Evidence-Based Reviews

Abuse of psychiatric medications: Not just stimulants and benzodiazepines

Current Psychiatry. 2019 January;18(1):10-16,21-24,26,38

References

1. Zemishlany Z, Aizenberg D, Weiner Z, et al. Trihexyphenidyl (Artane) abuse in schizophrenic patients. Int Clin Psychopharmacol. 1996;11(3):199-202.
2. Crawshaw JA, Mullen PE. A study of benzhexol abuse. Brit J Psychiatry. 1984;145:300-303.
3. Woody GE, O’Brien CP. Anticholinergic toxic psychosis in drug abusers treated with benztropine. Comp Psychiatry. 1974;15(5):439-442.
4. Lowry TP. Trihexyphenidyl abuse. Am J Psychiatry. 1977;134(11):1315.
5. Rouchell AM, Dixon SP. Trihexyphenidyl abuse. Am J Psychiatry. 1977;134(11):1315.
6. Kaminer Y, Munitz H, Wijsenbeek H. Trihexyphenidyl (Artane) abuse: euphoriant and anxiolytic. Brit J Psychiatry. 1982;140(5):473-474.
7. Nappo SA, de Oliviera LG, Sanchez Zv, et al. Trihexyphenidyl (Artane): a Brazilian study of its abuse. Subst Use Misuse. 2005;40(4):473-482.
8. Pullen GP, Best NR, Macguire J. Anticholinergic drug abuse: a common problem? Brit Med J (Clin Res Ed). 1984;289(6445):612-613.
9. Rubinstein JS. Abuse of antiparkinsonian drugs: feigning of extrapyramidal symptoms to obtain trihexyphenidyl. JAMA. 1978;239(22):2365-2366.
10. Mohan D, Mohandas E, Dube S. Trihexyphenidyl abuse. Brit J Addiction. 1981:76(2);195-197.
11. Marken PA, Stoner SC, Bunker MT. Anticholinergic drug abuse and misuse. CNS Drugs. 1996;5(3):190-199.
12. Buhrich N, Weller A, Kevans P. Misuse of anticholinergic drugs by people with serious mental illness. Psychiatric Serv. 2000;51(7):928-929.
13. Goldstein MR, Kasper R. Hyperpyrexia and coma due to overdose of benztropine. South Med J. 1968;61(9):984.
14. Petkovi´c S, Durendi´c-Brenesel M, Dolai M, et al. Fatal intoxication because of trihexyphenidyl. J Forensic Sci. 2011;56(5):1383-1386.
15. McIntyre IM, Mallett P, Burton CG, et al. Acute benztropine intoxication and fatality. J Forensic Sci. 2014;59(6):1675-1678.
16. Dilsaver SC. Antimuscarinic agents as substances of abuse: A review. J Clin Psychopharmacol. 1988:8(1):14-22.
17. Haddad P. Do antidepressants have any potential to cause addiction? J Psychopharmacol. 1999;13(3):300-307.
18. Haddad PM. Do antidepressants cause dependence? Epidemiol Psichiatr Soc. 2005;14(2):58-62.
19. Shenouda R, Desan PH. Abuse of tricyclic antidepressant drugs: a case series. J Clin Psychopharmacol. 2013;33(3):440-442.
20. van Broekhoven F, Kan CC, Zitman FG. Dependence potential of antidepressants compared to benzodiazepines. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26(5):939-943.
21. Evans EA, Sullivan MA. Abuse and misuse of antidepressants. Subst Abuse Rehabil. 2014;5:107-120.
22. Warner CH, Bobo W, Warner C, et al. Antidepressant discontinuation syndrome. Am Fam Physician. 2006;74(3):449-456.
23. Lichtigfeld FJ, Gillman MA. Antidepressants are not drugs of abuse or dependence. Postgrad Med J. 1998;74(875):529-532.
24. Diagnostic and statistical manual of mental disorders, 5th ed. Washington, DC: American Psychiatric Association; 2013.
25. Read J, Cartwright C, Gibson K. Adverse emotional and interpersonal effects reported by 1829 New Zealanders while taking antidepressants. Psychiatry Res. 2014;216(1):67-73.
26. Haddad P, Anderson I. Antidepressants aren’t addictive: clinicians have depended on them for years. J Psychopharmacol. 1999;13(3):291-292.
27. Carey B, Gebeloff R. Many people taking antidepressants discover they cannot quit. New York Times. https://www.nytimes.com/2018/04/07/health/antidepressants-withdrawal-prozac-cymbalta.html. Published April 7, 2018. Accessed December 11, 2018.
28. Kim D, Steinhart B. Seizures induced by recreational abuse of bupropion tablets via nasal insufflation. CJEM. 2010;12(2):158-161.
29. McCormick J. Recreational bupropion in a teenager. Br J Clin Pharmacol. 2002;53(2):214.
30. Welsh C, Doyon S. Seizure induced by insufflation of bupropion. N Engl J Med. 2002; 347(2):951.
31. Baribeau D, Araki KF. Intravenous bupropion: A previously undocumented method of abuse of a commonly prescribed antidepressant agent. J Addict Med. 2013;7(3):216-217.
32. Hill SH, Sikand H, Lee J. A case report of seizure induced by bupropion nasal insufflation. Prim Care Companion J Clin Psych. 2007;9(1):67-69.
33. Yoon G, Westermeyer J. Intranasal bupropion abuse. Am J Addict. 2013;22(2):180.
34. Reeves RR, Ladner ME. Additional evidence of the abuse potential of bupropion. J Clin Psychopharmacol. 2013;33(4):584-585.
35. Oppek K, Koller G, Zwergal A, et al. Intravenous administration and abuse of bupropion: a case report and a review of the literature. J Addict Med. 2014;8(4):290-293.
36. Strike M, Hatcher S. Bupropion injection resulting in tissue necrosis and psychosis: previously undocumented complications of intravenous bupropion use disorder. J Addict Med. 2015;9(3):246-250.
37. Schifano F, Chiappini S. Is there a potential of misuse for venlafaxine and bupropion? Front Pharmacol. 2018;9:239.
38. Tryon J, Logan N. Antidepressant Wellbutrin becomes ‘poor man’s cocaine’ on Toronto streets. Global News. https://globalnews.ca/news/846576/antidepressant-wellbutrin-becomes-poor-mans-cocaine-on-toronto-streets/. Published September 18, 2013. Accessed December 11, 2018.
39. Stassinos GL, Klein-Schwartz W. Bupropion “abuse” reported to US Poison Centers. J Addict Med. 2016;10(5):357-362.
40. Hilliard WT, Barloon L, Farley P, et al. Bupropion diversion and misuse in the correctional facility. J Correct Health Care. 2013;19(3):211-217.
41. Griffith JD, Carranza J, Griffith C, et al. Bupropion clinical assay for amphetamine-like abuse potential. J Clin Psychiatry.1983;44(5 Pt 2):206-208.
42. Miller L, Griffith J. A comparison of bupropion, dextroamphetamine, and placebo in mixed-substance abusers. Psychopharmacol (Berl). 1983;80(3):199-205.
43. Berigan TR, Russell ML. Treatment of methamphetamine cravings with bupropion: A case report. Prim Care Companion J Clin Psychiatry. 2001;3(6):267-268.
44. Tardieu T, Poirier Y, Micallef J, et al. Amphetamine-like stimulant cessation in an abusing patient treated with bupropion. Acta Psychiatr Scand. 2004;109(1):75-78.
45. Newton TF, Roache JD, De La Garza R, et al. Bupropion reduces methamphetamine-induced subjective effects and cue-induced cravings. Neuropsychopharmacology. 2006;31(7):1537-1544.
46. Margolin A, Kosten TR, Avants SK, et al. A multicenter trial for cocaine dependence in methadone-maintained patients. Drug Alcohol Depend. 1995;40(2):125-131.
47. Shoptaw S, Heinzerling KG, Rotheram-Fuller E, et al. Bupropion hydrochloride versus placebo, in combination with cognitive behavioral therapy, for the treatment of cocaine abuse/dependence. J Addict Dis. 2008;27(1):13-23.
48. Anderson AL, Li S, Markova D, et al. Bupropion for the treatment of methamphetamine dependence in non-daily users: a randomized, double-blind placebo-controlled trial. Drug Alcohol Depend. 2015;150:170-174.
49. Shoptaw S, Heinzerling KG, Rotheram-Fuller E, et al. Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence. Drug Alcohol Depend. 2008;96(3):222-232.
50. Elkashef AM, Rawson RA, Anderson AL, et al. Bupropion for the treatment of methamphetamine dependence. Neuropsychopharmacology. 2008;33(5):1162-1170.
51. Heinzerling KG, Swanson A, Hall TM, et al. Randomized, placebo-controlled trial of bupropion in methamphetamine-dependent participants with less than daily methamphetamine use. Addiction. 2014;109(11):1878-1886.
52. Doenecke AL, Heuerman RC. Treatment of haloperidol abuse with diphenhydramine. Am J Psychiatry. 1980;137(4):487-488.
53. Weddington WW, Leventhal BL. Sadistic abuse of haloperidol. Am J Psychiatry. 1982;139:132-133.
54. Basu D, Marudkar M, Khurana H. Abuse of neuroleptic drugs by psychiatric patients. Indian J Med Sci. 2000;54(2):59-62.
55. Pierre JM, Shnayder I, Wirshing DA, et al. Intranasal quetiapine abuse. Am J Psychiatry 2004;161(9):1718.
56. Reeves RR. Abuse of olanzapine by substance abusers. J Psychoactive Drugs. 2007;39(3):297-299.
57. Kumsar NA, Erol A. Olanzapine abuse. Subst Abus. 2013;34(1):73-74.
58. Lai C. Olanzapine abuse was relieved after switching to aripiprazole in a patient with psychotic depression. Prog Neuropsychpharmacol Biol Psychiatry. 2010;34(7):1363-1364.
59. James PD, Fida AS, Konovalov P, et al. Non-medical use of olanzapine by people on methadone treatment. BJPsych Bull. 2016;40(6):314-317.
60. Reeves RR, Brister JC. Additional evidence of the abuse potential of quetiapine. South Med J. 2007;100(8):834-836.
61. Murphy D, Bailey K, Stone M, et al. Addictive potential of quetiapine. Am J Psychiatry. 2008;165(7):918.
62. Paparrigopoulos T, Karaiskos D, Liappas J. Quetiapine: another drug with potential for misuse? J Clin Psychiatry. 2008;69(1):162-163.
63. Reeves RR, Burke RS. Abuse of the combination of gabapentin and quetiapine. Prim Care Companion CNS Disord. 2014;16(5): doi: 10.4088/PCC.14l01660.
64. Morin AK. Possible intranasal quetiapine misuse. Am J Health Syst Pharm. 2007;64(7):723-725.
65. Caniato RN, Gundabawady A, Baune BT, et al. Malingered psychotic symptoms and quetiapine abuse in a forensic setting. J Forens Psychiatr Psychol. 2009;20(6):928-935.
66. Hussain MZ, Waheed W, Hussain S. Intravenous quetiapine abuse. Am J Psychiatry. 2005; 162(9):1755-1756.
67. Waters BM, Joshi KG. Intravenous quetiapine-cocaine use (“Q-ball”). Am J Psychiatry. 2007;164(1):173-174.
68. Haridas A, Kushon D, Gurmu S, et al. Smoking quetiapine: a “Maq ball?” Prim Psychiatry. 2010;17:38-39.
69. Cubala WJ, Springer J. Quetiapine abuse and dependence in psychiatric patients: a systematic review of 25 case reports in the literature. J Subs Use. 2014;19(5):388-393.
70. Piróg-Balcerzak A, Habrat B, Mierzejewski P. Misuse and abuse of quetiapine [in Polish]. Psychiatr Pol. 2015;49(1):81-93.
71. Pinta ER, Taylor RE. Quetiapine addiction? Am J Psychiatry. 2007;164(1):174.
72. Tamburello AC, Lieberman JA, Baum RM, et al. Successful removal of quetiapine from a correctional formulary. J Amer Acad Psychiatr Law. 2012;40(4):502-508.
73. Tarasoff G, Osti K. Black-market value of antipsychotics, antidepressants, and hypnotics in Las Vegas, Nevada. Am J Psychiatry. 2007;164(2):350.
74. Reccoppa L. Less abuse potential with XR formulation of quetiapine. Am J Addiction. 2010;20(2):178.
75. McLarnon ME, Fulton HG, MacIsaac C, et al. Characteristics of quetiapine misuse among clients of a community-based methadone maintenance program. J Clin Psychopharmacol. 2012;32(5):721-723.
76. Reddel SE, Bruno R, Burns L, et al. Prevalence and associations of quetiapine fumarate misuse among an Australian national city sample of people who regularly inject drugs. Addiction. 2013;109(2):295-302.
77. Malekshahi T, Tioleco N, Ahmed N, et al. Misuse of atypical antipsychotics in conjunction with alcohol and other drugs of abuse. J Subs Abuse Treat. 2015;48(1):8-12.
78. Klein-Schwartz W, Schwartz EK, Anderson BD. Evaluation of quetiapine abuse and misuse reported to poison centers. J Addict Med. 2014;8(3):195-198.
79. Klein L, Bangh S, Cole JB. Intentional recreational abuse of quetiapine compared to other second-generation antipsychotics. West J Emerg Med. 2017;18(2):243-250.
80. Chiappini S, Schifano F. Is there a potential of misuse for quetiapine?: Literature review and analysis of the European Medicines Agency/European Medicines Agency Adverse Drug Reactions’ Database. J Clin Psychopharmacol. 2018;38(1):72-79.
81. Lee J, Pilgrim J, Gerostamoulos D, et al. Increasing rates of quetiapine overdose, misuse, and mortality in Victoria, Australia. Drug Alcohol Depend. 2018;187:95-99.
82. Mattson ME, Albright VA, Yoon J, et al. Emergency department visits involving misuse and abuse of the antipsychotic quetiapine: Results from the Drug Abuse Warning Network (DAWN). Subst Abuse. 2015;9:39-46.
83. Brutcher RE, Nader SH, Nader MA. Evaluation of the reinforcing effect of quetiapine, alone and in combination with cocaine, in rhesus monkeys. J Pharmacol Exp Ther. 2016;356(2):244-250.
84. Kim DR, Staab JP. Quetiapine discontinuation syndrome. Am J Psychiatry. 2005;162(5):1020.
85. Thurstone CC, Alahi P. A possible case of quetiapine withdrawal syndrome. J Clin Psychiatry. 2000;61(8):602-603.
86. Kohen I, Kremen N. A case report of quetiapine withdrawal syndrome in a geriatric patient. World J Biol Psychiatry. 2009;10(4 pt 3):985-986.
87. Yargic I, Caferov C. Quetiapine dependence and withdrawal: a case report. Subst Abus. 2011;32(3):168-169.
88. Koch HJ. Severe quetiapine withdrawal syndrome with nausea and vomiting in a 65-year-old patient with psychotic depression. Therapie. 2015;70(6):537-538.
89. Fischer BA, Boggs DL. The role of antihistaminic effects in the misuse of quetiapine: a case report and review of the literature. Neurosci Biobehav Rev. 2010;34(4):555-558.
90. Longoria J, Brown ES, Perantie DC, et al. Quetiapine for alcohol use and craving in bipolar disorder. J Clin Psychopharmacol. 2004;24(1):101-102.
91. Monnelly EP, Ciraulo DA, Knapp C, et al. Quetiapine for treatment of alcohol dependence. J Clin Psychopharmacol. 2004;24(5):532-535.
92. Kennedy A, Wood AE, Saxon AJ, et al. Quetiapine for the treatment of cocaine dependence: an open-label trial. J Clin Psychopharmacol. 2008;28(2):221-224.
93. Mariani JJ, Pavlicova M, Mamczur A, et al. Open-label pilot study of quetiapine treatment for cannabis dependence. Am J Drug Alcohol Abuse. 2014;40(4):280-284.
94. Guardia J, Roncero C, Galan J, et al. A double-blind, placebo-controlled, randomized pilot study comparing quetiapine with placebo, associated to naltrexone, in the treatment of alcohol-dependent patients. Addict Behav. 2011;36(3):265-269.
95. Litten RZ, Fertig JB, Falk DE, et al; NCIG 001 Study Group. A double-blind, placebo-controlled trial to assess the efficacy of quetiapine fumarate XR in very heavy-drinking alcohol-dependent patients. Alcohol Clin Exp Res. 2012;36(3):406-416.
96. Tapp A, Wood AE, Kennedy A, et al. Quetiapine for the treatment of cocaine use disorder. Drug Alcohol Depend. 2015;149:18-24.
97. Markowitz JS, Finkenbine R, Myrick H, et al. Gabapentin abuse in a cocaine user: Implications for treatment. J Clin Psychopharmacol. 1997;17(5):423-424.
98. Reccoppa L, Malcolm R, Ware M. Gabapentin abuse in inmates with prior history of cocaine dependence. Am J Addict. 2004;13(3):321-323.
99. Victorri-Vigneau C, Guelais M, Jolliet P. Abuse, dependency and withdrawal with gabapentin: a first case report. Pharmacopsychiatry. 2007;40(1):43-44.
100. Bonnet U, Sherbaum N. How addictive are gabapentin and pregabalin? A systematic review. Eur Neuropsychopharmacol. 2017;27(12):1185-1215.
101. Schifano F, D’Offizi S, Piccione M, et al. Is there a recreational misuse potential for pregabalin? Analysis of anecdotal online reports in comparison with related gabapentin and clonazepam data. Psychother Psychosom. 2011;80(2):118-122.
102. Evoy KE, Morrison MD, Saklad SR. Abuse and misuse of pregabalin and gabapentin. Drugs. 2017;77(4):403-426.
103. Smith RV, Havens JR, Walsh SL. Gabapentin misuse, abuse and diversion: a systematic review. Addiction. 2016;111(7):1160-1174.
104. Chiappini S, Shifano F. A decade of gabapentinoid misuse: an analysis of the European Medicines Agency’s ‘suspected adverse drug reactions’ database. CNS Drugs. 2016;30(7):647-654.
105. Buttram ME, Kurtz SP, Dart R, et al. Law enforcement-derived data on gabapentin diversion and misuse, 2002-2015: diversion rates and qualitative research findings. Pharmacoepidemiol Drug Saf. 2017;26(9):1083-1086.
106. Kapil V, Green JL, Le Lait M, et al. Misuse of the y-aminobutyric acid analogues baclofen, gabapentin and pregabalin in the UK. Br J Clin Pharmacol. 2013;78(1):190-191.
107. Peckham AM, Fairman KA, Sclar DA. Prevalence of gabapentin abuse: comparison with agents with known abuse potential in a commercially insured US population. Clin Drug Invest. 2017;37(8):763-773.
108. Smith RV, Lofwall MR, Havens JR. Abuse and diversion of gabapentin among nonmedical prescription opioid users in Appalachian Kentucky. Am J Psychiatry. 2015;172(5):487-488.
109. Peckham AM, Evoy KE, Covvey JR, et al. Predictors of gabapentin overuse with or without concomitant opioids in a commercially insured U.S. population. Pharmacotherapy. 2018;38(4):436-443.
110. Smith BH, Higgins C, Baldacchino A, et al. Substance misuse of gabapentin. Br J Gen Pract. 2012;62(601):401-407.
111. Baird CRW, Fox P, Colvin LA. Gabapentinoid abuse in order to potentiate the effect of methadone: a survey among substance misusers. Eur Addict Res. 2014;20(3):115-118.
112. Lyndon A, Audrey S, Wells C, et al. Risk to heroin users of polydrug use of pregabalin or gabapentin. Addiction. 2017;112(9):1580-1589.
113. Peckham AM, Fairman KA, Sclar DA. All-cause and drug-related medical events associated with overuse of gabapentin and/or opioid medications: a retrospective cohort analysis of a commercially insured US population. Drug Saf. 2018;41(2):213-228.
114. Gomes T, Juurlink DN, Antoniou T, et al. Gabapentin, opioids, and the risk of opioid-related death: a population-based nested case-control study. PLoS Med. 2017;14(10):e10022396. doi: 10.1371/journal.pmed.1002396.
115. Peckham AM, Fairman K, Sclar DA. Policies to mitigate nonmedical use of prescription medications: how should emerging evidence of gabapentin misuse be addressed? Exp Opin Drug Saf. 2018;17(5):519-523.
116. Raby WN. Gabapentin for cocaine cravings. Am J Psychiatry. 2000;157(12):2058-2059.
117. Myrick H, Henderson S, Brady KT, et al. Gabapentin in the treatment of cocaine dependence: a case series. J CLin Psychiatry. 2001;62(1):19-23.
118. Raby WN, Coomaraswamy S. Gabapentin reduces cocaine use among addicts from a community clinic sample. J Clin Psychiatry. 2004;65(1):84-86.
119. Hart CL, Ward AS, Collins ED, et al. Gabapentin maintenance decreases smoked cocaine-related subjective effects, but not self-administration by humans. Drug Alcohol Depend. 2004;73(3):279-287.
120. Bisaga A, Aharonovich E, Garawi F, et al. A randomized placebo-controlled trial of gabapentin for cocaine dependence. Drug Alc Depend. 2006;81(3):267-274.
121. Hart CL, Haney M, Collins ED, et al. Smoked cocaine self-administration by humans is not reduced by large gabapentin maintenance doses. Drug Alcohol Depend. 2007;86(2-3):274-277.
122. Furieri FA, Nakamura-Palacios EM. Gabapentin reduces alcohol consumption and craving: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2007;68(11):1691-1700.
123. Mason BJ, Quello S, Goodell V, et al. Gabapentin treatment for alcohol dependence: a randomized clinical trial. JAMA Intern Med. 2014;174(1):70-77.
124. Martinotti G, Di Nicola M, Tedeschi D, et al. Pregabalin versus naltrexone in alcohol dependence: a randomised, double-blind, comparison trial. J Psychopharmacol. 2010;24(9):1367-1374.
125. Mason BJ, Crean R, Goodell V, et al. A proof-of-concept randomized controlled study of gabapentin: effects on cannabis use, withdrawal and executive function deficits in cannabis-dependent adults. Neuropsychpharmacology. 2012;27(7):1689-1698.
126. Enke O, New HA, New CH, et al. Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis. CMAJ. 2018;190(26):E786-E793.
127. Cartwright C, Gibson K, Read J, et al. Long-term antidepressant use: patient perspectives of benefits and adverse effects. Patient Prefer Adherence. 2016;10:1401-1407.
128. American Society of Addiction Medicine. Public policy statement: definition of addiction. https://www.asam.org/docs/default-source/public-policy-statements/1definition_of_addiction_long_4-11.pdf?sfvrsn=a8f64512_4. Published August 15, 2011. Accessed July 23, 2018.

Problematic, even if not addictive

It is sometimes claimed that “addiction” to psychiatric medications is not limited to stimulants and benzodiazepines.^27,127 Although anticholinergics, antidepressants, antipsychotics, and gabapentinoids can be drugs of abuse, with some users reporting physiologic withdrawal upon discontinuation, there is only limited evidence that the M/A of these psychiatric medications is associated with the characteristic features of a more complete definition of “addiction,” which may include:

inability to consistently abstain
impairment in behavioral control
diminished recognition of significant problems associated with use
a dysfunctional emotional response to chronic use.¹²⁸

Nonetheless, the literature documenting anticholinergic, antidepressant, antipsychotic, and gabapentinoid M/A includes several common features, including:

initial reports among those with limited access to illicit drugs (eg, young people and incarcerated individuals) and subsequent spread to a wider population with more unconventional routes of administration
use for recreational purposes and other subjective pseudo-therapeutic effects, often in combination with alcohol and illicit drugs
greater M/A potential of certain medications within each of these drug classes (eg, trihexyphenidyl, bupropion, quetiapine)
malingering psychiatric symptoms in order to obtain medications from prescribers and diversion for black market sale
observations that medications might constitute therapy for SUDs that were not supported in subsequent RCTs (with the exception of gabapentin for alcohol and cannabis use disorders)
increasing evidence of toxicity related to M/A, which suggests that prescription by clinicians has limited benefit and high risk for patients with SUDs.

Bottom Line

Some psychiatric medications are taken as drugs of abuse. Clinicians should be particularly aware of the misuse/abuse potential of anticholinergics, antidepressants, antipsychotics, and gabapentinoids, and use them cautiously, if at all, when treating patients with existing substance use disorders.

Related Resources

Substance Abuse and Mental Health Services Administration. Prescription drug misuse and abuse. https://www.samhsa.gov/topics/prescription-drug-misuse-abuse.
Substance Abuse and Mental Health Services Administration. Types of commonly misused or abused drugs. https://www.samhsa.gov/prescription-drug-misuse-abuse/types.
National Institute on Drug Abuse. Misuse of prescription drugs. https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/summary.
National Institute on Drug Abuse. New clinician screening tool available for substance use. https://www.drugabuse.gov/news-events/news-releases/2018/06/newclinician-screening-tool-available-substance-use.

Drug Brand Names

Amitriptyline • Elavil, Endep
Benztropine • Cogentin
Biperiden • Akineton
Bupropion • Wellbutrin, Zyban
Chlorpromazine • Thorzine
Fluoxetine • Prozac
Haloperidol • Haldol
Olanzapine • Zyprexa
Orphenadrine • Disipal, Norflex
Pregabalin • Lyrica, Lyrica CR
Procyclidine • Kemadrin
Quetiapine • Seroquel
Tianeptine • Coaxil, Stablon
Tranylcypromine • Parnate
Trifluoperazine • Stelazine
Trihexyphenidyl • Artane, Tremin
Venlafaxine • Effexor