| Hypertension (label). Psychiatric uses are typically off-label (formulation- and population-dependent). View labelExact | Hypertension labeling commonly starts at 0.1 mg twice daily (morning and bedtime) (label). | Alpha-2 adrenergic agonist; reduces central sympathetic outflow (antihypertensive; also used off-label in psychiatry). | Hepatic metabolism (multiple pathways) | Single-dose range 12–16 h | No | | - Baseline and periodic blood pressure and heart rate, especially during titration or dose changes.
- Orthostasis, dizziness, and sedation; adjust dosing timing and review interacting medications if symptoms emerge.
- Renal impairment and medication adherence; missed doses can trigger rebound hypertension in some patients.
- Discontinuation plan documented in advance to reduce rebound hypertension and agitation risk.
| No | 2025-12-30 |
|---|
| Hypertension (label). Off-label use occurs for ADHD symptoms and hyperarousal (practice pattern). View labelExact | Hypertension labeling: start 1 mg once daily at bedtime to minimize somnolence; if response is inadequate after 3–4 weeks, 2 mg once daily may be used (label). | Alpha-2A adrenergic agonist (centrally acting antihypertensive; sometimes used off-label as a psychiatric adjunct). | Hepatic oxidative metabolism | Single-dose mean 17 h; Single-dose range 10–30 h | No | | - Baseline and periodic blood pressure and heart rate, especially during titration.
- Sedation, dizziness, and orthostasis; reassess driving, falls risk, and daytime functioning.
- Review co-prescribed antihypertensives and sedatives at initiation and dose changes.
- Document a taper plan early to reduce abrupt discontinuation and rebound hypertension risk.
| No | 2025-12-30 |
|---|
propranololAdjunctive therapyBrands: INDERAL, INDERAL LA | Hypertension; angina pectoris; atrial fibrillation ventricular rate control; post-MI mortality reduction; migraine prophylaxis; essential tremor; hypertrophic subaortic stenosis; pheochromocytoma adjunct (label). View labelExact | Label dosing varies widely by indication (hypertension, arrhythmias, migraine prophylaxis). In psychiatric use, dose selection should be tied to the specific target symptom and the patient’s cardiopulmonary risk.
Performance anxiety (off label): low single doses taken before a time-limited event are common; start low and confirm tolerability with a trial dose (monitor heart rate, blood pressure, and dizziness). | Nonselective beta-adrenergic receptor blocker (beta-1/beta-2 antagonism). | CYP2D6, CYP1A2, CYP2C19, Glucuronidation | Single-dose range 3–6 h | No | — | - Check baseline heart rate, blood pressure, and asthma/COPD history before starting.
- Monitor bradycardia, hypotension, dizziness, and fatigue after dose changes.
- Reassess mood and sleep after initiation; discontinue or adjust if adverse effects outweigh benefit.
- Taper rather than stopping abruptly after sustained use, especially in coronary disease risk.
| No | 2025-12-29 |
|---|
prazosinAdjunctive therapyBrands: MINIPRESS | Hypertension (label); commonly used off label for PTSD-related nightmares. View labelExact | PTSD nightmares (off label): start 1 mg at bedtime; titrate gradually (often in 1 mg increments) based on nightmare frequency and tolerability. | Alpha-1 adrenergic antagonist; reduces sympathetic tone (vasodilation). | Hepatic | Single-dose range 2–3 h | No | — | - Check blood pressure (including orthostatic vitals) during initiation and after dose increases; counsel hydration and slow positional changes.
- Reassess falls risk and co-prescribed sedatives/antihypertensives; adjust titration speed accordingly.
- Define a reassessment milestone for nightmare response; taper and stop if benefit is unclear after an adequate trial.
- If doses are missed for several days, restart low and retitrate to reduce first-dose syncope risk.
| No | 2025-12-28 |
|---|