Drug	Starting	Titration	Maximum	Adverse Reactions
Anticonvulsants
Gabapentin (Neurontin)	300 mg/day	100-300 mg weekly as tolerated	3600 mg/day	Dose-dependent CNS/respiratory depression, immediate/delayed hypersensitivity, suicidality*
Pregabalin (Lyrica)	50-75 mg/ TID	50-75 mg weekly as tolerated	600 mg/day	Dose-dependent CNS/respiratory depression, delayed hypersensitivity reactions, peripheral edema, blurred vision, weight gain, suicidality*
Tricyclic Antidepressants (TCAs)
Nortriptyline (Pamelor)	10-25 mg/night	10-25 mg weekly	100 mg/day	Anticholinergic effects, arrhythmia, CNS depression, SIADH, blurred vision, orthostatic hypotension, serotonin syndrome (SS), suicidality**
Amitriptyline (Elavil)	10-25 mg/night	10-25 mg weekly	100 mg/day	Anticholinergic effects, bleeding risk, arrhythmias, CNS depression, hyponatremia, blurred vision, orthostatic hypotension, SS, suicidality**
Doxepin (Silenor)	10-25 mg/night	10-25 mg weekly	300 mg/day	Sedation, anticholinergic effects, QT prolongation, seizures, xerostomia, increased appetite, suicidality**
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Venlafaxine (Effexor)	37.5 mg/day	37.5 mg/day q4 days	150 mg/day	Mania, bleeding, hypertension, hepatotoxicity, hyponatremia, blurred vision, SS, sexual dysfunction, suicidality**
Duloxetine (Cymbalta)	30 mg/day	30 mg q2 weeks	120 mg/day
First generation (typical) antipsychotic
Pimozide (Orap)	0.5-1 mg/day	0.5-1 mg weekly as tolerated	10 mg/day (or 0.2 mg/kg/day)	Constipation, xerostomia, akathisia, drowsiness, blurry vision, QT prolongation, insomnia

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