Informed Consent for Medications F-24277 Series: Psychotropic Medications
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| Medication Brand Name Word Version | Medication Generic Name Word Version | Medication Name PDF version | Medication Category | Last Revise Date |
|---|---|---|---|---|
| Blank Form | Blank Form | Blank Form | Blank Form | 11/01/2016 |
| Blank Spanish | Blank Form in Spanish | Blank Spanish | Blank Spanish | 11/01/2016 |
| Tenex, Intuniv XR | guanfacine | Tenex, Intuniv XR | Attention-Deficit/Hyperactivity Disorder (ADHD) | 04/05/2021 |
| No brand name available | phenobarbital | phenobarbital | Barbiturate and Barbiturate-Like Anticonvulsants | 06/08/2017 |
| Compro | prochlorperazine | prochlorperazine | Antipsychotic Agent (phenothiazine) Antiemetic | 09/24/2019 |
| Mellaril | thioridazine | thioridazine | Antipsychotic Agent (phenothiazine) | 10/30/2019 |
| Abilify, Abilify Maintena, Abilify MyCite, Aristada, Aristada Initio | aripiprazole | Abilify, Abilify Maintena, Abilify MyCite, Aristada, Aristada Initio | Antipsychotic, Antidepressant, Bipolar, Mood-Stabilizing Agent | 08/19/2020 |
| Adderall Adderall XR | dextroamphetamine and amphetamine | Adderall Adderall | Central Nervous System Stimulant | 05/27/2021 |
| Ambien, Ambien CR | zolpidem | Ambien, Ambien CR | Sedative, Hypnotic | 09/24/2019 |
| Anafranil | clomipramine | Anafranil | Antidepressant (tricyclic) | 10/06/2021 |
| Aricept | donepezil | Aricept | Dementia, Alzheimer's Treatment | 05/20/2020 |
| Aristada | aripiprazole lauroxil | Aristada | Atypical Antipsychotic | 08/09/2018 |
| Artane | trihexyphenidyl | Artane | Antidyskinetic | 09/24/2019 |
| Atarax | hydroxyzine hydrochloride | Atarax | Antihistamine, Sedative, Antianxiety | 04/09/2021 |
| Ativan | lorazepam | Ativan | Antianxiety Agent/Anticonvulsant (benzodiazepine) | 10/11/2021 |
| Aventyl, Pamelor | nortriptyline | Aventyl, Pamelor | Antidepressant (tricyclic) | 09/24/2019 |
| Belsomra | suvorexant | Belsomra | Sedative, Hypnotic | 08/09/2018 |
| Benadryl | diphenhydramine | Benadryl | Antihistamine, Sedative, Antianxiety | 05/20/2020 |
| BuSpar | buspirone | BuSpar | Antianxiety Agent | 10/11/2021 |
| Caplyta | lumateperone | Caplyta | Antipsychotic | 07/13/2020 |
| Catapres | clonidine | Catapres | Alpha Adrenergic Agonist, Antihypertensive | 05/20/2020 |
| Celexa | citalopram | Celexa | Antidepressant (SSRI) | 10/11/2021 |
| Clozaril | clozapine | Clozaril | Atypical Antipsychotic Agent | 08/09/2018 |
| Cogentin | benztropine | Cogentin | Anticholinergic | 10/29/2018 |
| Adhansia XR; Aptensio XR; Concerta; Cotempla XR-ODT; Jornay PM; Metadate ER; Methylin; QuilliChew ER; Quillivant XR; Relexxii; Ritalin; Ritalin LA. | methylphenidate | Adhansia XR; Aptensio XR; Concerta; Cotempla XR-ODT; Jornay PM; Metadate ER; Methylin; QuilliChew ER; Quillivant XR; Relexxii; Ritalin; Ritalin LA. | Central Nervous System Stimulant | 05/27/2021 |
| Corgard | nadolol | Corgard | Beta-Adrenergic Blocker | 10/29/2018 |
| Cymbalta | duloxetine | Cymbalta | Antidepressant | 10/30/2019 |
| Dalmane | flurazepam | Dalmane | Sedative, Hypnotic (benzodiazepine) | 11/10/2017 |
| Daytrana | methylphenidate transdermal | Daytrana | Central Nervous System Stimulant | 05/27/2021 |
| Depakote, Depakote DR, Depakote ER, Depakote Sprinkles | valproic acid | Depakote, Depakote DR, Depakote ER, Depakote Sprinkles | Anticonvulsant, Mood-Stabilizing Agent | 05/27/2021 |
| Depo-Provera, Provera | medroxyprogesterone acetate | Depo-Provera, Provera | Progestin (systemic, for non-contraceptive use) | 03/23/2021 |
| Desyrel | trazodone | Desyrel | Antidepressant | 10/11/2021 |
| Dexedrine, Zenzedi, ProCentra | dextroamphetamine | Dexedrine, Zenzedi, ProCentra | Central Nervous System Stimulant | 03/23/2021 |
| Effexor, Effexor XR | venlafaxine | Effexor, Effexor XR | Antidepressant | 04/05/2021 |
| Elavil | amitriptyline | Elavil | Antidepressant (tricyclic) | 11/22/2017 |
| Eskalith, Eskalith CR, Lithobid | lithium | Eskalith, Eskalith CR, Lithobid | Mood-Stabilizing Agent | 07/13/2020 |
| Exelon | rivastigmine | Exelon | Alzheimer's Treatment | 05/27/2021 |
| Fanapt | iloperidone | Fanapt | Antipsychotic Agent, Atypical | 10/30/2019 |
| Focalin, Focalin XR | dexmethylphenidate | Focalin, Focalin XR | Central Nervous System Stimulant | 04/05/2021 |
| Gabitril | tiagabine | Gabitril | Anticonvulsant | 05/27/2021 |
| Geodon | ziprasidone | Geodon | Antipsychotic, Mood-Stabilizing Agent | 08/20/2020 |
| Halcion | triazolam | Halcion | Sedative, Hypnotic (benzodiazepine) | 06/18/2020 |
| Haldol | haloperidol | Haldol | Antipsychotic Agent (phenothiazine) | 07/13/2020 |
| Inderal, Inderal XL, Hemangeol, InnoPran XL | propranolol, propranolol XR | Inderal, Inderal XL, Hemangeol, InnoPran XL | Beta-Adrenergic Blocker | 05/27/2021 |
| Invega | paliperidone | Invega | Antipsychotic Agent (benzisoxazole) | 07/13/2020 |
| Invega Sustenna | paliperidone | Invega Sustenna | Antipsychotic Agent (benzisoxazole) | 10/29/2018 |
| Invega Trinza | paliperidone palmitate | Invega Trinza | Atypical Antipsychotic | 05/09/2016 |
| Klonopin | clonazepam | Klonopin | Antianxiety Agent, Anticonvulsant (benzodiazepine) | 11/13/2017 |
| Lamictal, Lamictal XR | lamotrigine | Lamictal, Lamictal XR | Anticonvulsant (phenyltriazine) | 05/13/2021 |
| Latuda | lurasidone | Latuda | Antipsychotic, Mood-Stabilizing Agent | 04/05/2021 |
| Lexapro | escitalopram | Lexapro | Antianxiety, Antidepressant (SSRI) | 06/17/2020 |
| Librium | chlordiazepoxide | Librium | Antianxiety Agent (benzodiazepine) | 11/13/2017 |
| Loxitane | loxapine | Loxitane | Antipsychotic Agent (dibenzoxazepine) | 07/13/2020 |
| Ludiomil | maprotiline | Ludiomil | Antidepressant | 07/13/2020 |
| Lunesta | eszopiclone | Lunesta | Sedative, Hypnotic | 06/17/2020 |
| Luvox, Luvox CR | fluvoxamine | Luvox, Luvox CR | Antidepressant | 10/30/2019 |
| Lyrica | pregabalin | Lyrica | Anticonvulsant | 10/29/2018 |
| Metadate CD, Metadate ER, Methylin, Methylin ER, Concerta, Ritalin, Ritalin LA, Ritalin-SR | methylphenidate | Metadate CD, Metadate ER, Methylin, Methylin ER, Concerta, Ritalin, Ritalin LA, Ritalin-SR | Central Nervous System Stimulant | 05/22/2017 |
| Minipress | prazosin | Minipress | Alpha Adrenergic Blocker | 10/29/2018 |
| Moban | molindone | Moban | Antipsychotic Agent (dihydroindolone) | 08/20/2020 |
| Namenda, Namenda XR | memantine | Namenda, Namenda XR | Alzheimer's Treatment | 04/13/2021 |
| Nardil | phenelzine | Nardil | MAO Inhibitor | 06/08/2017 |
| Navane | thiothixene | Navane | Antipsychotic Agent (thioxanthene) | 08/20/2020 |
| Neurontin, Gralise | gabapentin | Neurontin, Gralise | Anticonvulsant | 04/05/2021 |
| Norpramin | desipramine | Norpramin | Antidepressant (tricyclic) | 08/09/2018 |
| Nuedexta | dextromethorphan hydrobromide/quinidine sulfate | Nuedexta | Antipsychotic, Antidepressant, Bipolar, Mood-Stabilizing Agent | 03/13/2017 |
| Nuplazid | pimavanserin | Nuplazid | Atypical Antipsychotic | 05/20/2020 |
| Orap | pimozide | Orap | Antipsychotic Agent | 08/20/2020 |
| Parnate | tranylcypromine | Parnate | MAO Inhibitor | 06/08/2017 |
| Paxil, Paxil CR, Pexeva | paroxetine | Paxil, Paxil CR, Pexeva | Antidepressant (SSRI) | 12/20/2016 |
| Periactin | cyproheptadine | Periactin | Antihistamine | 07/10/2017 |
| Pristiq | desvenlafaxine | Pristiq | Antidepressant | 04/16/2021 |
| Prolixin | fluphenazine | Prolixin | Antipsychotic – First Generation (Typical); Phenothiazine Derivative | 06/17/2020 |
| Prozac | fluoxetine | Prozac | Antidepressant (SSRI) | 06/17/2020 |
| Remeron, Remeron SolTab | mirtazapine | Remeron, Remeron SolTab | Antidepressant | 08/25/2020 |
| Restoril | temazepam | Restoril | Sedative, Hypnotic (benzodiazepine) | 11/13/2017 |
| ReVia | naltrexone | ReVia | Opioid antagonist | 06/08/2017 |
| Rexulti | brexpiprazole | Rexulti | Antipsychotic, Mood-Stabilizing Agent | 06/18/2020 |
| Risperdal, Risperdal Consta | risperidone | Risperdal, Risperdal Consta | Antipsychotic, Mood-Stabilizing Agent | 04/16/2021 |
| Ritalin, Ritalin LA, Ritalin-SR, Concerta, Metadate CD, Metadate ER, Methylin, Methylin ER | methylphenidate | Ritalin, Ritalin LA, Ritalin-SR, Concerta, Metadate CD, Metadate ER, Methylin, Methylin ER | Central Nervous System Stimulant | 05/22/2017 |
| Rozerem | ramelteon | Rozerem | Sedative, Hypnotic | 08/21/2020 |
| Saphris, Secuado | asenapine | Saphris, Secuado | Antipsychotic, Antimanic | 06/25/2020 |
| Serax | oxazepam | Serax | Antianxiety Agent (benzodiazepine) | 11/13/2017 |
| Seroquel, Seroquel XR | quetiapine | Seroquel, Seroquel XR | Antipsychotic, Mood-Stabilizing Agent | 06/25/2020 |
| Serzone | nefazodone | Serzone | Antidepressant | 08/25/2020 |
| Sinequan | doxepin | Sinequan | Antidepressant (tricyclic), Antianxiety, Sleep Aid | 06/17/2020 |
| Sonata | zaleplon | Sonata | Sedative, Hypnotic | 04/16/2021 |
| Stelazine | trifluoperazine | Stelazine | Antipsychotic Agent (phenothiazine) | 04/16/2021 |
| Strattera | atomoxetine | Strattera | Central Nervous System Agent | 12/22/2017 |
| Suboxone & Suboxone Film Strips | buprenorphine and naloxone sublingual tablet & film | Suboxone & Suboxone Film Strips | Maintenance treatment of opioid dependence | 06/08/2017 |
| Symbyax | olanzapine + fluoxetine | Symbyax | Antipsychotic, Antidepressant | 08/25/2020 |
| Symmetrel | amantadine | Symmetrel | Antidyskinetic | 08/09/2018 |
| Tegretol | carbamazepine | Tegretol | Anticonvulsant, Mood-Stabilizing Agent | 08/09/2018 |
| Tenormin | atenolol | Tenormin | Beta-Adrenergic Blocker | 12/22/2017 |
| Thorazine | chlorpromazine | Thorazine | Antipsychotic Agent (phenothiazine) | 03/30/2018 |
| Tofranil | imipramine | Tofranil | Antidepressant (tricyclic) | 05/20/2020 |
| Topamax | topiramate | Topamax | Anticonvulsant, Migraine Headache Prevention | 05/28/2021 |
| Tranxene | clorazepate | Tranxene | Antianxiety Agent (benzodiazepine) | 11/13/2017 |
| Trilafon | perphenazine | Trilafon | Antipsychotic Agent (phenothiazine) | 08/25/2020 |
| Trileptal | oxcarbazepine | Trileptal | Anticonvulsant | 06/08/2017 |
| Trintellix | vortioxetine | Trintellix | Antidepressant | 12/04/2019 |
| Valium | diazepam | Valium | Antianxiety Agent, Antispastic, Anticonvulsive (benzodiazepine) | 11/13/2017 |
| Viibryd | vilazodone | Viibryd | Antidepressant | 08/16/2017 |
| Visken | pindolol | Visken | Beta-Adrenergic Blocker | 06/08/2017 |
| Vistaril | hydroxyzine | Vistaril | Antihistamine, Sedative, Antianxiety | 10/30/2019 |
| Vivitrol, Revia | naltrexone | Vivitrol, Revia | Opioid Blocker | 05/28/2021 |
| Vraylar | cariprazine | Vraylar | Anticonvulsant, Mood-Stabilizing Agent | 06/18/2020 |
| Vyvanse | lisdexamfetamine | Vyvanse | Central Nervous System Stimulant | 05/28/2021 |
| Wellbutrin, Zyban | bupropion | Wellbutrin, Zyban | Antidepressant | 09/07/2017 |
| Xanax | alprazolam | Xanax | Antianxiety Agent (benzodiazepine) | 11/13/2017 |
| Zoloft | sertraline | Zoloft | Antidepressant (SSRI) | 07/10/2017 |
| Zyprexa; Zyprexa Zydis; Zyprexa for Injection, Zyprexa Relprevv | olanzapine | Zyprexa; Zyprexa Zydis; Zyprexa for Injection, Zyprexa Relprevv | Antipsychotic, Bipolar Agent | 04/16/2021 |