Early Morning Waking Excessively Orderly or Perfectionistic

Size: px
Start display at page:

Download "Early Morning Waking Excessively Orderly or Perfectionistic"

Transcription

1 COLLEGE OF MEDICINE Jacksonville 580 W 8 th St T-2 6 th Fl Ste Dupont Station Ct Department of Psychiatry Jacksonville, FL Jacksonville, Fl Division of Adult Psychiatry Phone Phone Fax Fax Date of Appointment: Age: Today s Date: Name: Preferred Name: Date of Birth: Referred By: What Are Your Concerns That Brought You In Today? Adult Patient History Questionnaire Please Circle All Symptoms That You Are Currently Experiencing: Sad Mood Racing Thoughts Panic Attacks Excessive Dieting Low Concentration/Memory Fear of Leaving the Focused on Body Weight or Image Energy/Fatigue Difficulties House Hopelessness Increased/Decreased Fear of Driving Change in Weight Sexual Interest Guilt Decreased Appetite Fear of Specific History of Trauma/Victim of Abuse Situations/Things Worthlessness Increased Appetite Fear of Being in Offender of Abuse Public Crying Spells Difficulty Falling Upsetting Thoughts Hearing Voices Others Do Not Asleep Decreased Excessive Sleeping Repetitive Thoughts Seeing Images Others Do Not Motivation or Behaviors Loss of Interest in Usual Activities Early Morning Waking Excessively Orderly or Perfectionistic Bizarre Ideas 1

2 Irritability Suicidal Thoughts Periods of Lost Time Hyperactivity Thoughts of Harming Excessive Anger / Others Aggressiveness Impulsiveness Self Harm/Cutting Difficulty Trusting Others Elevated Mood Anxious/Worried Binge Eating / Purging Recent Upsetting Change or Loss Alcohol Abuse Drug Abuse Overuse of Prescription Medication Medications: Please list all medications or supplements that you are currently taking. Include psychiatric and medical medications. Medication Dose (mg, units,ml, etc) Doses per day (AM, twice daily, at bedtime, etc) Have you experienced a head injury? If so, please explain what happened, your age, and if you were unconscious: Primary Care Physician: Clinic Address and Phone Number: Current Medical Diagnoses i.e. asthma, diabetes, seizures, etc 4. Treatment? Previous Surgeries Approximate Date Location/Hospital Previous Hospitalizations Approximate Date Location/Hospital Medication Allergies: Food Allergies: 2

3 Past Psychiatric History Have you ever seen a psychiatrist? If so, please provide information about providers, dates, and treatment rendered. Have you ever seen a psychologist? Have you ever seen a therapist (i.e. LMHC, LCSW, LMFT)? Have you ever been hospitalized for psychiatric reasons? If so, where and when? Developmental History: Any Learning Disabilities (i.e. reading, dyslexia, writing, math, etc)?: Attended Special Education Classes?: Received Any Developmental Services (i.e. physical, speech, occupational therapy, etc)?: Social History: Marital Status: Single Married Divorced Widowed Partnered Lives With (Name, Age, and Relation to Yourself): Highest Grade Attended: Occupation and Employment (specialty, where you work, and how long): Military History: Arrest History or Pending Legal Issues (i.e. divorce, disability, bankruptcy, etc): 3

4 Family History: Please indicate if there is a family history of the following conditions and WHO is affected with the condition. Anxiety Heart disease Depression Bipolar disorder ADHD Autism Eating Disorders Learning disabilities Other psychiatric conditions? Sudden cardiac death Cancer Alcoholism Drug abuse Thyroid problems Seizures Other medical conditions? Substance Abuse History: Please circle all that you have used in the past 2 years: Alcohol Marijuana (weed) Cocaine (crack, coke) Tobacco Opiates (heroin, pain killers, methadone) Benzodiazepines (Xanax, Klonipin, Ativan, Valium) MDMA (ecstasy) LSD (acid, hallucinogens) Over the Counter (cough syrup, triple C s) Bath Salts, Spice, K2 Amphetamines (speed, Adderall, Ritalin) Inhalants (dusters, whip its) Other: Other: In the past two years, there have been one or more episodes of memory loss due to substance abuse? Yes or No There are personality changes due to the use of substances. Yes or No In the past 5 years, there has been one or more arrest due to substance or alcohol use? Yes or No Someone close to you thinks you may have a serious substance abuse problem. Yes or No There is a history of serious problems with the use of substances. Yes or No There is a history of substance abuse treatment. Yes or No 4

5 Past Psychiatric Medication Anti Depressants Amitriptyline (Elavil) Bupropion (Wellbutrin) Citalopram (Celexa) Clomipramine (Anafranil) Desipramine (Norpramin) Doxepin (Sinequan) Escitalopram (Lexapro) Fluoxetine (Prozac) Fluvoxamine (Luvox) Imipramine (Tofranil) Mitrazapine (Remeron) Nefazodone (Serzone) Nortriptyline (Pamelor) Paroxetine (Paxil) Phenelzine (Nardil) Dexvenlafaxine (Pristiq) Sertraline (Zoloft) Tranylcypromine (Parnate) Trazodone (Desyrel) Venlafaxine (Effexor) AntiAnxiety Alprazolam (Xanax) Buspirone (Buspar) Chlordiazepoxide (Librium) Clonazepam (Klonopin) Clorazepate (Tranxene) Diazepam (Valium) Flurazepam (Dalmane) Hydroxyzine (Vistaril) Lorazepam (Ativan) Oxazepam (Serax) Temazepam (Restoril) Triazolam (Halcion) Zolpidem (Ambien) Response (Good, Fair, Poor) Antipsychotic Olanzapine (Zyprexa) Perphenazine (Trilafon) Pimozide (Orap) Quetiapine (Seroquel) Risperidone (Risperdal) Asenapine (Saphris) Thioridazine (Mellaril) Thiothixene (Navane) Trifluperazine (Stelazine) Mood Stabilizers Carbamazepine (Tegretol) Gabapentin (Neurontin) Lamotrigine (Lamictal) Lithium (Lithobid, etc) Topiramate (Topamax) Valproic Acid (Depakote, etc) ADHD Medications Amphetemine salts (Adderall, etc) Clonidine (Kapvay, Catapres) Dexmethylphenidate (Focalin) Guanfacine (Intuniv, Tenex) Methylphenidate (Ritalin, Concerta, Daytrana, etc) Strattera (Atomoxetine) Vyvanse (Lisdexamfetamine) Miscellaneous Thyroid (Synthroid, Cytomel) Dilantin (Phenytoin) Propranolol (Inderal) Naltrexone (Revia) Benztropine (Cogentin) Trihexyphenidyl (Artane) L-Dopa Response (Good, Fair, Poor) Antipsychotic Aripiprazade (Abilify) Fluphenazine (Prolixin) Haloperidol (Haldol) Lurasidone (Latuda) Other Medications 5

Child & Adolescent Patient History Questionnaire

Child & Adolescent Patient History Questionnaire COLLEGE OF MEDICINE Jacksonville 6266 Dupont Station Ct Department of Psychiatry Jacksonville, Fl 32217 Child & Adolescent Phone 904-383-1038 Fax 904-383-1660 Date of Appointment: Chronologic Age: Today

More information

PSYCHOSOMATIC INSTITUTE OF SAN ANTONIO New Patient Information

PSYCHOSOMATIC INSTITUTE OF SAN ANTONIO New Patient Information PSYCHOSOMATIC INSTITUTE OF SAN ANTONIO New Patient Information Name: Last: First: MI: Birth Date: Sex: M F Marital Status: Single Married Divorced Separated Widowed Partnered Other Preferred name: Emergency

More information

Mental Health Intake Form

Mental Health Intake Form Mental Health Intake Form Please complete all information on this form and bring it to the first visit. It may seem long, but most of the questions require only a check, so it will go quickly. You may

More information

PSYCHOPHARMACOLOGY AND WORKING WITH PSYCHIATRY PROVIDERS. Juanaelena Garcia, MD Psychiatry Director Institute for Family Health

PSYCHOPHARMACOLOGY AND WORKING WITH PSYCHIATRY PROVIDERS. Juanaelena Garcia, MD Psychiatry Director Institute for Family Health PSYCHOPHARMACOLOGY AND WORKING WITH PSYCHIATRY PROVIDERS Juanaelena Garcia, MD Psychiatry Director Institute for Family Health Learning Objectives Learn basics about the various types of medications that

More information

Psychiatric Medications: Pearls and Pitfalls. The majority of medications used in patients with psychiatric diagnoses have more than one use.

Psychiatric Medications: Pearls and Pitfalls. The majority of medications used in patients with psychiatric diagnoses have more than one use. Psychiatric Medications: Pearls and Pitfalls Rule #1 The majority of medications used in patients with psychiatric diagnoses have more than one use. Without access to the patient s medical record, to review

More information

Antianxiety & Sedative/Hypnotic Agents (Updated 4-08) Generic Name Brand Name Adults Adolescents & Children Xanax 4 mg non-fda approved Alprazolam

Antianxiety & Sedative/Hypnotic Agents (Updated 4-08) Generic Name Brand Name Adults Adolescents & Children Xanax 4 mg non-fda approved Alprazolam This medication summary contains both SCVHHS formulary and non-formulary medications. Bolded agents reflect non-formulary status at SCVHHS. The inclusion of the non-formulary medications are intended to

More information

The Use of Medication in Autism. Charlotte Hollman MD October 11, 2013

The Use of Medication in Autism. Charlotte Hollman MD October 11, 2013 The Use of Medication in Autism Charlotte Hollman MD October 11, 2013 Medication Indications Unresponsive to nonpharmacologic intervention Behavior has a negative impact on function Medication-responsive

More information

MRN (For Office Use Only) PATIENT INFORMATION. Patient Name Last First M.I. Age Date of Birth Male Female Marital Status

MRN (For Office Use Only) PATIENT INFORMATION. Patient Name Last First M.I. Age Date of Birth Male Female Marital Status Date MRN (For Office Use Only) PATIENT INFORMATION Patient Name Last First M.I. SS# Age Date of Birth Male Female Marital Status Email Address Street/Apt # City State Zip Code Phone: Home Work Cell Occupation

More information

Medications Used in the Management of Disruptive Behavior Disorders

Medications Used in the Management of Disruptive Behavior Disorders The following medication chart is provided as a brief guide to some of the medications used in the management of various behavior disorders, along with their potential benefits and possible side effects.

More information

Genetic Testing. depression? right medication for your. help you find the. Mm -

Genetic Testing. depression? right medication for your. help you find the. Mm - Genetic Testing -J help you find the Mm - right medication for your depression? One of the worst side effects of a psychotropic medication is when it just doesn't work Selecting the medication that's right

More information

Can Genetic Testing help you find. the right medication. for your depression?

Can Genetic Testing help you find. the right medication. for your depression? Can Genetic Testing help you find the right medication for your depression? One of the worst side effects of a psychotropic medication is when it just doesn t work Selecting the medication that s right

More information

No. 21 November 2012

No. 21 November 2012 No. 21 November 2012 Psychiatric Medication for Children and Adolescents Part 1- How Medications Are Used Medication can be an effective part of the treatment for several psychiatric disorders of childhood

More information

Psychiatric Intake Packet

Psychiatric Intake Packet Mindful Therapy Group 21907 64th Ave W Suite 200, Mountlake Terrace, WA 98043 206.319.4446 info@mindfultherapygroup.com www.mindfultherapygroup.com Psychiatric Intake Packet Mindful Therapy Group Psychiatric

More information

Lamictal, lamotrigine Lithium, lithobid, eskalith Depakote, valproate Trileptal, oxcarbazepine Tegretol, equetro, carbamazepine Atypicals (aripiprazole, abilify, olanzapine, zyprexa, invega, risperdal,

More information

Serenity Psychiatry, LLC Mimi Armellino, DO Of Coastal Counseling Associates. Patient History Form

Serenity Psychiatry, LLC Mimi Armellino, DO Of Coastal Counseling Associates. Patient History Form Serenity Psychiatry, LLC Mimi Armellino, DO Of Coastal Counseling Associates Patient History Form Name Date Age DOB SSN Address City State ZIP Patient s Telephone (H) (W) (Cell) Email Job Title or School

More information

University of Florida & Shands Adult Psychiatry Outpatient Clinic Intake Form

University of Florida & Shands Adult Psychiatry Outpatient Clinic Intake Form University of Florida & Shands Adult Psychiatry Outpatient Clinic Intake Form Date Name Age Address Home phone Work phone Cell phone What issue(s) bring(s) you to the Psychiatry Clinic? What has been stressing

More information

E-TRIP [EMORY TREATMENT RESISTANCE INTERVIEW FOR PTSD] OVERVIEW

E-TRIP [EMORY TREATMENT RESISTANCE INTERVIEW FOR PTSD] OVERVIEW E-TRIP [EMORY TREATMENT RESISTANCE INTERVIEW FOR PTSD] OVERVIEW Start the E-TRIP assessment by handing the PTSD Medication Treatment Record and PTSD Psychotherapy Treatment Record pages to the patient.

More information

Oral Fluid Drug Testing March 23 rd, 2015

Oral Fluid Drug Testing March 23 rd, 2015 Oral Fluid Drug Testing March 23 rd, 2015 Drug Testing Options Breath Blood Meconium Vitreous Hair Sweat Urine Oral Drug Testing Options Oral Fluid and Blood and Breath Actual levels (immediate use, up

More information

Psychiatric Medication Review. July 2015

Psychiatric Medication Review. July 2015 Psychiatric Medication Review July 2015 Purpose The purpose of this training module is to offer basic information on medications and their recommendations of use for specific psychiatric disorders. This

More information

NorthSTAR. Pharmacy Manual

NorthSTAR. Pharmacy Manual NorthSTAR Pharmacy Manual Revised March 2007 Table of Contents I. Introduction II. III. IV. Antidepressants New Generation Antipsychotic Medications Mood Stabilizers V. ADHD Medications VI. VII. Anxiolytics

More information

PSYCHIATRY. Patient Name: Date: / / Date of Birth: / / Age: Pharmacy Name: Pharmacy Phone #:

PSYCHIATRY. Patient Name: Date: / / Date of Birth: / / Age: Pharmacy Name: Pharmacy Phone #: Patient Name: Date: / / Date of Birth: / / Age: Pharmacy Name: Pharmacy Phone #: Primary Care Physician: Current Therapist/Counselor: How did you hear about us? Internet Insurance Other Providers (specialty):

More information

Same as above. Address on File with Insurance Company: Phones (home): (cell): (work): Address: Referral Source: Name: Phone:

Same as above. Address on File with Insurance Company: Phones (home): (cell): (work):  Address: Referral Source: Name: Phone: Mental Health Intake Information Please complete all information on this form and bring it to the first visit. It may seem long, but most of the questions require only a check, so it will go quickly. You

More information

Psychiatric Evaluation Intake Form

Psychiatric Evaluation Intake Form Psychiatric Evaluation Intake Form 1. Patient Contact Information Patient Name Preferred Name Last First MI Address_ Best contact phone number: Email address: Primary Care Physician Tel Fax Pharmacy Phone

More information

Note: must consider drug half-life and when take drug relative to bedtime. Note: must consider drug half-life, esp. re. SOI, SMI, & hangover effects

Note: must consider drug half-life and when take drug relative to bedtime. Note: must consider drug half-life, esp. re. SOI, SMI, & hangover effects DRUG EFFECTS ON SLEEP (p.1) Note: Gained by clinical observation often, not by FDA guidelines as part of a consistent protocol in the preapproval screening of new drugs (unless the new drug s stated purpose

More information

Depression and Anxiety: When to Treat, How to Treat, and When to Refer

Depression and Anxiety: When to Treat, How to Treat, and When to Refer Depression and Anxiety: When to Treat, How to Treat, and When to Refer J. Luke Engeriser, MD Residency Program Director; Assistant Professor USACOM, Department of Psychiatry Deputy Chief Medical Officer

More information

Concurrent Disorder refers to any psychiatric condition that may occur in a person with addiction or in recovery from addiction.

Concurrent Disorder refers to any psychiatric condition that may occur in a person with addiction or in recovery from addiction. Concurrent Disorder refers to any psychiatric condition that may occur in a person with addiction or in recovery from addiction. This self report Symptom Inventory will provide your doctor with basic information

More information

Arizona Department of Health Services/ Division of Behavioral Health Services Behavioral Health Drug List Effective 1/1/2014

Arizona Department of Health Services/ Division of Behavioral Health Services Behavioral Health Drug List Effective 1/1/2014 Arizona Department of Health Services/ Division of Behavioral Health Services Behavioral Health Drug List Effective 1/1/2014 The Arizona Department of Health Services, Division of Behavioral Health Services,

More information

REACHOUT NEWS Child Welfare Professional Development Project

REACHOUT NEWS Child Welfare Professional Development Project Spring 2009 School of Social Work Stephen F. Austin State University Child Welfare Professional Development Project Inside this issue: Psychiatric Medication For Children And Adolescents Part II Types

More information

Wiregrass Behavioral Systems, PC Intake Paperwork

Wiregrass Behavioral Systems, PC Intake Paperwork Dr. Bascom K. Bradshaw 6501 US Highway 431 N Headland, AL 36345 Phone: 334-695-2253 bradshaw@wiregrassbehavioralsystems.com www.wiregrassbehavioralsystems.com DATE OF APPOINTMENT: NAME: DATE OF BIRTH:

More information

INTAKE PAPERWORK DATE OF APPOINTMENT NAME DATE OF BIRTH ADDRESS CELL PHONE HOME PHONE PREFERRED METHOD OF CONTACT SOCIAL SECURITY NUMBER

INTAKE PAPERWORK DATE OF APPOINTMENT NAME DATE OF BIRTH ADDRESS CELL PHONE HOME PHONE  PREFERRED METHOD OF CONTACT SOCIAL SECURITY NUMBER Dr. Victoria Kelly 7110 W. Central Ave, Suite C Toledo, OH 43617 Phone : 567-455-5433 Fax : 567-455-5434 info@psychiatrytoledo.com www.psychiatrytoledo.com INTAKE PAPERWORK DATE OF APPOINTMENT NAME DATE

More information

ADULT INITIAL EVALUATION: Patient Form

ADULT INITIAL EVALUATION: Patient Form ADULT INITIAL EVALUATION: Patient Form Date: Patient: DOB: Referred by: Name of Person completing this form if not patient: Briefly describe the events that led to this appointment. Have there been any

More information

Medications A detailed booklet that describes mental disorders and the medications for treating them includes a comprehensive list of medications.

Medications A detailed booklet that describes mental disorders and the medications for treating them includes a comprehensive list of medications. A detailed booklet that describes mental disorders and the medications for treating them includes a comprehensive list of medications. 2014 Contents Introduction: Mental Health Medications...1 What are

More information

May 12, DAL: DAL SUBJECT: Warm Weather Advisory. Dear Administrator/Operator:

May 12, DAL: DAL SUBJECT: Warm Weather Advisory. Dear Administrator/Operator: May 12, 2015 DAL: DAL 15-12 SUBJECT: Warm Weather Advisory Dear Administrator/Operator: During periods of warm temperatures you are expected to provide your residents with a comfortable and safe environment

More information

Beyond ADHD and Stimulants: What You Need to Know about Psychiatric Medications in the School Setting

Beyond ADHD and Stimulants: What You Need to Know about Psychiatric Medications in the School Setting Beyond ADHD and Stimulants: What You Need to Know about Psychiatric Medications in the School Setting S C H O O L N U R S E C O N F E R E N C E C H A L L E N G E S A N D C H A N G E S I N T O D A Y S S

More information

Appropriate utilization of psychotropic medications and the Georgia Families 360 program. Amber Hammontree, LPC Clinical Trainer Georgia Families 360

Appropriate utilization of psychotropic medications and the Georgia Families 360 program. Amber Hammontree, LPC Clinical Trainer Georgia Families 360 Appropriate utilization of psychotropic medications and the Georgia Families 360 program Amber Hammontree, LPC Clinical Trainer Georgia Families 360 GAPEC-1202-16 March 2016 1 Learning objectives A general

More information

Title 19/21 GMH/SA & Non-Title 19/21 SMI Behavioral Health Drug List Updated 06/01/2016

Title 19/21 GMH/SA & Non-Title 19/21 SMI Behavioral Health Drug List Updated 06/01/2016 Title 19/21 GMH/SA & Non-Title 19/21 SMI Behavioral Health Drug List Updated 06/01/2016 Effective April 1, 2014, Mercy Maricopa Integrated Care began operations as the Regional Behavioral Health Authority

More information

A BRIEF OVERVIEW OF PSYCHOTROPIC MEDICATION USE FOR PERSONS WITH INTELLECTUAL DISABILITIES

A BRIEF OVERVIEW OF PSYCHOTROPIC MEDICATION USE FOR PERSONS WITH INTELLECTUAL DISABILITIES INTRODUCTION A BRIEF OVERVIEW OF PSYCHOTROPIC MEDICATION USE FOR PERSONS WITH INTELLECTUAL DISABILITIES Individuals with intellectual disabilities are not uncommonly prescribed psychotropic medications.

More information

Proposal No Page 1 of 8. Exhibit C. Top 100 Drugs by Claim Count REGIONAL CLINICS

Proposal No Page 1 of 8. Exhibit C. Top 100 Drugs by Claim Count REGIONAL CLINICS Proposal No. 269-4611 Page 1 of 8 REGIONAL CLINICS 1 185006301 CLONAZEPAM TAB 0.5MG 107 2 59762491001 SERTRALINE TAB 100MG 79 3 60505251901 CITALOPRAM TAB 20MG 75 4 50111043401 TRAZODONE TAB 100MG 73 5

More information

12629 LIBRIUM CHLORDIAZEPOXIDE HCL 12637 LIBRIUM CHLORDIAZEPOXIDE HCL 12645 LIBRIUM CHLORDIAZEPOXIDE HCL 13110 VALIUM DIAZEPAM 13277 VALIUM DIAZEPAM 24406 LITHANE LITHIUM CARBONATE 25836 SURMONTIL TRIMIPRAMINE

More information

Mental Health Medications

Mental Health Medications Mental Health Medications National Institute of Mental Health U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Contents Mental Health Medications..............................................................1

More information

Psychotropic Medication Reference Chart

Psychotropic Medication Reference Chart Psychotropic Medication Reference Chart Appendix 4.14 This chart is not an all-inclusive list of medications. If you have a question regarding the classification of a medication you may consult websites

More information

Patient Information Sheet (Please fill out

Patient Information Sheet (Please fill out Patient Information Sheet (Please fill out Patient Full Name: Name you go by: Age: completely!) SSN: / / Marital Status: Sex: M / F DOB: / / Address: City: State: Zip code: Home Phone: ( ) Work: ( ) Cell:

More information

ADJUSTMENT DISORDER WITH DEPRESSION OR ANXIETY

ADJUSTMENT DISORDER WITH DEPRESSION OR ANXIETY ADJUSTMENT DISORDER WITH DEPRESSION OR ANXIETY BEHAVIORAL DEFINITIONS 1 Depressive symptoms (eg, sad mood, tearfulness, feelings of hopelessness) that develop in response to an identifiable stressor (eg,

More information

Module #5. Optional Training. Psychotropic Medications and Children and Adolescents

Module #5. Optional Training. Psychotropic Medications and Children and Adolescents Module #5. Optional Training Psychotropic Medications and Children and Adolescents The following training provides information on psychotropic medications, their use with children and adolescents in general

More information

Psychological Evaluation

Psychological Evaluation Psychological Evaluation Patient Information Name: DOB: Current Age: Female Male 1. Martial Status (fill in only one): 2. What is your primary role (fill in only one): Never married Wage earner, full-time

More information

Handout 2 List of medications used to treat mental illness

Handout 2 List of medications used to treat mental illness Navigating Boundaries: Setting Sail With A Mentally Ill Client Handout 2 List of medications used to treat mental illness Information synthesized from www.drugs.com. Additional Information: CR following

More information

Overview of Mental Health Medication Trends

Overview of Mental Health Medication Trends America s State of Mind Report is a Medco Health Solutions, Inc. analysis examining trends in the utilization of mental health related medications among the insured population. The research reviewed prescription

More information

SECTION M BEHAVIORAL HEALTH SERVICES

SECTION M BEHAVIORAL HEALTH SERVICES Phoenix Health Plan s (PHP) goal for its members is to ensure that behavioral health services are readily available for Title XIX (Medicaid) and the Title XXI (KidsCare) members. Comprehensive behavioral

More information

EMORY CLINIC, INC. Brain Health Center 12 Executive Park Dr. Atlanta, GA 30329 404-728-6302

EMORY CLINIC, INC. Brain Health Center 12 Executive Park Dr. Atlanta, GA 30329 404-728-6302 New Patient Packet 03/10/2015 EMORY CLINIC, INC. Brain Health Center 12 Executive Park Dr. Atlanta, GA 30329 404-728-6302 Thank you for allowing us to assist in your care. We look forward to meeting you.

More information

YOUR MEDICATIONS WHAT YOU SHOULD KNOW

YOUR MEDICATIONS WHAT YOU SHOULD KNOW YOUR MEDICATIONS WHAT YOU SHOULD KNOW A Handbook For People With Developmental Disabilities Developmental Disabilities Area Board 10 Developmental Disabilities Area Board 10 411 N. Central Avenue Suite

More information

Psychopharmacology in Children & Adolescents. Susan Sharp, D.O. Department of Psychiatry and Behavioral Sciences Kansas University Medical Center

Psychopharmacology in Children & Adolescents. Susan Sharp, D.O. Department of Psychiatry and Behavioral Sciences Kansas University Medical Center Psychopharmacology in Children & Adolescents Susan Sharp, D.O. Department of Psychiatry and Behavioral Sciences Kansas University Medical Center Treating Children and Adolescents Diagnostic hypothesis

More information

PSYCHIATRIC ASSOCIATES PC 5918 HARBOUR PARK DRIVE MIDLOTHIAN, VA P L E A S E P R I N T

PSYCHIATRIC ASSOCIATES PC 5918 HARBOUR PARK DRIVE MIDLOTHIAN, VA P L E A S E P R I N T Patient Information PSYCHIATRIC ASSOCIATES PC 5918 HARBOUR PARK DRIVE MIDLOTHIAN, VA 23112 P L E A S E P R I N T Patient: DOB: SSN: Address: City: State Zip Code: Sex: M F Marital Status: Married Single

More information

Medicines for Treating Depression. A Review of the Research for Adults

Medicines for Treating Depression. A Review of the Research for Adults Medicines for Treating Depression A Review of the Research for Adults Is This Information Right for Me? Yes, if: A doctor or other health care professional has told you that you have depression. Your doctor

More information

Fundamentals of Pharmacology for Veterinary Technicians Chapter 22

Fundamentals of Pharmacology for Veterinary Technicians Chapter 22 Figure 22-1 Figure 22-2 Figure 22-3 Figure 22-4 Figure 22-5 Table 22-1 Neurotransmitters Involved in Behavior Disorders acetylcholine Neurotransmitter that communicates between nerves and muscles that

More information

North Pacific Epilepsy Research 2311 NW Northrup Street Suite #202 Portland, Oregon Tel: Fax:

North Pacific Epilepsy Research 2311 NW Northrup Street Suite #202 Portland, Oregon Tel: Fax: Panic Disorder North Pacific Epilepsy Research 2311 NW Northrup Street Suite #202 Portland, Oregon 97210 Tel: 503-291-5300 Fax: 503-291-5303 Panic disorder is a type of anxiety disorder. When panic attacks

More information

Medication Side Effects

Medication Side Effects Medication side effects All meds All medications have side effects. Side effects for any given medication may vary from person to person. As we look at the following medications and their side effects,

More information

Morphine IR Avinza, Kadian, MS Contin (Morphine sulfate ER) Dilaudid (hydromorphone IR) Exalgo (hydromorphone ER) Opana (oxymorphone IR and ER)

Morphine IR Avinza, Kadian, MS Contin (Morphine sulfate ER) Dilaudid (hydromorphone IR) Exalgo (hydromorphone ER) Opana (oxymorphone IR and ER) Pre - PA Allowance Quantity Immediate-release Formulations Morphine sulfate (IR) Opana (oxymorphone) IR Dilaudid (hydromorphone) IR 360 tablets per 90 days Extended-release Formulations Avinza (morphine

More information

PSYCHIATRIC MEDICATION USE DURING PREGNANCY AND BREASTFEEDING

PSYCHIATRIC MEDICATION USE DURING PREGNANCY AND BREASTFEEDING E-Resource May 2014 PSYCHIATRIC MEDICATION USE DURING PREGNANCY AND BREASTFEEDING Psychotropic medication use during pregnancy may have adverse effects, however, there is a growing body of evidence that

More information

CO-OCCURRING DISORDERS In Substance Abuse

CO-OCCURRING DISORDERS In Substance Abuse CO-OCCURRING DISORDERS In Substance Abuse Part III: Treatment of COD, with focus on psychotropic medications A Workshop for Alameda County SUD Treatment Providers March 25, 2016 Rob Lee, MD Some Addiction

More information

Overview of Psychopharmacology. Practical information for the therapist

Overview of Psychopharmacology. Practical information for the therapist Overview of Psychopharmacology Practical information for the therapist Goals of this Lecture Overview of commonly used medications When to refer for medication evaluation When to contact your collaborating

More information

BIPOLAR DISORDER A GUIDE FOR INDIVIDUALS AND FAMILIES FOR THE TREATMENT OF BIPOLAR DISORDER IN ADULTS

BIPOLAR DISORDER A GUIDE FOR INDIVIDUALS AND FAMILIES FOR THE TREATMENT OF BIPOLAR DISORDER IN ADULTS BIPOLAR DISORDER A GUIDE FOR INDIVIDUALS AND FAMILIES FOR THE TREATMENT OF BIPOLAR DISORDER IN ADULTS A publication of the Massachusetts Department of Mental Health and the Massachusetts Division of Medical

More information

State Supported Living Centers Statewide Policy & Procedures. Psychiatry Services POLICY:

State Supported Living Centers Statewide Policy & Procedures. Psychiatry Services POLICY: State Supported Living Centers Statewide Policy & Procedures Policy Number: 007.3 Effective: MM/DD/YYYY DRAFT Replaces: 007.2 POLICY: PURPOSE: Psychiatry Services The purpose of this policy is to ensure

More information

Why is medication recommended as part of the treatment for mental illness?

Why is medication recommended as part of the treatment for mental illness? Medications for Psychiatric Disorders Introduction This article discusses medications for psychiatric disorders. Information is provided about the effects of medications, including their advantages and

More information

Medication Management: ADHD

Medication Management: ADHD Medication Management: ADHD March 6, 2004 Pacific Northwest Neuropsychological Society Samuel H. Zinner, M.D. Developmental/Behavioral Pediatrics University of Washington ADHD - Etiology Neurobiology Neurotransmitters

More information

STABLE. STAndards for BipoLar Excellence. A Performance Measurement & Quality Improvement Program DATA COLLECTION FORMS BIPOLAR DISORDER

STABLE. STAndards for BipoLar Excellence. A Performance Measurement & Quality Improvement Program DATA COLLECTION FORMS BIPOLAR DISORDER STABLE STAndards for BipoLar Excellence A Performance Measurement & Quality Improvement Program DATA COLLECTION FORMS BIPOLAR DISORDER Diagnosis & Index Episode Visit Case Finding & Selection Background

More information

ANTIDEPRESSANT MEDICINES. A GUIDE for ADULTS With DEPRESSION

ANTIDEPRESSANT MEDICINES. A GUIDE for ADULTS With DEPRESSION ANTIDEPRESSANT MEDICINES A GUIDE for ADULTS With DEPRESSION August 2007 FAST FACTS ON ANTIDEPRESSANTS The antidepressants in this guide work for treating depression. Most people can find one that makes

More information

Treatment of Children with Mental Disorders

Treatment of Children with Mental Disorders QUESTIONS & ANSWERS Treatment of Children with Mental Disorders DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE NATIONAL INSTITUTES OF HEALTH A Note to Parents There has been public concern

More information

ADULT FEMALE NEW PATIENT INFORMATION FORM

ADULT FEMALE NEW PATIENT INFORMATION FORM The Fort Christian Psychiatric Center Shaw Wendi Fortuchang, M.D., P.C. ADULT FEMALE NEW PATIENT INFORMATION FORM How were you referred to our office? Patient s Full Name Age: Date of Birth: Gender: Email

More information

Depression. Medicines To Help You

Depression. Medicines To Help You Medicines To Help You Depression Use this guide to help you talk to your doctor, pharmacist, or nurse about your medicines for depression. The guide lists all of the FDA-approved products now available

More information

POPULAR DEPRESSION MEDICATIONS

POPULAR DEPRESSION MEDICATIONS Popular Depression Medications A Helpful Guide to Antidepressant Drugs POPULAR DEPRESSION MEDICATIONS A Helpful Guide to Antidepressant Drugs Popular Depression Medications A Helpful Guide to Antidepressant

More information

Psychotropic Medication

Psychotropic Medication Page 1 T I P S F O R P R A C T I C E Psychotropic Medication Psychotropic medications are symptomatic medications that affect attention, emotions, or behaviors. Communication between the physician, NDHHS

More information

Psychiatry Cheat Sheet

Psychiatry Cheat Sheet Psychiatry Cheat Sheet Jazzlyn Gallardo, D.O. Normal TSH: 0.45 5.10 miu/l Check TSH again 4-6 weeks after each thyroid dose change. Levothyroxine: starting dose 25 mcg/d Take thyroid meds on empty stomach

More information

MOOD DISORDERS PART II BIPOLAR AFFECTIVE DISORDER (BAD) Todd Stull, M.D. James Sorrell, M.D.

MOOD DISORDERS PART II BIPOLAR AFFECTIVE DISORDER (BAD) Todd Stull, M.D. James Sorrell, M.D. MOOD DISORDERS PART II BIPOLAR AFFECTIVE DISORDER (BAD) Todd Stull, M.D. James Sorrell, M.D. BIPOLAR AFFECTIVE DISORDER (BAD) General Assessment is challenging Input important Change in level of functioning

More information

Statistics & Trends in Psychiatric Medications

Statistics & Trends in Psychiatric Medications Statistics & Trends in Psychiatric Medications Presented by: Matt Bierds, MA, LPC, LSOTP www.thecounselorcoach.com Quotes I told my psychiatrist that everyone hates me. He said I was being ridiculous-

More information

PSYCHIATRIC MEDICATIONS IN PREGNANCY AND LACTATION. Lauren O Brien, MD PGY3 11/5/14

PSYCHIATRIC MEDICATIONS IN PREGNANCY AND LACTATION. Lauren O Brien, MD PGY3 11/5/14 PSYCHIATRIC MEDICATIONS IN PREGNANCY AND LACTATION Lauren O Brien, MD PGY3 11/5/14 OBJECTIVES Identify common psychiatric illnesses Discuss the categorization of medication in pregnancy and lactation Review

More information

University of Florida & Shands Adult Psychiatry Outpatient Clinic Intake Form

University of Florida & Shands Adult Psychiatry Outpatient Clinic Intake Form University of Florida & Shands Adult Psychiatry Outpatient Clinic Intake Form Date Name Age Address Home phone Work phone Cell phone What issue(s) bring(s) you to the Psychiatry Clinic? What has been stressing

More information

New Patient Information. Address: City: State: Zip: Ph#: Cell#:

New Patient Information. Address: City: State: Zip: Ph#: Cell#: Patient Information: Last Name: New Patient Information First Name: Address: City: State: Zip: Ph#: Cell#: S.S.N: Email: May we contact you by email? Yes No Date of Birth: May we send you information about

More information

Antipsychotics and the Nursing Home

Antipsychotics and the Nursing Home Antipsychotics and the Nursing Home Lisa M. O Hara, PharmD, CGP Corporate Director of Clinical Services The State Operations Manual Part 1: F329 Unnecessary Drugs Medication Management Defined Helps promote

More information

Finding the right medicine for you just got easier. Now your genes can help guide your treatment plan

Finding the right medicine for you just got easier. Now your genes can help guide your treatment plan Finding the right medicine for you just got easier Now your genes can help guide your treatment plan What s the right treatment for me? If you ve ever tried a medication that didn t work or caused you

More information

Bipolar Disorder. Mania is the word that describes the activated phase of bipolar disorder. The symptoms of mania may include:

Bipolar Disorder. Mania is the word that describes the activated phase of bipolar disorder. The symptoms of mania may include: Bipolar Disorder What is bipolar disorder? Bipolar disorder, or manic depression, is a medical illness that causes extreme shifts in mood, energy, and functioning. These changes may be subtle or dramatic

More information

The Antipsychotic Algorithms for treatment of Schizophrenia

The Antipsychotic Algorithms for treatment of Schizophrenia Medication Dosing Table ATYPICAL Atypical First Dose Titration Range Schedule 12.5 mg. (½ a 25 mg tab) Starting Day 3, dose is increased every 3 days > Day 2: 25 mg hs Day 3: 25 mg bid Day 6: 25 mg am

More information

The Role of Medication in the Treatment of Emotional and Behavioral Concerns for Children on the Spectrum

The Role of Medication in the Treatment of Emotional and Behavioral Concerns for Children on the Spectrum The Role of Medication in the Treatment of Emotional and Behavioral Concerns for Children on the Spectrum Charles Cartwright, M.D Director YAI Autism Center Uncomplicated Autism Spectrum Disorders (ASD)

More information

[Please note that child can also refer to an adult with Rett syndrome]

[Please note that child can also refer to an adult with Rett syndrome] International Rett Syndrome Foundation Conference 2009 Elaine Tierney, M.D. Kennedy Krieger Institute & Johns Hopkins University School of Medicine Baltimore, MD [Please note that child can also refer

More information

4/17/2013. Outline. Brain Development. Brain Development, Effects of Trauma, and Appropriate Use of Psychotropic Medications

4/17/2013. Outline. Brain Development. Brain Development, Effects of Trauma, and Appropriate Use of Psychotropic Medications Brain Development, Effects of Trauma, and Appropriate Use of Psychotropic Medications An Introduction to Disorders and Drugs Outline Why are we talking about this? Trauma affects normal brain development

More information

SACRAMENTO COUNTY MENTAL HEALTH

SACRAMENTO COUNTY MENTAL HEALTH ALPHA AGONISTS Clonidine (Catapres) Guanfacine (Tenex) BENEFITS OF THIS MEDICATION These medications are commonly used to treat high blood pressure. Your doctor may have prescribed these medications to

More information

Neurotransmitters Made Easy: The Mood Teeter-Totter

Neurotransmitters Made Easy: The Mood Teeter-Totter Neurotransmitters Made Easy: The Mood Brad Lander PhD, LICDC Clinical Director / Psychologist Talbot Hall - Addiction Medicine at The Ohio State University Wexner Medical Center Key Point #1 Thinking and

More information

Psychotropic Drug List

Psychotropic Drug List Psychotropic Drug List Current at January 2011. This is a list of pyschotropic medications available in Australia. These are important medications for the treatment of a variety of health conditions, as

More information

New Treatments. For Bipolar Disorder. Po W. Wang, MD Clinical Associate Professor Bipolar Disorders Clinic Stanford University School of Medicine

New Treatments. For Bipolar Disorder. Po W. Wang, MD Clinical Associate Professor Bipolar Disorders Clinic Stanford University School of Medicine New Treatments For Bipolar Disorder Po W. Wang, MD Clinical Associate Professor Bipolar Disorders Clinic Stanford University School of Medicine Abbott Laboratories AstraZeneca Bristol-Myers Squibb Corcept

More information

Recognition and Treatment of Depression in Parkinson s Disease

Recognition and Treatment of Depression in Parkinson s Disease Recognition and Treatment of Depression in Parkinson s Disease Web Ross VA Pacific Islands Health Care System What is depression? Depression is a serious medical condition that affects a person s feelings,

More information

A PARENTS GUIDE TO THE MEDICAL TREATMENT OF ADHD WHEN THERE IS ALSO AUTISM OR ASPERGER SYNDROME

A PARENTS GUIDE TO THE MEDICAL TREATMENT OF ADHD WHEN THERE IS ALSO AUTISM OR ASPERGER SYNDROME A PARENTS GUIDE TO THE MEDICAL TREATMENT OF ADHD WHEN THERE IS ALSO AUTISM OR ASPERGER SYNDROME EDWARD B. AULL, M.D. 13450 N. MERIDIAN SUITE 354 CARMEL, INDIANA 46032 317 582 7654 FAX 317 582 7660 BEHAVIORAL

More information

Distress in Cancer. Depression and Anxiety in MDS and Related Diseases 5/17/2010

Distress in Cancer. Depression and Anxiety in MDS and Related Diseases 5/17/2010 Depression and Anxiety in MDS and Related Diseases Alan D. Valentine, M.D. Evaluations of Health and Well-being in Psychological Functioning, Physical Functioning, Social Functioning, and Symptoms and

More information

MEDICATIONS USED FOR BEHAVIORAL & EMOTIONAL DISORDERS

MEDICATIONS USED FOR BEHAVIORAL & EMOTIONAL DISORDERS MEDICATIONS USED FOR BEHAVIORAL & EMOTIONAL DISORDERS A GUIDE FOR PARENTS, FOSTER PARENTS, FAMILIES, YOUTH, CAREGIVERS, GUARDIANS, AND SOCIAL WORKERS Final May 10, 2010 Overview This booklet is a guide

More information

MEDICATIONS AND TOURETTE S DISORDER: COMBINED PHARMACOTHERAPY AND DRUG INTERACTIONS. Barbara Coffey, M.D., Cheston Berlin, M.D., Alan Naarden, M.D.

MEDICATIONS AND TOURETTE S DISORDER: COMBINED PHARMACOTHERAPY AND DRUG INTERACTIONS. Barbara Coffey, M.D., Cheston Berlin, M.D., Alan Naarden, M.D. MEDICATIONS AND TOURETTE S DISORDER: COMBINED PHARMACOTHERAPY AND DRUG INTERACTIONS Barbara Coffey, M.D., Cheston Berlin, M.D., Alan Naarden, M.D. Introduction Tourette Syndrome (TS) or Tourette s Disorder

More information

Introduction to Alzheimer s Medications and Off Label Prescriptions

Introduction to Alzheimer s Medications and Off Label Prescriptions A Publication of Together In This TM Introduction to Alzheimer s Medications and Off Label Prescriptions A Guide for Family Knowledge to Empower You to Fight Back 2015 TogetherInThis.com. All rights reserved

More information

Psychotropic Medications

Psychotropic Medications Psychotropic Medications Medicating children and adolescents for psychiatric problems or learning disabilities continues to be an area of controversy. There are currently two opposing poles in this discussion.

More information

Help and Healing: Section 1: Identification, Education and Talking Points PHQ-9. Talking Points. Strategies for Patient and Family Education

Help and Healing: Section 1: Identification, Education and Talking Points PHQ-9. Talking Points. Strategies for Patient and Family Education Help and Healing: Resources for Depression Care and Recovery Section 1: Identification, Education and PHQ-9 Strategies for Patient and Family Education Patient Education - Depression Fact Sheet Example

More information

Major Depression. What is major depression?

Major Depression. What is major depression? Major Depression What is major depression? Major depression is a serious medical illness affecting 9.9 million American adults, or approximately 5 percent of the adult population in a given year. Unlike

More information

We look forward to seeing you on at with Dr..

We look forward to seeing you on at with Dr.. Florida Recovery Center 4001 S.W. 13 th street Gainesville, FL 32608 We look forward to seeing you on at with Dr.. You are scheduled with our Addiction Clinic, located at 4001 S.W 13 th street, Gainesville,

More information

Medication management of Behavioral Problems in Patients with End Stage Dementia

Medication management of Behavioral Problems in Patients with End Stage Dementia Medication management of Behavioral Problems in Patients with End Stage Dementia Clinical Features in Late Stage Dementia Alzheimer's Delusions, agitation Frontotemporal - Personality changes, disinhibition,

More information