Antidepressants | SSRIs (20 mg oral paroxetine once daily, 20 mg oral citalopram once daily) | Nausea, tremor, hyponatremia |
15–30 mg mirtazapine nightly | Sedation, weight gain, myelosuppression |
150 mg oral clomipramine once daily | Orthostatic hypotension, urinary retention, constipation, worsening cognition |
100–500 mg oral trazodone once daily | Sedation, orthostatic hypotension, priapism |
Antiandrogens | 100–500 mg IM medroxyprogesterone acetate weekly | Fatigue, weight gain, hot or cold flashes, depression, elevated blood glucose, insomnia |
10 mg oral cyproterone acetate once daily | Gynecomastia, galactorrhea, worsening diabetes control, depression, osteoporosis, adrenal insufficiency on withdrawal, hepatotoxicity (liver enzymes should be checked if it is used) |
5 mg oral finasteride once daily | Gynecomastia, testicular pain, depression |
Estrogens | 0.625 mg oral conjugated estrogen once daily | Weight gain, depression, gynecomastia, venous thromboembolism |
0.05-0.1 mg/d estrogen transdermal patch |
1 mg oral diethylstilbestrol once daily |
GnRH analogues | 7.5 mg IM leuprolide monthly | Weight gain, bone pain, osteoporosis, pituitary apoplexy (rare) |
Antipsychotics | 1.5–3 mg oral haloperidol once daily | Sedation, extrapyramidal symptoms, falls, weight gain, ventricular arrhythmias |
25 mg oral quetiapine once daily |
Anticonvulsants | 100–300 mg oral gabapentin 3 times daily | Sedation, depression, ataxia, tremor |
200 mg oral carbamazepine once daily | Sedation, depression, motor ataxia, hyponatremia, Stevens-Johnson syndrome, agranulocytosis, hepatotoxicity Use of carbamazepine requires monitoring with regular laboratory testing |
Cholinesterase inhibitors | 1.5–6 mg rivastigmine twice daily | Nausea, urinary incontinence, syncope Potential for emergence of hypersexuality |
5–10 mg oral donepezil once daily |
H2 receptor blockers | 400–1600 mg/d oral cimetidine (nightly or divided doses; eg, 400 mg twice daily) | Worsening cognition, dizziness, multiple drug-drug interactions |
β-blockers | 5–20 mg oral pindolol twice daily | Hypotension, fatigue, bradycardia, bronchospasm |
40–80 mg oral propranolol twice daily |
Antifungals | 100–200 mg ketoconazole once daily | Sedation, headache, rash, photosensitivity, gastrointestinal upset, pruritus, hepatotoxicity |
Potassium-sparing diuretics | 12.5 mg spironolactone once daily | Hyperkalemia, gynecomastia, change in hair growth, upper gastrointestinal ulcers, agranulocytosis |