Patient
:___________________ _______________________________Date
: _______________________________Exhibit to Petition for Consent to Involuntary Administration of Psychiatric Medicines
|
Generic Name |
Brand Name |
Current Uses |
|
Alprazolam |
Xanax |
Anti-Anxiety |
|
Amitriptyline |
Elavil |
Anti-Depressant |
|
Amoxapine |
Asendin |
Anti-Depressant |
|
Amphetamine |
Adderall |
Stimulant |
|
Aripiprazole |
Abilify |
Anti-Psychotic |
|
Atenolol |
Tenormin |
Anti-Anxiety |
|
Bupropion |
Wellbutrin |
Anti-Depressant, Stimulant |
|
Buspirone |
BuSpar |
Anti-Anxiety |
|
Carbamazepine |
Tegretol |
Mood Stabilizer |
|
Chlordiazepoxide |
Librium |
Anti-Anxiety |
|
Chlorpromazine |
Thorazine |
Anti-Psychotic |
|
Citalopram |
Celexa |
Anti-Depressant, -Anxiety |
|
Clomipramine |
Anafranil |
Anti-Obsessive, -Depressant |
|
Clonazepam |
Klonopin |
Panic, Anti-Anxiety |
|
Clorazepate |
Tranxene |
Anti-Anxiety |
|
Clozapine |
Clozaril |
Anti-Psychotic |
|
Desipramine |
Norpramin |
Anti-Depressant, Stimulant |
|
Dextroamphetamine |
Dexedrine |
Stimulant |
|
Diazepam |
Valium |
Anti-Anxiety |
|
Divalproex Sodium |
Depakote |
Mood Stabilizer |
|
Doxepin |
Sinequan |
Anti-Depressant |
|
Fluoxetine |
Prozac |
Anti-Depressant, -Obsessive, -Anxiety |
|
Fluphenazine |
Prolixin |
Anti-Psychotic |
|
Fluvoxamine |
Luvox |
Anti-Obsessive,-Depressant, -Anxiety |
|
Gabapentin |
Neurontin |
Mood Stabilizer |
|
Haloperidol |
Haldol |
Anti-Psychotic |
|
Imipramine |
Tofranil |
Anti-Depressant, Panic |
|
Lamotrigine |
Lamictal |
Mood Stabilizer |
|
Lithium |
Eskalith, Lithobid, Lithonate, Lithotabs |
Mood Stabilizer |
|
Lorazepam |
Ativan |
Anti-Anxiety |
|
Loxapine |
Loxitane |
Anti-Psychotic |
|
Mesoridazine |
Serentil |
Anti-Psychotic |
|
Methylphenidate |
Ritalin |
Stimulant |
|
Mirtazapine |
Remeron |
Anti-Depressant |
|
Molindone |
Moban |
Anti-Psychotic |
|
Nefazodone |
Serzone |
Anti-Depressant |
|
Nortriptyline |
Pamelor |
Anti-Depressant |
|
Olanzapine |
Zyprexa |
Anti-Psychotic |
|
Oxazepam |
Serax |
Anti-Anxiety |
|
Paroxetine |
Paxil |
Anti-Depressant, -Obsessive, |
|
Pemoline |
Cylert |
Stimulant |
|
Perphenazine |
Trilafon |
Anti-Psychotic |
|
Phenelzine |
Nardil |
Anti-Depressant |
|
Prazepam |
Centrax |
Anti-Anxiety |
|
Propranolol |
Inderal |
Beta Blocker |
|
Protriptyline |
Vivactil |
Anti-Depressant |
|
Quetiapine |
Seroquel |
Anti-Psychotic |
|
Risperidone |
Risperdal |
Anti-Psychotic |
|
Sertraline |
Zoloft |
Anti-Depressant, -Obsessive,-Anxiety |
|
Thioridazine |
Mellaril |
Anti-Psychotic |
|
Thiothixene |
Navane |
Anti-Psychotic |
|
Topiramate |
Topamax |
Mood Stabilizer |
|
Tranylcypromine |
Parnate |
Anti-Depressant |
|
Trazodone |
Desyrel |
Anti-Depressant |
|
Trifluoperazine |
Stelazine |
Anti-Psychotic |
|
Trimipramine |
Surmontil |
Anti-Depressant |
|
Valproic Acid |
Depakene, Depakote |
Mood Stabilizer |
|
Venlafaxine |
Effexor |
Anti-Depressant |
|
Ziprasidone |
Geodon |
Anti-Psychotic |
Petitioner signature: _______________________________________
Form published by: R. Shawn Majette, VSB 19372
Thompson and McMullan P.C.
100 Shockoe Slip
Richmond, Virginia 23219
804/698-6233 (V) 804/780-1813 (F)
Rxexhibit