Gen. Medications History Guide (Editable Template)

	A	B	C	E	F	G
1	Medication History Guide
2	Total Daily Dose is the Recommended Therapeutic Dose of a Medication. Most insurance carriers require a therapetic dose to as 'an adequate medication trial'
3	TCA/Tetracyclic
4	Brand Names	Treatment Type	Total Daily Dose	Brand Names	Treatmnet Type	Total Daily Dose
5	Elavil, Endep	Amitriptyline	200mg	Tofranil	Imipramine	200mg
6	Norpramin, Pertofran	Desipramine	200mg	Srmontil	Trimipramine	200mg
7	Anafranil	Clomipramine	200mg	Ludiomil	Maprotilene	200mg
8	Sinequan	Doxepin	200mg	Merital	Nomifensine	200mg
9	Pamelor, Aventyl	Nortiptyline	75mg	Vivactil	Protriptylin	40mg
10	SSRI
11	Brand Names	Treatment Type	Total Daily Dose	Brand Name	Treatment Type	Total Daily Dose
12	Prozac	Fluoxetine	20mg	Celexa	Citalopram	20mg
13	Luvox	Fluvoxamine	200mg	Paxil	Paroxetine	20mg
14	Paxel CR	Paroxetine CR	25mg	Zoloft	Sertraline	100mg
15	Lexapro	Escitalopram	10mg
16	SNRI
17	Brand Names	Treatment Type	Total Daily Dose	Brand Name	Treatment Type	Total Daily Dose
18	Effexor (IR, XR)	Venlafaxine	225mg	Cymbalta	Duloxetine	40mg
19	Pristiq	Desvenlafaxine	50mg	Fetzima	Levomilnacipran	40mg
20	Other Antidepressants
21	Brand Names	Treatment Type	Total Daily Dose	Brand Names	Treatment Type	Total Daily Dose
22	Wllbutrine (IR, SR, XL), Aplenzin	Bupropion	300mg; Aplenzine 2 pills	Remeron	Mirtazapine	30mg
23	Serone	Nefazodone	300mg	Desyrel, Oleptro	Trazadone( incl. XR)	400mg; Oleptro 200mg
24	Asendin	Amozapine	400mg	Viibryd	Vilazodone	40mg
25	Brintellix	Vortioxetine	20mg
26	Augmenting Agents
27	Brand Names	Treatment Type	Total Daily Dose	Brand Names	Treatment Type	Total Daily Dose
28	Abilify, Geodon, Risperdal, Seroquel, Zyprexa, Invega, Saphris, Rexulti	Atyoical Antipsychotics	Any Dose	Eskalith, Lithobid, Others	Lithium	Any Dose
29	Thyroid Hormone	Synthriod, Levoxyl	Any Dose	Symbyax	Olanzapin, Fluoxetin	Any Dose
30	ECT
31	≥7 Treatments Total During One Episode
32	Common Side Effects Inclue:
33	Anxiety, Nervousness, Confusion, Lack of Focus, Anger/Aggression, Irritability, Flat Mood, Sadness, Crying Spells, Disinterest in Activities, Delusions, Sexual Dysfunction, Weight Gain, Vomiting, Loss of Appetite, Fatigue, Headaches, Body Aches, Acute or Chronic Pain, Memory Problems, Mood Swings, Anxiety/Panic Attacks, Impulsiveness, Laziness, Self-Neglect, Insomnia, NIghtmare/Terrors, Over Sleeping, Suiidal Thought and Ideation, GI Issues, Tremors, Depression Worsened, Apathy, Dull Mood
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