Medication Audit Criteria and Guidelines

Psychotropic Monitoring Guidelines - 2015 (PDF) Posted November, 2015

Appendix A - Purpose of Laboratory Monitoring

Table A - Cytochrome P450 Drug Metabolism

Medication Audit Criteria and Checklist
Amoxapine (Asendin®)
amoxapine (Asendin®) Criteria, February, 2008 (MS Word)
amoxapine (Asendin®) Checklist, February, 2008 (MS Word)
Antipsychotics chlorpromazine (Thorazine®), fluphenazine (Prolixin®), haloperidol (Haldol®), loxapine (Loxitane®), perphenazine (Trilafon®), thiothixene (Navane®), trifluoperazine (Stelazine®)
antipsychotics chlorpromazine (Thorazine®), fluphenazine (Prolixin®), haloperidol (Haldol®), loxapine (Loxitane®), perphenazine (Trilafon®), thiothixene (Navane®), trifluoperazine (Stelazine®) Criteria, October, 2015 (PDF)
antipsychotics chlorpromazine (Thorazine®), fluphenazine (Prolixin®), haloperidol (Haldol®), loxapine (Loxitane®), perphenazine (Trilafon®), thiothixene (Navane®), trifluoperazine (Stelazine®) Checklist, October, 2015 (PDF)
Antipsychotics thioridazine (Mellaril®)antipsychotics thioridazine (Mellaril®) Criteria, October, 2015 (PDF)
antipsychotics thioridazine (Mellaril®) Checklist, October, 2015 (PDF)
Benzodiazepines alprazolam (Xanax®), chlordiazepoxide (Librium®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), Oxazepam (Serax®), temazepam (Restoril®), triazolam (Halcion®), Clonazepam (Klonopin®)benzodiazepines alprazolam (Xanax®), chlordiazepoxide (Librium®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), Oxazepam (Serax®), temazepam (Restoril®), triazolam (Halcion®), Clonazepam (Klonopin®) Criteria, February, 2006 (MS Word)
benzodiazepines alprazolam (Xanax®), chlordiazepoxide (Librium®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), Oxazepam (Serax®), temazepam (Restoril®), triazolam (Halcion®), Clonazepam (Klonopin®) Checklist, February, 2006 (MS Word)
Beta-blockers propranolol (Inderal®), atenolol (Tenormin®), metoprolol (Lopressor®), nadolol (Corgard®)beta-blockers propranolol (Inderal®), atenolol (Tenormin®), metoprolol (Lopressor®), nadolol (Corgard®) Criteria, February, 2006 (MS Word)
beta-blockers propranolol (Inderal®), atenolol (Tenormin®), metoprolol (Lopressor®), nadolol (Corgard®) Checklist, February, 2006 (MS Word)
Bupropion (Wellbutrin® and Wellbutrin® SR)bupropion (Wellbutrin® and Wellbutrin® SR) Criteria, February, 2006 (MS Word)
bupropion (Wellbutrin® and Wellbutrin® SR) Checklist, February, 2006 (MS Word)
Buspirone (Buspar®)buspirone (Buspar®) Criteria, February, 2006 (MS Word)
buspirone (Buspar®) Checklist, February, 2006 (MS Word)
Carbamazepine (Tegretol®)carbamazepine (Tegretol®) Criteria, January, 2015 (PDF)
carbamazepine (Tegretol®) Checklist, January, 2015 (PDF)
Clomipramine (Anafranil®)clomipramine (Anafranil®) Criteria, February, 2006 (MS Word)
clomipramine (Anafranil®) Checklist, February, 2006 (MS Word)
Clonidine (Catapres@) guanfacine (Tenex@)clonidine (Catapres@) guanfacine (Tenex@) Criteria, June, 2009 (MS Word) 
clonidine (Catapres@) guanfacine (Tenex@) Checklist, June, 2009 (MS Word)  
Clozapine (Clozapril®, Fazaclo®)clozapine (Clozapril®, Fazaclo®) Criteria - October 2015 (PDF)
clozapine (Clozapril®, Fazaclo®) Checklist - October 2015 (PDF)
Decanoates fluphenazine decanoate (Prolixin® Decanoate), haloperidol decanoate (Haldol® Decanoate)decanoates fluphenazine decanoate (Prolixin® Decanoate), haloperidol decanoate (Haldol® Decanoate) Criteria, October, 2015 (PDF)
decanoates fluphenazine decanoate (Prolixin® Decanoate), haloperidol decanoate (Haldol® Decanoate) Checklist, October, 2015 (PDF)
Duloxetine (Cymbalta®)duloxetine (Cymbalta®) Criteria, March, 2006 (MS Word)
duloxetine (Cymbalta®) Checklist, March, 2006 (MS Word)
Gabapentin (Neurontin®)gabapentin (Neurontin®) Criteria, January, 2015 (PDF)
gabapentin (Neurontin®) Checklist, January, 2015 (PDF)
Lamotrigine (Lamictal®)lamotrigine (Lamictal®) Criteria, January, 2015 (PDF)
lamotrigine (Lamictal®) Checklist, January, 2015 (PDF)
Lithium (Eskalith®, Lithobid®, Eskalith CR®, etc.)lithium (Eskalith®, Lithobid®, Eskalith CR®, etc.) Criteria, January, 2015 (PDF)
ithium (Eskalith®, Lithobid®, Eskalith CR®, etc.) Checklist, January, 2015 (PDF)
Mirtazapine (Remeron®)mirtazapine (Remeron®) Criteria, February, 2006 (MS Word)
mirtazapine (Remeron) Checklist, February, 2006 (MS Word)
Monoamine oxidase inhibitors phenelzine (Nardil®), tranylcypromine (Parnate®)monoamine Oxidase Inhibitors phenelzine (Nardil®), tranylcypromine (Parnate®) Criteria, February, 2006 (MS Word)
monoamine Oxidase Inhibitors phenelzine (Nardil®), tranylcypromine (Parnate®) Checklist, February, 2006 (MS Word)
Naltrexone (Revia®)naltrexone (Revia®) Criteria, February, 2006 (MS Word)
naltrexone (Revia®) Checklist, February, 2006 (MS Word)
Nefazodone (Serzone®)nefazodone (Serzone®) Criteria, February, 2006 (MS Word)
nefazodone (Serzone®) Checklist, February, 2006 (MS Word)
Oxcarbazepine (Trileptal®)oxcarbazepine (Trileptal®) Criteria, January, 2015 (PDF)
oxcarbazepine (Trileptal®) Checklist, January, 2015 (PDF)
Risperidone (Risperdal®, Risperdal Consta®), olanzapine (Zyprexa®, Zyprexa® Relprevv™), paliperidone (Invega®, Invega Sustenna®), quetiapine (Seroquel®), ziprasidone (Geodon®), aripiprazole (Abilify®, Abilify® Maintena™, Aristada®), asenapine (Saphris®), iloperidone (Fanapt®), lurasidone (Latuda®), brexpiprazole (Rexulti®)risperidone (Risperdal®, Risperdal Consta®), olanzapine (Zyprexa®, Zyprexa® Relprevv™), paliperidone (Invega®, Invega Sustenna®), quetiapine (Seroquel®), ziprasidone (Geodon®), aripiprazole (Abilify®, Abilify® Maintena™, Aristada®), asenapine (Saphris®), iloperidone (Fanapt®), lurasidone (Latuda®), brexpiprazole (Rexulti®) Criteria - April 2017 (PDF)
risperidone (Risperdal®, Risperdal Consta®), olanzapine (Zyprexa®, Zyprexa® Relprevv™), paliperidone (Invega®, Invega Sustenna®), quetiapine (Seroquel®), ziprasidone (Geodon®), aripiprazole (Abilify®, Abilify® Maintena™, Aristada®), asenapine (Saphris®), iloperidone (Fanapt®), lurasidone (Latuda®), brexpiprazole (Rexulti®)  Checklist - April 2017 (PDF)
Sedating antihistamines diphenhydramine HCL (Benadryl®), hydroxyzine HCL (Atarax®)sedating antihistamines diphenhydramine HCL (Benadryl®), hydroxyzine HCL (Atarax®) Criteria, February, 2006 (MS Word)
sedating antihistamines diphenhydramine HCL (Benadryl®), hydroxyzine HCL (Atarax®) Checklist, February, 2006 (MS Word)
SSRIs: citalorpam (Celex®), fluoxetine (Prozac®), sertraline (Zoloft®), paroxetine (Paxil®), fluvoxamine (Lubox®)SSRIs: citalorpam (Celex®), fluoxetine (Prozac®), sertraline (Zoloft®), paroxetine (Paxil®), fluvoxamine (Lubox®) Criteria, October, 2006 (MS Word)
SSRIs: citalorpam (Celex®), fluoxetine (Prozac®), sertraline (Zoloft®), paroxetine (Paxil®), fluvoxamine (Lubox®) Checklist, October, 2006 (MS Word)
Stimulants methylphenidate (Ritalin®, Concerta™), dextroamphetamine (Dexedrine®), dextroamphetamine/amphetamine mixture (Adderall®)stimulants methylphenidate (Ritalin®, Concerta™), dextroamphetamine (Dexedrine®), dextroamphetamine/amphetamine mixture (Adderall®) Criteria, March, 2006 (MS Word) (MS Word) 
stimulants methylphenidate (Ritalin®, Concerta™), dextroamphetamine (Dexedrine®), dextroamphetamine/amphetamine mixture (Adderall®) Checklist, March, 2006 (MS Word)
Topiramate (Topamax®)topiramate (Topamax®) Criteria, January, 2015 (PDF)
topiramate (Topamax®) Checklist, January, 2015 (PDF)
Trazodone (Desyrel®)trazodone (Desyrel®) Criteria, February, 2006 (MS Word)
trazodone (Desyrel®) Checklist, February, 2006 (MS Word)
Tricyclic antidepressants amitriptyline (Elavil®), desipramine (Norpramin®, Pertofrane®), doxepin (Sinequan®), imipramine (Tofranil®), maprotiline (Ludiomil®), nortriptyline (Pamelor®, Aventyl®), protriptyline (Vivactil®), trimipramine (Surmontil®)tricyclic antidepressants amitriptyline (Elavil®), desipramine (Norpramin®, Pertofrane®), doxepin (Sinequan®), imipramine (Tofranil®), maprotiline (Ludiomil®), nortriptyline (Pamelor®, Aventyl®), protriptyline (Vivactil®), trimipramine (Surmontil®) Criteria, February, 2006 (MS Word)
tricyclic antidepressants amitriptyline (Elavil®), desipramine (Norpramin®, Pertofrane®), doxepin (Sinequan®), imipramine (Tofranil®), maprotiline (Ludiomil®), nortriptyline (Pamelor®, Aventyl®), protriptyline (Vivactil®), trimipramine (Surmontil®) Checklist, February, 2006 (MS Word)
Valproic acid (Depakene®), divalproex sodium (Depakote®)valproic acid (Depakene®), divalproex sodium (Depakote®) Criteria, January, 2015 (PDF)
valproic acid (DepakeneE®), divalproex sodium (Depakote®) Checklist, January, 2015 (PDF)
Venlafaxine (Effexor® and Effexor® ER)venlafaxine (Effexor® and Effexor® ER) Criteria, February, 2006 (MS Word)
venlafaxine (Effexor® and Effexor® ER) Checklist, February, 2006 (MS Word)
Zaleplon (Sonata®)zaleplon (Sonata®) Criteria, February, 2006 (MS Word)
zaleplon (Sonata®) Checklist, February, 2006 (MS Word)
Zolpidem (Ambien®)zolpidem (Ambien®) Criteria, February, 2006 (MS Word)
zolpidem (Ambien®) Checklist, February, 2006 (MS Word)
Medication Audit Criteria and Checklists 


Last updated June 2, 2017