristada Initio) Reserve citalopram (Celexa) asenapine (Saphris) desipramine (Norpramin) asenapine (Secuado) nonformulary desvenlafaxine (Pristiq, Khedezla) nonformulary brexpiprazole (Rexulti) doxepin (Sinequan) cariprazine (Vraylar) duloxetine (Cymbalta) chlorpromazine (Thorazine) escitalopram (Lexapro) clozapine (Clozaril, Fazaclo, Versacloz) esketamine (Spravato) Reserve Reserve fluoxetine (Prozac) droperidol (Inapsine) nonformulary imipramine (Tofranil) fluphenazine (Prolixin) ketamine (Ketalar) Reserve fluphenazine decanoate (Prolixin D) levomilnacipran (Fetzima) nonformulary haloperidol (Haldol) maprotiline (Ludiomil) nonformulary haloperidol decanoate (Haldol D) mirtazapine (Remeron, Remeron SolTab) iloperidone (Fanapt) Reserve nefazodone (Serzone) nonformulary loxapine (Loxitane) nortriptyline (Pamelor, Aventyl) loxapine inhalant (Adasuve) nonformulary paroxetine (Paxil, Paxil CR) lumateperone (Caplyta) protriptyline (Vivactil) nonformulary lurasidone (Latuda) sertraline (Zoloft) olanzapine (Zyprexa, Zyprexa Zydis) trazodone (Desyrel) olanzapine pamoate (Zyprexa Relprevv) trimipramine (Surmontil) nonformulary Reserve venlafaxine (Effexor, Effexor XR) paliperidone (Invega) vilazodone (Viibryd) nonformulary paliperidone palmitate (Invega Sustenna) vortioxetine (Trintellix) nonformulary paliperidone palmitate (Invega Trinza) nonformulary perphenazine (Trilafon) pimozide (Orap) nonformulary quetiapine (Seroquel) quetiapine (Seroquel XR) nonformulary risperidone (Risperdal, Risperdal M-Tab) risperidone (Risperdal Consta) risperidone (Perseris) nonformulary thioridazine (Mellaril) Reserve thiothixene (Navane) trifluoperazine (Stelazine) ziprasidone (Geodon) Monoamine Oxidase Inhibitors Substance Use Treatments isocarboxazid (Marplan) nonformulary acamprosate (Campral) phenelzine (Nardil) buprenorphine (Subutex) Reserve selegiline (Emsam) nonformulary buprenorphine/naloxone (Suboxone) Reserve tranylcypromine (Parnate) disulfiram (Antabuse) naltrexone (ReVia) naltrexone (Vivitrol) Reserve topiramate (Topamax) Anxiolytics/Sedatives/Hypnotics Miscellaneous Drugs alprazolam (Xanax, Xanax XR) atomoxetine (Strattera) buspirone (BuSpar) atenolol (Tenormin) chlordiazepoxide (Librium) clomipramine (Anafranil) clonazepam (Klonopin) clonidine (Catapres) clorazepate (Tranxene) clonidine ER (Kapvay) nonformulary diazepam (Valium) fluvoxamine (Luvox) diphenhydramine (Benadryl) gabapentin (Neurontin) eszopiclone (Lunesta) guanfacine (Tenex, Intuniv) flurazepam (Dalmane) nonformulary metoprolol (Lopressor) hydroxyzine (Atarax, Vistaril) nadolol (Corgard) nonformulary lorazepam (Ativan) propranolol (Inderal) midazolam (Versed) naltrexone (ReVia) oxazepam (Serax) olanzapine/fluoxetine (Symbyax) nonformulary pentobarbital (Nembutal) nonformulary pindolol (Visken) nonformulary ramelteon (Rozerem) nonformulary pimavanserin (Nuplazid) nonformulary suvorexant (Belsomra) nonformulary prazosin (Minipress) temazepam (Restoril) triazolam (Halcion) zaleplon (Sonata) nonformulary zolpidem (Ambien) zolpidem (Ambien CR) nonformulary Mood Stabilizers Stimulants carbamazepine (Tegretol, Tegretol XR, Carbatrol, amphetamine/dextroamphetamine mixture Equetro) (Adderall, Adderall XR) divalproex sodium (Depakote, Depakote ER, dexmethylphenidate ER (Focalin XR) Depakote Sprinkles) dexmethylphenidate (Focalin) nonformulary lamotrigine (Lamictal) dextroamphetamine (Dexedrine, Dexedrine, lithium (Eskalith, Eskalith CR, Lithobid) Zenzedi) oxcarbazepine (Trileptal) lisdexamfetamine (Vyvanse) Reserve topiramate (Topamax) methamphetamine (Desoxyn) nonformulary valproic acid (Depakene) methylphenidate (Ritalin, Ritalin SR, Concerta, Metadate, Metadate CD, Jornay PM) methylphenidate patch (Daytrana) nonformulary methylphenidate soln (Quillivant XR) nonformulary Other This category must be approved prior to inclusion in this Instrument Updated Jan 2021 .
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