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chlordiazepoxide/amitriptyline — CareFirst (Caremark)

depression associated with anxiety in patients age ≥ 65 years

Preferred products

  • desipramine (Norpramin)
  • nortriptyline (Pamelor)

Initial criteria

  • The request is for chlordiazepoxide/amitriptyline for depression associated with anxiety
  • The patient age ≥ 65 years
  • The patient has experienced an inadequate treatment response or intolerance to at least TWO of the following agents: a serotonin-norepinephrine reuptake inhibitor (SNRI), a selective serotonin reuptake inhibitor (SSRI), mirtazapine, bupropion, trazodone
  • The patient has experienced an inadequate treatment response or intolerance to a trial of desipramine (Norpramin) or nortriptyline (Pamelor)