| Treatment of alcohol dependence; blockade of the effects of exogenously administered opioids in the management of opioid dependence (label). View labelExact | Alcohol dependence: 50 mg once daily was used in placebo-controlled outpatient trials for up to 12 weeks as an adjunct to psychosocial methods (label). | Opioid receptor antagonist used for alcohol dependence and for opioid dependence relapse prevention via opioid blockade; requires an opioid-free period to avoid precipitated withdrawal and has hepatotoxicity cautions at higher doses. | Extensive hepatic metabolism (first pass) | Single-dose mean 4 h | No | — | - Liver function testing (baseline and follow-up), especially with alcohol-related liver disease (label/clinical).
- Opioid exposure screening and documentation of opioid-free verification strategy (label/clinical).
- Monitoring for nausea, dizziness, and fatigue that can affect adherence and function (clinical).
- Perioperative/acute pain planning because opioid analgesia may be ineffective while naltrexone is active (clinical).
| No | 2026-02-12 |
|---|
bupropionAdjunctive therapyBrands: WELLBUTRIN | MDD; seasonal affective disorder; smoking cessation (SR). View labelExact | XL: start 150 mg qAM for 3–7 days, increase to 300 mg qAM; may increase to 450 mg qAM if needed. | Norepinephrine–dopamine reuptake inhibitor (NDRI). | CYP2B6 | Steady-state mean 21 h | No | — | - Blood pressure at baseline and after dose changes, especially when nicotine replacement is used.
- Seizure risk factors (eating disorder history, alcohol/benzodiazepine withdrawal, electrolyte disturbances) before initiation and at follow-up.
- Sleep and anxiety during early titration; dose timing and titration speed are common levers for tolerability.
- Mood elevation or agitation in bipolar-spectrum illness; coordinate prevention plans via the bipolar disorder hub.
- Medication list review to ensure only one bupropion-containing product is active (to reduce accidental dose escalation across brands).
| No | 2026-02-12 |
|---|
| Adjunctive therapy in partial seizures (epilepsy); postherpetic neuralgia (label). Off-label psychiatry use includes anxiety symptoms and insomnia adjuncts. View labelExact | In psychiatric practice, a bedtime dose is often used initially for sleep maintenance or nocturnal anxiety, with slower titration based on next-day sedation and dizziness.
If daytime dosing is used for persistent somatic anxiety, daytime doses are added cautiously and driving/fall risk is reassessed; gabapentin is often not framed as an indefinite “PRN calming” medication. | Alpha-2-delta (α2δ) ligand that modulates voltage-gated calcium channels and reduces excitatory neurotransmitter release. | Not appreciably metabolized (label). | Single-dose range 5–7 h | No | | - Renal function (eGFR/CrCl) before starting and after clinical changes that may reduce clearance.
- Sedation, dizziness, gait instability, and driving/fall risk during titration.
- Reassess for peripheral edema and weight changes over weeks to months.
- Misuse/diversion signals (early refills, dose escalation, co-use with opioids/alcohol).
- Tapering rather than abrupt stopping after sustained daily use.
| No | 2026-02-12 |
|---|
| 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 |
|---|