Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Methadone(click to collapse)
1/4 selected
Methadone
Dolophine · Methadose
Opioid Agonist · C-II
FDA-approved indications
- Opioid use disorder: detoxification and maintenance treatment
- Management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate
Off-label uses
- Neonatal abstinence syndrome
MechanismFull mu-opioid agonist and NMDA receptor antagonist used for opioid use disorder maintenance and chronic pain
Half-life8-59 hours (mean ~24-36 hours with chronic dosing)
Decision GuideWhen to pick each / when to consider an alternative
Methadone
Consider when
- Opioid use disorder with high tolerance — full mu-agonist effective where partial agonists (buprenorphine) may precipitate withdrawal or provide insufficient blockade
- Pregnancy with OUD — ACOG/SAMHSA-recommended first-line MOUD; longest safety record in neonatal outcomes
- Patient benefits from structured daily monitoring — OTP framework provides built-in accountability and wraparound services
- Co-occurring chronic pain and OUD — analgesic efficacy at maintenance doses addresses both conditions simultaneously
- +1 more
Consider an alternative when
- QTc prolongation risk — boxed warning for dose-dependent QTc prolongation and torsades de pointes; baseline and follow-up ECGs required
- Daily clinic visits not feasible — OTP regulations require observed daily dosing initially; bupropion office-based prescribing offers flexibility
- Taking strong CYP3A4 inducers — rifampin, phenytoin, carbamazepine can precipitate withdrawal by reducing methadone levels unpredictably
- Respiratory compromise or benzodiazepine co-use — no ceiling on respiratory depression unlike buprenorphine's partial agonist safety margin
- +1 more
| Axis | Methadone opioid-agonist |
|---|---|
| Boxed Warnings | |
Abuse / addiction liability | |
Respiratory depression (opioid / CNS depressant co-use) | |
| CNS | |
Sedation / somnolence | |
| Metabolic | |
Weight gain | |
| Autonomic | |
Orthostatic hypotension | |
Sweating | |
| Cardiac | |
QTc prolongation | |
| GI | |
Nausea / GI (general) | |
Constipation / GI hypomotility | |
| Sexual | |
Sexual dysfunction | |
| Interactions | |
CYP interactions / DDI profile | |