| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Class | Med | Dose (level) | Frequencies, formulations | Side effects (putative causes) | Receptor antagonism | Class-wide notes | Half life (hrs) | 1A2 | 2B6 | 2C9 | 2C19 | 2D6 | 3A4 | ABCB1 | Notes about interactions | FDA approval | |||||||
2 | ||||||||||||||||||||||||
3 | SSRIs | Escitalopram (Lexapro) | 10-40 | Sex dysfxn (SERT) | SERT | 30 | s | - | s | s | - | s | MDD ('02), GAD ('03), OCD (__), generic ('12) | |||||||||||
4 | Citalopram (Celexa) | 20-40/80 | Sex dysfxn (SERT), ↑ QTc (R-citalopram) | SERT, H1 | 36 | s | - | s | s | - | s | MDD ('98), generic ('03) | ||||||||||||
5 | Fluvoxamine (Luvox) | 50-300 | BID, CR | Sex dysfxn (SERT) | SERT, σ1 | 15 | --- | s | -- | -- | --- | -- | s | -- | - | s | ____s clozapine | OCD-kids ('97), MDD-CR ('08) | ||||||
6 | Sertraline (Zoloft) | 50-300 | Sex dysfxn (SERT) | SERT, DAT, σ1 | 24 | - | -- | s | -- | s | -- | s | --- | s | -- | s | - | s | dose dependent 2D6 inhibition | MDD ('91), Panic-kids ('97), PMDD & OCD-kids ('02), social anxiety disorder (__), generic ('06) | ||||
7 | Fluoxetine (Prozac) | 20-80 | Weekly | Sex dysfxn (SERT), activating (5HT2c, NET) | SERT, 5HT2c, NET (weak) | 8 days | - | -- | -- | s | -- | s | --- | s | -- | s | - | s | MDD ('87), generic ('01), weekly ('01), PMDD (__), bulimia (__), OCD (__), MDD-kids (__), OCD-kids (__) | |||||
8 | Paroxetine (Paxil) | 20-80 | CR | Sex dysfxn (SERT, NOS), antichol (M1) | SERT, M1, NOS, NET (weak) | 20 | - | --- | - | --- | s | -- | s | - | s | MDD (__), Panic ('96), MDD-CR ('99), Panic-CR ('02), OCD (__) | ||||||||
9 | SPARIs | Vilazodone (Viibryd) | Less sex dysfnx (5HT1a), GI (rapid ↑ in 5HT) | SERT, 5HT1a (p-ag) | MDD ('11) | |||||||||||||||||||
10 | SNRIs | Venlafaxine (Effexor) | 150-375 | XR | Sex dysfxn (SERT), nausea & ↑BP & sweating (NET) | SERT >>> NET (stronger at higher doses) | 10 | s | - | s | s | MDD-XR ('97), GAD ('99), generic ('06), generic-XR ('10) | ||||||||||||
11 | --> Desvenlafaxine (Pristiq) | 50-400 | Sex dysfxn (SERT) | SERT >> NET (stronger at higher doses) | 10 | -- | s | s (UGTs) | MDD ('08) | |||||||||||||||
12 | Duloxetine (Cymbalta) | 40-120 | BID | Sex dysfxn (SERT), HA, urinary hesitancy (NET) | SERT > NET | 15 | s | -- | s | MDD ('04), Diabetic neuropathy ('04), GAD ('07), generic ('13) | ||||||||||||||
13 | Milnacipran (Savella) | BID | Urinary hesitancy & sweating (NET) | NET > SERT | Fibromyalgia (__) | |||||||||||||||||||
14 | Levo-milnacipran ER (Fetzima) | MDD | ||||||||||||||||||||||
15 | NDRIs | Bupropion (Wellbutrin) | 300-450 | SR, XL | seizures, HA, activating (NET, DAT) | NET, DAT | 24 | s | s | s | -- | s | s | s (2A6, 2E1, glucuronidation) | MDD ('85, withdrawn '86, re-introduced '89), MDD-SR ('96), Smoking ('97), MDD-XL ('03), SAD ('06), MDD-HBr ('08) | |||||||||
16 | α2 antags | Mirtazapine (Remeron) | 15-45 | ↑ sleep, fatigue, appetite, & ↓ anxiety (H1) | α2, H1, 5HT2a, 5HT2c, 5HT3 | 30 | s | s | s | s (glucuronidation) | MDD ('96), MDD-SL ('01) | |||||||||||||
17 | SARIs | Trazodone | 25-500 | XR | ↑ sleep (5HT2a, α1, H1), priapism (1:6000), oHTN | 5HT2a, α1, H1; 5HT2c & SERT (at 150+ mg) | 8 | s | MDD ('81), MDD-ER ('10) | |||||||||||||||
18 | Tricyclics (SNRIs) | Doxepin | 100-300 | most antichol (can give 3-6 mg for insomnia) | NET, α1, H1, M1, VG-NaCh (weak) | 15 | Insomnia | |||||||||||||||||
19 | Amitriptyline (Elavil) | 100-300 | most antichol (can give 10-25 mg for insomnia) | NET, α1, H1, M1, VG-NaCh (weak) | 15 | |||||||||||||||||||
20 | --> Nortriptyline (Pamelor) | 50-200 | less antichol & oHTN; ↑ NE | NET, α1, H1, M1, VG-NaCh (weak) | 30 | |||||||||||||||||||
21 | Imipramine | 100-300 | ↑ NE | NET, α1, H1, M1, VG-NaCh (weak) | 12 | |||||||||||||||||||
22 | --> Desipramine | 100-300 | ↑ NE | NET, α1, H1, M1, VG-NaCh (weak) | 18 | |||||||||||||||||||
23 | Clomipramine (Anafranil) | 100-250 | also used for OCD; ↑ 5HT | SERT, NET, α1, H1, M1, VG-NaCh (weak) | 32 | |||||||||||||||||||
24 | Protriptyline | 20-60 | energizing | NET, α1, H1, M1, VG-NaCh (weak) | 3 days | |||||||||||||||||||
25 | MAOIs | Phenelzine (Nardil) | 45-90 | oHTN | Irreversible, MAO-A, MAO-B | 12 | ||||||||||||||||||
26 | Tranylcypromine (Parnate) | 30-60 | Irreversible, MAO-A, MAO-B | 2 | ||||||||||||||||||||
27 | Isocarboxazid (Marplan) | Irreversible | MDD ('98) | |||||||||||||||||||||
28 | Selegiline (TD) (Emsam) | 6-12 | Less MAOA-I in gut, so less tyr restriction needed | Irreversible, MAO-A (high doses), MAO-B | 24 | |||||||||||||||||||
29 | Moclobemide | 300-600 | Despite reversibility, tyramine restriction still needed | Reversible, MAO-A | 2 | |||||||||||||||||||
30 | Other Anti- depressants | L-methylfolate (Deplin) | ||||||||||||||||||||||
31 | Vortioxetine (Brintellix) | MDD | ||||||||||||||||||||||
32 | SAMe | 800-1600 | Mild anxiety, insomnia, dry mouth, GI, possible 5HT s/o when combined with other serotinergics | |||||||||||||||||||||
33 | St. John's wort | 900-1800 | Dry mouth, dizziness, GI, phototoxicity, possible 5HT s/o | decreases immunosuppressants, warfarin, antiretrivirals, digoxin | ||||||||||||||||||||
34 | Omega-3 (EPA, DHA) | 1000-2000 | Fishy taste; GI | |||||||||||||||||||||
35 | Mood Stabilizers | Lithium (depress +, euthymia ++, mania +) | 900-1800 (0.6-1.1) | DR | sedating, poor cog, tremor, ARF, hypothy, polydip, edema, GI, ↑ app, Ebstein's anomaly | 21 | increased by thiazides, ACE/ARBs, NSAIDs | Manic depression-CR ('96) | ||||||||||||||||
36 | Divalproex (Depakote) (depress -, euthymia +, mania ++) | 1000-2000 (70-120) | very sedating, poor cog, alopecia, liver tox, inc NH3, GI, ↑ app, neural tube defects | 14 | increases ASA, coumadin, (ox)carbamazapine | Migraines ('96), Mania-DR ('08) | ||||||||||||||||||
37 | Lamotrigine (Lamictal) (depress +, euthymia /, mania -) | 200-400 | SJS/TEN (avoid w/ slow titration), benign rash (5-10%), HA, tremor, cleft palate | 29 | doubled by depakote; reduced by estrogens (pregnancy, OCPs) | |||||||||||||||||||
38 | Carbamazepine (Tegretol) (depress /, euthymia +, mania +) | 800-1200 (8-12) | very sedating, ataxia, diplopia, dangerous rashes, liver tox, aplastic anemia, SIADH, GI | 2 days | decreases immunosuppressants, OCPs, depakote, and itself | |||||||||||||||||||
39 | Oxcarbazepine (Trileptal) (depress ?, euthymia ?, mania ?) | 1.5 mg/kg | less rash, liver tox, aplastic anemia, app stimulation vs. carbamazepine | 2 | less decreases in the drugs listed for carbamazepine | |||||||||||||||||||
40 | Typical Anti- psychotics | HIGH: Haloperidol (Haldol) | 5-15 | IM (monthly) | High EPS, TD 3-7% / yr, hyperPRL 50%, ↑ QTc | Schizophrenia ('67) | ||||||||||||||||||
41 | HIGH: Fluphenazine (Prolixin) | 5-15 | IM (monthly) | High EPS, TD 3-7% / yr, hyperPRL 50% | Schizophrenia ('59) | |||||||||||||||||||
42 | MID: Perphenazine (Trilafon) | 16-64 | Mod EPS, TD, wt, sedat, oHTN; hyperPRL 50% | Schizophrenia ('57) | ||||||||||||||||||||
43 | LOW: Chlorpromazine (Thorazine) | 300-600 | Severe oHTN and sedation; hyperPRL 50% | Schizophrenia ('54) | ||||||||||||||||||||
44 | Atypical Anti- psychotics | HIGH: Risperidone (Risperdal) | 3-6 | IM (bi-monthly) | High EPS, TD, hyperPRL 90%; mod wt, oHTN | ___ ('93), Schizophrenia ('96), MDD (__), Bipolar maintenance (__) | ||||||||||||||||||
45 | HIGH: --> Paliperidone (Invega) | 6-12 | IM (monthly) | High EPS, TD, hyperPRL 90%; mod wt, oHTN | Schizophrenia ('06) | |||||||||||||||||||
46 | MID: Ziprasidone (Geodon) | 120-280 | Effectiveness; food causes ↑ absortpion by 40% | Schizophrenia ('01), Agitation-IM ('02) | ||||||||||||||||||||
47 | MID: Olanzapine (Zyprexa) | 10-20 | IM (monthly) | Severe weight, moderate sedation | Psychotic disorder sxms ('96), Bipolar maintenance (__), Bipolar depression (__) | |||||||||||||||||||
48 | MID: Asenapine (Saphris) | 10-20 | Can't eat or drink for 10 minutes; mod sedation | Schizophrenia & Mania ('09) | ||||||||||||||||||||
49 | Lurasidone (Latuda) | Schizophrenia ('10) | ||||||||||||||||||||||
50 | Iloperidone (Fanapt) | Schizophrenia ('09) | ||||||||||||||||||||||
51 | LOW: Quetiapine (Seroquel) | 400-800 | Severe weight and sedation, moderate oHTN | 6 | Schizophrenia ('97), Bipolar depression (__) | |||||||||||||||||||
52 | LOW: Clozapine (Clozaril) | 200-450 | Agran, szs, myocard, drooling; sev wt, sedation, oHTN | Schizophrenia ('89) | ||||||||||||||||||||
53 | AG/ANTAG: Aripiprazole (Abilify) | 15-30 | Akathisia, activating | Schizophrenia ('02), Bipolar maintenance (__) | ||||||||||||||||||||
54 | Anxiolytic | Buspirone (BuSpar) | 30-60 | HA, dizziness; ?effective | ||||||||||||||||||||
55 | Beta- blockers | Propranolol | 10 - 60 | |||||||||||||||||||||
56 | Atenolol | 25 - 150 | ||||||||||||||||||||||
57 | Benzo- diazepines | Alprazolam (Xanax) | 0.5-2 | Fast onset (30 minutes) | Clinical dur: 3-4 hrs | 6-20 | Anxiety & panic disorder ('81) | |||||||||||||||||
58 | Lorazepam (Ativan) | 1-4 | Medium onset (30-60 minutes) | Clinical dur: 4-6 hrs | 10-20 | metabolized outside the liver (OTL) | Anxiety ('77) | |||||||||||||||||
59 | Clonazepam (Klonopin) | 0.25-1 | Medium onset (1 hour) | Clinical dur: 6-8 hrs | 18-50 | Panic disorder ('75) | ||||||||||||||||||
60 | Chlordiazepoxide (Librium) | 25-100 | Medium onset (2 hours) | Clinical dur: 4-6 hrs | 30-100 | Anxiety & alcohol withdrawal ('60) | ||||||||||||||||||
61 | DIazepam (Valium) | 5-20 | Fast onset (30 minutes) | Clinical dur: 4-6 hrs | 30-100 | Anxiety & alcohol withdrawal ('63) | ||||||||||||||||||
62 | Deltas | Gabapentin (Neurontin) | ||||||||||||||||||||||
63 | Pregabalin (Lyrica) | |||||||||||||||||||||||
64 | GABA-a antags | Zaleplon (Sonata) | 5-20 | Fast onset, nocturnal eating, somnambulism | 1 | Insomnia (1999) | ||||||||||||||||||
65 | Zolpidem (Ambien) | 5 - 10 | SL | Fast onset, nocturnal eating, somnambulism | 1 - 5 | Insomnia ('09), SL ('11) | ||||||||||||||||||
66 | Zolpidem ER (Ambien CR) | 6.25-12.5 | 1.5-2.4 | |||||||||||||||||||||
67 | Eszopiclone (Lunesta) | 1-3 | Fast onset, nocturnal eating, somnambulism, bad taste | 3 - 6 | Insomnia | |||||||||||||||||||
68 | Melotin- ergics | Agomelatine (Valdoxan) | MT1 (ag), MT2 (ag), 5HT2b, 5HT2c | |||||||||||||||||||||
69 | Ramelteon (Rozerem) | 8-16 | Fast onset, ? less effective; HA, dizziness | Doesn't bind to GABA | 1.5-5 | Insomnia | ||||||||||||||||||
70 | Melatonin | 0.3-5 | Headache | 0.5-2 | ||||||||||||||||||||
71 | Stimulants | Methylphenidate (Ritalin IR) | 5-20, 140 | High abuse potential (AP), rebound effects, TID | Stimulants: insomnia, decreased appetite (monitor weight), dry mouth, stomach upset, elevated HR and BP (monitor), dysphoria, irritability, headaches; often these resolve over several days | 2-4 | ||||||||||||||||||
72 | Methylphen. HCl (Ritalin LA) | 20-40, 140 | 8 | ADHD (2002) | ||||||||||||||||||||
73 | Methylphen. ER (Concerta) | 18-54, 140 | Zero AP | 12 | ADHD (2000) | |||||||||||||||||||
74 | Methylphen. HCl (Quillivant XR) | ADHD (2012) | ||||||||||||||||||||||
75 | Methylphen. biphasic (Metadate CD) | ADHD (2001) | ||||||||||||||||||||||
76 | Methylphen. TD (Daytrana) | 10 | 12-15 | |||||||||||||||||||||
77 | Dex-methylphen. (Focalin) | 2.5-10, 70 | BID | 4-6 | ||||||||||||||||||||
78 | Dex-methylphen. HCl (Focalin XR) | 10, 70 | Not generic | 8-12 | ADHD (2001) | |||||||||||||||||||
79 | Amphetamine (Adderall) | 5-20, 70 | High AP, BID | MAOI (reversible, weak) | 6 | ADHD (1996) | ||||||||||||||||||
80 | Amphet. ER (Adderall XR) | 15-30, 70 | Zero AP | 12 | ADHD (2001) | |||||||||||||||||||
81 | Dex-amphet. (Dexedrine, Dextrostat) | 5-40, 70 | High AP, BID | 4 | ||||||||||||||||||||
82 | Dex-amphet. spansules (Dexedrine) | 5-20, 70 | BID | 6-8 | ||||||||||||||||||||
83 | Lis-dex-amphet. (Vyvanse) | 30, 70 | ADHD (2007) | |||||||||||||||||||||
84 | Other ADHD meds | Modafinil (Provigil) | 100-400 | QD or BID | decreases OCPs | |||||||||||||||||||
85 | Armodafinil (Nuvigil) | |||||||||||||||||||||||
86 | Pemoline (Cylert) | ADHD (1998) | ||||||||||||||||||||||
87 | Atomoxetine (Strattera) | 40, 100 | little added benefit over 1.2 mg/kg/day, QD or BID | ADHD in kids/adol/adults (2002) | ||||||||||||||||||||
88 | Guanfacine ER (Intuniv) | ADHD in kids/adolesc. (2009) | ||||||||||||||||||||||
89 | Ach- esterase inhibitors | Donepezil (Aricept) | Alzheimer's disease (1996) | |||||||||||||||||||||
90 | Galantamine (Razadyne) | |||||||||||||||||||||||
91 | Rivastigmine (Exelon) | |||||||||||||||||||||||
92 | NMDA antag | Memantine (Namenda) | ||||||||||||||||||||||
93 | Memory | Ginkgo biloba | 120-240 | GI, HA, irritability, dizzy, bleed if anticoag/antiplatelet | ||||||||||||||||||||
94 | Opioid maintenance | Buprenorphine+nalaxone (Suboxone) | SL | Opioid dependence (PO in 2002, SL in 2013) | ||||||||||||||||||||
95 | Methadone | PO | ||||||||||||||||||||||
96 | Alcohol cessation | Naltrexone IM (Vivitrol) | Opioid dependence (2010), alcohol dependence (2006) | |||||||||||||||||||||
97 | Acamprosate | |||||||||||||||||||||||
98 | Smoking cessation | Varenicline (Chantix) | Nicotine addiction (2006) | |||||||||||||||||||||
99 | Zyban SR | smoking cessation (1997) | ||||||||||||||||||||||
100 | Nicoderm CQ | Smoking cessation (1996) | ||||||||||||||||||||||