Medications
Psychiatry
Psychiatry
The effect of psychoactive medications should be evaluated in the same manner as any other medication. LEOs should not be restricted simply because they are being treated with psychoactive medication(s). They need appropriate evaluation regarding the effect of these medications, as well as the underlying condition(s). Many LEOs may work without restrictions when taking psychoactive medications with ongoing monitoring.
Antidepressants
Antidepressants – Monoamine Oxidase Inhibitors
| Isocarboxazid | MARPLAN |
| Phenelzine | NARDIL |
| Selegiline | EMSAM |
| Tranylcypromine | PARNATE |
D – diagnosis may dictate restriction
Antidepressants – Selective Serotonin Reuptake Inhibitors (SSRIs)
| Citalopram | CELEXA |
| Escitalopram | LEXAPRO |
| Fluoxetine | PROZAC |
| Fluvoxamine | LUVOX |
| Paroxetine | PAXIL |
| Sertraline | ZOLOFT |
A – approved while on duty
D – diagnosis may dictate restriction
Antidepressants – Trycyclic Agents
| Amitriptyline | ELAVIL |
| Clomipramine | ANAFRANIL |
| Desipramine | NORPRAMIN |
| Doxepin | SINEQUAN |
| Imipramine | TOFRANIL |
| Nortriptyline | PAMELOR |
| Protroptyline | VIVACTIL |
T – temporary restriction at beginning of treatment; monitor for behavior changes, drowsiness, orthostatic hypotension, visual disturbances
D – diagnosis may dictate restriction
Antidepressants – Other Agents
| Bupropion | WELLBUTRIN |
T – temporary restriction at beginning of treatment; monitor for behavior changes, dizziness, tremor, visual disturbances
D – diagnosis may dictate restriction
| Duloxetine | CYMBALTA |
T – temporary restriction at beginning of treatment; monitor for behavior changes, dizziness, drowsiness
D – diagnosis may dictate restriction
| Mirtazapine | REMERON |
T – temporary restriction at beginning of treatment; monitor for behavior changes, sedation
D – diagnosis may dictate restriction
| Nefazodone | SERZONE |
| Trazodone | DESYREL |
T – temporary restriction at beginning of treatment; monitor for behavior changes, sedation, hypotension, visual disturbances
D – diagnosis may dictate restriction
| Venlafaxine | EFFEXOR |
T – temporary restriction at beginning of treatment; monitor for behavior changes, dizziness, drowsiness, visual disturbances
D – diagnosis may dictate restriction
Antipsychotics
| Aripiprazole | ABILIFY |
| Clozapine | CLOZARIL |
| Chlorpromazine | THORAZINE |
| Fluphenazine | PROLIXIN |
| Haloperidol | HALDOL |
| Olanzapine | ZYPREXA |
| Perphenazine | TRILAFON |
| Pimozide | ORAP |
| Quetiapine | SEROQUEL |
| Risperidone | RISPERDAL |
| Thioridazine | MELLARIL |
| Thiothixene | NAVANE |
| Ziprasidone | GEODON |
T – temporary restriction at beginning of treatment; monitor for behavior changes, sedation, hyperglycemia, visual disturbances, extrapyramidal symptoms, orthostatic hypotension
D – diagnosis may dictate restriction
Anxiolytics – Hypnotics
Anxiolytics – Hypnotics – Benzodiazepines
| Alprazolam | XANAX |
| Chlordiazepoxide | LIBRIUM |
| Clorazepate | TRANXENE |
| Diazepam | VALIUM |
| Estazolam | PROSOM |
| Flurazepam | DALMANE |
| Lorazepam | ATIVAN |
| Midazolam | VERSED |
S – short-term use approved if taken off duty (with appropriate delay before returning to full duty to assure that there are no further residual effects); psychiatric evaluation recommended for long-term use (more than a few days); risk of sedation
D – diagnosis may dictate restriction
| Temazepam | RESTORIL |
S – short-term use approved if taken off duty/12 hours (with appropriate delay before returning to full duty to assure that there are no further residual effects); psychiatric evaluation recommended for long-term use (more than a few days); risk of sedation
D – diagnosis may dictate restriction
| Triazolam | HALCION |
R – approved only if assigned to restricted duty; safer alternatives should be used given the potential for hallucinations
| Oxazepam | SERAX |
S – short-term use approved if taken off duty (with appropriate delay before returning to full duty to assure that there are no further residual effects); psychiatric evaluation recommended for long-term use (more than a few days); risk of sedation
D – diagnosis may dictate restriction
Anxiolytics – Hypnotics – Other
| Buspirone | BUSPAR |
S – approved if taken off duty (with appropriate delay before returning to full duty to assure that there are no further residual effects); psychiatric evaluation recommended for long-term use (more than a few days); risk of sedation
D – diagnosis may dictate restriction
| Chloral Hydrate | NOCTEC |
S – approved if taken off duty (with appropriate delay before returning to full duty to assure that there are no further residual effects); psychiatric evaluation recommended for long-term use (more than a few days); risk of sedation
D – diagnosis may dictate restriction
Mood Regulators
| Carbamazepine | TEGRETOL |
| Lamotrigine | LAMICTAL |
T – temporary restriction at beginning of treatment; monitor for behavior changes, ataxia, visual disturbances, sedation
D – diagnosis may dictate restriction
| Lithium | LITHOBID |
T – temporary restriction at beginning of treatment; monitor for behavior changes, ataxia, sedation, lithium toxicity
D – diagnosis may dictate restriction
| Topiramate | TOPAMAX |
T – temporary restriction at beginning of treatment; monitor for behavior changes, visual disturbances, sedation
D – diagnosis may dictate restriction
| Valproic acid | DEPAKOTE |
T – temporary restriction at beginning of treatment; monitor for behavior changes, sedation
D – diagnosis may dictate restriction
Stimulants
| Amphetamine and dextroamphetamine | ADDERALL |
| Dextroamphetamine | DEXEDRINE |
| Methylphenidate | RITALIN, CONCERTA |
T – temporary restriction at beginning of treatment; monitor for behavior changes, visual disturbance, hypertension
D – diagnosis may dictate restriction
Other Psychiatric Medications
| Acamprosate | CAMPRAL |
T – temporary restriction at beginning of treatment; monitor for behavior changes, dizziness
D – diagnosis may dictate restriction
| Atomoxetine | STRATTERA |
T – temporary restriction at beginning of treatment; monitor for behavior changes, hypertension
D – diagnosis may dictate restriction
| Disulfiram | ANTABUSE |
T – temporary restriction at beginning of treatment; monitor for behavior changes, cardiovascular side effects
D – diagnosis may dictate restriction
| Modafinil | PROVIGIL |
T – temporary restriction at beginning of treatment; monitor for behavior changes, visual disturbances
D – diagnosis may dictate restriction
| Naltrexone | REVIA |
T – temporary restriction at beginning of treatment; monitor for behavior changes, dizziness, sedation
D – diagnosis may dictate restriction
| Nicotine and oral and nasal and transdermal forms |
A – approved while on duty
| Phentermine | |
| Sibutramine | MERIDIA |
T – temporary restriction at beginning of treatment; monitor for behavior changes, hypertension
| Varenicline | CHANTIX |
T – temporary restriction at beginning of treatment; monitor for behavior changes, hypertension, visual disturbances