Consent Drug List - January 2012

Consent Drug List - January 2012

<p> 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.</p><p>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.</p><p>The Executive Formulary Committee does not endorse the use of nonformulary drugs </p><p>Antidepressants Anxiolytics/Sedatives/Hypnotics amitriptyline (Elavil) alprazolam (Xanax, Xanax XR) amoxapine (Asendin) buspirone (BuSpar) bupropion (Wellbutrin, Wellbutrin SR) chloral hydrate (Noctec) bupropion (Wellbutrin XL) chlordiazepoxide (Librium) citalopram (Celexa) clonazepam (Klonopin) desipramine (Norpramin) clorazepate (Tranxene) desvenlafaxine (Pristiq) nonformulary diazepam (Valium) doxepin (Sinequan) diphenhydramine (Benadryl) duloxetine (Cymbalta) eszopiclone (Lunesta) nonformulary escitalopram (Lexapro) flurazepam (Dalmane) nonformulary fluoxetine (Prozac) hydroxyzine (Atarax, Vistaril) imipramine (Tofranil) lorazepam (Ativan) maprotiline (Ludiomil) oxazepam (Serax) mirtazapine (Remeron, Remeron SolTab) pentobarbital (Nembutal) nonformulary nefazodone (Serzone) nonformulary ramelteon (Rozerem) nonformulary nortriptyline (Pamelor, Aventyl) temazepam (Restoril) paroxetine (Paxil, Paxil CR) triazolam (Halcion) protriptyline (Vivactil) zaleplon (Sonata) sertraline (Zoloft) zolpidem (Ambien) trazodone (Desyrel) trimipramine (Surmontil) Mood Stabilizers venlafaxine (Effexor, Effexor XR) carbamazepine (Tegretol, Tegretol XR, Carbatrol, Equetro) divalproex sodium (Depakote, Depakote ER) Antipsychotics lithium (Eskalith, Eskalith CR, Lithobid) aripiprazole (Abilify) valproic acid (Depakene) asenapine (Saphris) oxcarbazepine (Trileptal) chlorpromazine (Thorazine) lamotrigine (Lamictal) clozapine (Clozaril, Fazaclo) Reserve droperidol (Inapsine) nonformulary Stimulants fluphenazine (Prolixin) amphetamine/dextroamphetamine fluphenazine decanoate (Prolixin D) mixture (Adderall, Adderall XR) haloperidol (Haldol) dexmethylphenidate (Focalin) nonformulary haloperidol decanoate (Haldol D) dextroamphetamine (Dexedrine) iloperidone (Fanapt) Reserve lisdexamfetamine (Vyvanse) nonformulary loxapine (Loxitane) methamphetamine (Desoxyn) nonformulary lurasidone (Latuda) methylphenidate (Ritalin, Ritalin SR, Concerta, Metadate, olanzapine (Zyprexa, Zyprexa Zydis) Metadate CD) olanzapine pamoate (Zyprexa Relprevv) Reserve methylphenidate patch (Daytrana) nonformulary paliperidone (Invega) paliperidone palmitate (Invega Sustenna) Chemical Dependency Adjuncts perphenazine (Trilafon) acamprosate (Campral) nonformulary pimozide (Orap) nonformulary disulfiram (Antabuse) quetiapine (Seroquel) naltrexone (ReVia, Vivitrol) quetiapine (Seroquel XR) nonformulary topiramate (Topamax) risperidone (Risperdal, Risperdal M-Tab) risperidone (Risperdal Consta) thioridazine (Mellaril) thiothixene (Navane) trifluoperazine (Stelazine) ziprasidone (Geodon)</p><p>Updated 1/12 Page 1 of 2 Monoamine Oxidase Inhibitors Miscellaneous Drugs isocarboxazid (Marplan) atomoxetine (Strattera) phenelzine (Nardil) atenolol (Tenormin) selegiline (Emsam) nonformulary clomipramine (Anafranil) tranylcypromine (Parnate) clonidine (Catapres) clonidine ER (Kapvay) nonformulary fluvoxamine (Luvox) gabapentin (Neurontin) guanfacine (Tenex) guanfacine ER (Intuniv) nonformulary metoprolol (Lopressor) nadolol (Corgard) propranolol (Inderal) reserpine (Serpasil) nonformulary naltrexone (ReVia) olanzapine/fluoxetine (Symbyax) nonformulary pindolol (Visken) nonformulary Other This category must be approved prior to inclusion in this instrument</p><p>Updated 1/12 Page 2 of 2</p>

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