Medication Form 
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Email *
Prozac (Fluoxetine)  *
10 mg
15 mg
20 mg
40mg
60mg
NA
Dose
Prozac (Fluoxetine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Paxil (Paroxetine)  *
10 mg
20mg
30mg
40mg
50mg
NA
Dose
Paxil (Paroxetine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Zoloft (Sertraline) *
25mg
50mg
100mg
150mg
200mg
NA
Dose
Zoloft (Sertraline) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Celexa (Citalopram) *
10mg
20mg
40mg
NA
Dose
Celexa (Citalopram) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Luvox (Fluvoxamine) *
25mg
50mg
100mg
150mg
NA
Dose
Luvox (Fluvoxamine) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Lexapro (Escitalopram) *
5mg
10mg
20mg
NA
Dose
Lexapro (Escitalopram) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Wellbutrin (Bupropion) *
75mg
100mg
150mg
200mg
300mg
450mg
NA
Dose
Wellbutrin (Bupropion) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Remeron (Mirtazapine)  *
15mg
30mg
45mg
NA
Dose
Remeron (Mirtazapine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Viibryd (Vilazodone)  *
10mg
20mg
40mg
NA
Dose
Viibryd (Vilazodone)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Effexor  (venlafaxine)  *
25mg
37.5mg
75mg
100mg
150mg
225mg
NA
Dose
Effexor  (venlafaxine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Cymbalta (Duloxetine) *
20mg
30mg
40mg
60mg
NA
Dose
Cymbalta (Duloxetine) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Pristiq  (Desvenlafaxine)  *
25mg
50mg
100mg
NA
Dose
Pristiq  (Desvenlafaxine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Anafranil (Clomipramine)  *
25mg
50mg
75mg
100mg
125mg
150mg
175mg
200mg
NA
Dose
Anafranil (Clomipramine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Lithium  *
150 mg
300 mg
450mg
600mg
NA
Dose
Lithium  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Depakote *
100 mg
125 mg
250 mg
500mg
NA
Dose
Depakote *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Lamictal (Lamotrigine)  *
2mg
5mg
25mg
50mg
100mg
150 mg
200mg
250 mg
300 mg
NA
Dose
Lamictal (Lamotrigine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Tegretol (Carbamazepine)  *
100 mg
200 mg
300mg
400mg
NA
Dose
Tegretol (Carbamazepine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Trileptal (Oxcarbazepine) *
10-40 mg
40-90mg
90-300mg
300mg
450mg
600mg
NA
Dose
Trileptal (Oxcarbazepine) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Neurontin (Gabapentin)  *
100mg
200 mg
300mg
400-500mg
600mg
600-900mg
900mg
NA
Dose
Neurontin (Gabapentin)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Topamax (Topiramate)  *
15 mg
20-25mg
50-75mg
100mg
200mg
300mg
400mg
NA
Dose
Topamax (Topiramate)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Haldol (Haloperidol) *
0.5mg
1mg
2mg
3mg
4mg
5mg
NA
Dose
Haldol (Haloperidol) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Prolixin (Fluphenazine) *
12.5mg
25mg
40mg
NA
Dose
Prolixin (Fluphenazine) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Loxitane (loxapine) *
10mg
20mg
50mg
100mg
150mg
200mg
250mg
NA
Dose
Loxitane (loxapine) *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Zyprexa (Olanzapine)  *
2.5mg
5mg
7.5mg
10mg
15mg
20mg
NA
Dose
Zyprexa (Olanzapine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Olanzapine-fluoxetine combination capsule *
3mg/25mg
6mg/25mg
6mg/50mg
12mg/25mg
12mg/50mg
NA
Dose
Olanzapine-fluoxetine combination capsule *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Seroquel (Quetiapine)  *
25mg
50mg
100mg
150mg
200mg
300mg
400mg
NA
Dose
Seroquel (Quetiapine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Risperdal (Risperidone)  *
0.5 mg
1mg
2mg
3mg
4mg
5mg
6mg
NA
Dose
Risperdal (Risperidone)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Invega (Paliperidone)  *
3 mg
6 mg
9 mg
12 mg
NA
Dose
Invega (Paliperidone)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Geodon (Ziprasidone)  *
10 mg
20 mg
40mg
NA
Dose
Geodon (Ziprasidone)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Abilify (Aripiprazole)  *
2mg
5 mg
10 mg
15 mg
20 mg
30 mg
NA
Dose
Abilify (Aripiprazole)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Saphris (Asenapine)  *
2.5mg
5 mg
10 mg
15mg
20mg
NA
Dose
Saphris (Asenapine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Fanapt (illoperidone)  *
2mg
4mg
6mg
12mg
18mg
20mg
24mg
NA
Dose
Fanapt (illoperidone)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Latuda (Lurasidone)  *
20 mg
40 mg
6 mg
80mg
100 mg
120mg
NA
Dose
Latuda (Lurasidone)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Clozaril (Clozapine)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Oleptro (trazodone)  *
50mg
100mg
150mg
300mg
NA
Dose
Oleptro (trazodone)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Ambien (Zolpidem)  *
1.75mg
3.5mg
5 mg
6.25 mg
10mg
12.5mg
NA
Dose
Ambien (Zolpidem)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Sonata (Zaleplon)  *
5mg
10 mg
15mg
20mg
10mg
12.5mg
NA
Dose
Sonata (Zaleplon)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Rozerem (Ramelteon)  *
8mg
NA
Dose
Rozerem (Ramelteon)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Lunesta (Eszopiclone)  *
1mg
2mg
3mg
NA
Dose
Lunesta (Eszopiclone)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Restoril (Temazepam)  *
10mg
20mg
30mg
40mg
NA
Dose
Restoril (Temazepam)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Buspar (Buspirone)  *
5mg
7.5mg
10mg
15mg
30mg
NA
Dose
Buspar (Buspirone)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Ativan (Lorazepam)  *
0.5mg
1mg
2mg
2.5mg
3mg
4mg
NA
Dose
Ativan (Lorazepam)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Xanax (Alprazolam)  *
0.25mg
0.5mg
1mg
2mg
3mg
NA
Dose
Xanax (Alprazolam)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
Klonapin  (Diazepam)  *
0.5mg
1mg
2mg
3mg
4mg
NA
Dose
Klonapin  (Diazepam)  *
Dose, Side effects, Dates taken, and why you stopped taking it or NA
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