• TMS Therapy Medication Checklist

    TMS Therapy Medication Checklist

  • Below is a list of common medications that are used to treat depression. Please mark the medications you have been prescribed in the past or are currently prescribed. Provide estimated dates of use and the reasons for discontinuing. If you have brought a medication list or had your records sent from your physician’s office, please fill out this form and bring those documents with your TMS therapy consult visit or fax to 503-990-6927 or email to info@oregontms.org

  • SSRI (Selective Serotonin Re-uptake Inhibitors) Medications

  • Generic Name

  • Brand Name

  •  

  • Generic Name

  • Brand Name

  •  

  • TCA (Tricyclic Antidepressants)

  • Generic Name

  • Brand Name

  • NDRI (Norepinephrine-Dopamine Reuptake Inhibitors) / Atypical Antidepressants

  • Generic Name

  • Brand Name

  •  

  • MAOI (Monoamine Oxidase Inhibitors)

  • Generic Name

  • Brand Name

  •  

  • SARI (Serotonin Antagonist and Reuptake Inhibitor)

  • Generic Name

  • Brand Name

  •  

  • MOOD STABILIZERS

  • Generic Name

  • Brand Name

  •  

  • This is a fill-in-the-field. Please add appropriate fields and text.

  •  
  • Should be Empty: