Sunday, July 11, 2021

Updated Medication Checklist for Psychiatrists


I decided to update the medication list that I posted here last February.  Not much has changed but I am using it for another couple of projects that I am working on. I am currently working on a detailed look at medications psychiatrists prescribe that may interact with medications used to treat atrial fibrillation (see previous post). I am also going to try to arrange the medications on this list according to the purported mechanisms of action.  The current available systems include the Neuroscience Based Nomenclature (NbN) and the Anatomical Therapeutic Chemical (ATC) Classification.  Both of these systems will involve many more categories and reformatting of the document.  I would like to retain the single page format for convenience.

Per the previous posts on this blog, I devised this sheet in order to get a more accurate idea about what my patients had taken in the past.  I found that they were able to recall many more previous treatments by reading through the list and that it was relatively efficient. I posted this list to Twitter to solicit recommendations and corrections and made some of those changes.  Several people suggested alphabetizing the lists, but I typically put the most recent medications at the top of the list and medications that made be no longer manufactured or more rarely prescribed at the bottom. There were some recommendations for medications that are available in other countries but not the US. I would be amenable to modifying the list for specific countries if someone could edit the current list and make sure it was corrected for the country that you are practicing in.  You could also just type up your own list.  You will also find several medications that have been discontinued either for safety or economic reasons. They are on the list because there are still relevant to the medication history of many patients.

I found that this list was also useful for research projects.  I was involved in a research project last year where there was some confusion about what psychiatric medications would be allowed in a study that looked at antidipsogenic medication. I showed my list to the Principle Investigator and other colleagues working on the project and we decided in a brief meeting the drugs that would be included or excluded in the protocol by just going through the document and checking them off. 

I wrote a more detailed post on this list last February with some disclaimers.  The same disclaimers apply. I don't make any guarantees that it is comprehensive or that you will find it useful. I think it does a fairly good job of illustrating the kinds of medications that psychiatrists prescribe, but that is always relative to the practice setting. During 22 years of inpatient practice, I was responsible for prescribing all of the medications that the patient was taking.  I had access to very good consultants, but had to do the initial treatment, medication reconciliation and adjustments as well as trying to address any new medical disorders. You certainly learn a lot of medicine and pharmacology in that setting, but on the other hand it is extremely time-consuming and with today's productivity demands - I would not recommend it. Nobody pays you for doing the job of two people, even though it is very efficient and patient-centered.  

The only major class of medication excluded from the table are acetylcholinesterase inhibitors ACHEIs) including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne).  These medications are used in the treatment of Alzheimer's Disease along with the NMDA receptor antagonist memantine (Namenda).  Psychiatrists prescribe these medications and the only reason they were not included in the table is space and the fact it would have required major formatting changes. 

Watch this space for further updates.  I will date and post links to new updates in the space below with the dates that the update occurred. I will also post the table looking at drug interactions with medications used to treat atrial fibrillation in the previous post.

George Dawson, MD, DFAPA

Link to Updates:

I have received a fair number of emails requesting this document from GDRIVE.  This link seems to work for me and it is publicly available. If it does not work for you email me and I will send you the most recent document.

Medication Checklist 07.11.2021 Link 

Medication Checklist 07.11.2021 Link  (Corrects valproate/divalproex section)

Medication Checklist 07.11.2021 Link  (Corrects misspelling of Caplyta)

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