About Waco Guide- Psychopharmacology
The Waco Guide to Psychopharmacology in Primary Care is a tool developed by faculty of the Waco Family Medicine Residency, in consultation with faculty of MGH Visiting through the Division of Professional and Public...
The Waco Guide to Psychopharmacology in Primary Care is a tool developed by faculty of the Waco Family Medicine Residency, in consultation with faculty of MGH Visiting through the Division of Professional and Public Education in the Department of Psychiatry, affiliated with Harvard Medical School Tools combine top-level evidence and expert opinion from world-renowned psychiatrists with primary care expertise from one of the nation’s premier family medicine training programs. This resource is ideal for primary care clinicians, including physicians, nurse practitioners, and physician assistants, as well as integrated behavioral health providers. The tools succinctly reflect standard and advanced primary care mental health practices and psychopharmacology for: . Adult . Pediatric & Adolescent . Geriatric . Perinatal and Women’s Mental Health . Substance Use Disorders Special Population considerations offering individually tailored pharmacotherapy recommendations include: . Obesity . Cardiac Impairment . Renal Impairment . Hepatic Impairment . Geriatric Why use The Waco Guide? . High-yield, evidence-based psychopharmacology . In office usability at the point-of-care to enhance medical decision making . Common language and framework for integrated and collaborative care practices . Tools account for cost and medication availability . Titration schedules, monitoring recommendations, and a list of side effects accompany each tool Treatment recommendations for the following disorders: Adult: . Major Depressive Disorder . Anxiety Disorders- Panic Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder . Bipolar Disorder . Posttraumatic Stress Disorder . Acute and Chronic Insomnia . Schizophrenia Spectrum and Other Psychotic Disorders . Acute Stress Disorder . Anorexia Nervosa . Antipsychotic Side Effect Management . Binge Eating Disorder . Bulimia Nervosa . Fibromyalgia . Intermittent Explosive Disorder . Neuropsychiatric Dementia . Obsessive-Compulsive Disorder . Tobacco Use Disorder . ADHD Pediatric & Adolescent Decision Support Tools . ADHD . Depression . Generalized anxiety . Bipolar disorder . Psychosis . Anorexia Nervosa . Binge Eating . Bulimia Nervosa . Autism Spectrum Disorder . Opioid Use Disorder Perinatal (Preconception, Antepartum, and Postpartum)/Women’s Mental Health: . Sexual Interest/Arousal Disorder . Obsessive Compulsive Disorder . Premenstrual Dysphoric Disorder . SSRI-Induced Sexual Dysfunction . Antepartum Tobacco Use Disorder Substance Use Disorders: . Alcohol Use Disorder . Antepartum Alcohol Use Disorder . Tobacco Use Disorder . Benzodiazepine Deprescribing . Opioid Use Disorder . Stimulant Use Disorder The decision support tools included are designed to be informational and to reflect current accepted practices at the time of publication. These tools are not intended to replace professional medical judgment or treatment of specific conditions. Heart of Texas Community Health Center (dba Waco Family Medicine) and the authors accept no responsibility for any damages, obligations, losses, liabilities, costs or expenses arising from use of the decision support tools contained herein. By using this app, you acknowledge that you have reviewed the above and accept these terms.
Version History Strength of Recommendation (SOR) Now Available View Strength of Recommendation details directly in the app. SORT tables are now displayed in-app (no PDFs), with clearer layout and improved readability. Medication Switching & Discontinuation Updates A new Discontinuation tool has been added alongside Switching. Easily toggle between switching and discontinuation for antidepressants and mood stabilizers. Improved accuracy and clearer medication states. Expanded Clinical Content • New Binge Eating (Adolescent) and Bulimia (Adolescent) content. • Updates to Depressive Disorder (including multiple subtypes), Autism, Alcohol Use Disorder (antepartum), and Antipsychotic Management. • Expanded and refreshed SORT tables across many disorders. • Medication updates, including search by brand name. Performance & Stability Improvements • Fixed medication switching issues and content-related crashes. • Improved error reporting and diagnostic support. 8.7 Mar 14 New clinical decision support tools are now available for Dementia and Adolescent Tobacco Use Disorder. Additionally, Perinatal Opioid Use Disorder, Alcohol Use Disorder, and Adolescent Stimulant Use Disorder have all been updated to reflect the latest best practices. 8.6 04/22/2025 Updated adolescent section. 8.5 04/05/2024 New age grouping for Adolescents! Adolescent Tools include Opioid Use Disorder, Anorexia Nervosa, Binge Eating & Bulimia Nervosa Other tools coming soon. 8.4 09/08/2023 General updates and tool refinements. 8.3 08/21/2023 Integrated Special Population calculators to Comprehensive Tool Section Enhanced Bipolar Decision Logic Refined language throughout app 8.2 05/19/2023 Updated language on medication warnings and clarified notes for medications. 8.1 02/14/2023 New for Adult: ADHD including special populations New for Pediatrics: ADHD New “Resources” section with tools to make clinical prescribing more efficient: • Antidepressant switching guide • Mood stabilizer switching guide • Medical calculators including STOP BANG, Child-Pugh, eGFR, BMI, and clinical opioid withdrawal scale (COWS) Plus minor fixes 8.0 01/17/2023 New for Adult: ADHD including special populations New for Pediatrics: ADHD New “Resources” section with tools to make clinical prescribing more efficient: • Antidepressant switching guide • Mood stabilizer switching guide • Medical calculators including STOP BANG, Child-Pugh, eGFR, BMI, and clinical opioid withdrawal scale (COWS) 7.0 08/30/2022 New for Adult: OCD including special populations New for Perinatal and Women’s Health: Opioid Use Disorder New for Substance Use: Opioid Use Disorder and Stimulant Use Disorder 6.0 06/01/2022 New for adults: OCD, Fibromyalgia, eating disorders, Acute Stress Disorder, among others. New for pediatrics: Autism Spectrum Disorder. New for Perinatal and Women’s Health: PMDD, sexual interest disorder, among others. New for Substance Use: benzodiazepine deprescribing, tobacco and alcohol use disorders, among others. 5.0 04/29/2022 Depressive Disorders, Post Traumatic Stress Disorder, Schizophrenia, and Chronic and Acute Insomnia, with special considerations for pediatrics, pregnancy, geriatrics, obesity, cardiac impairment, renal impairment, and hepatic impairment. 4.0 08/19/2021 Chronic and Acute Insomnia, and Schizophrenia with special considerations for obesity, cardiac impairment, renal impairment, and hepatic impairment. Tailored recommendations for Schizophrenia for preconception and antepartum, and Psychosis postpartum and pediatric populations. 3.0 08/13/2021 Generalized Anxiety Disorder, Social Anxiety Disorder, and Panic Disorder with special considerations for obesity, cardiac impairment, renal impairment, and hepatic impairment. Tailored recommendations for GAD for preconception, antepartum, and postpartum. 2.0 06/28/2021 Bipolar decision support, medications, and reference updates. 1.3 04/20/2021 Additional medication notes. 1.2 04/05/2021 Bipolar decision support improvements 1.1 04/02/2021 1.0 03/04/2021
Previous Versions
Here you can find the changelog of Waco Guide- Psychopharmacology since it was posted on our website on 2021-12-23 23:02:37.
The latest version is 8.7 and it was updated on 2026-10-12 18:44:47. See below the changes in each version.
Waco Guide- Psychopharmacology version 8.7
Updated At: 2026-10-08
Changes: Version History Strength of Recommendation (SOR) Now Available
View Strength of Recommendation details directly in the app. SORT tables are now displayed in-app (no PDFs), with clearer layout and improved readability.
Medication Switching & Discontinuation Updates
A new Discontinuation tool has been added alongside Switching. Easily toggle between switching and discontinuation for antidepressants and mood stabilizers. Improved accuracy and clearer medication states.
Expanded Clinical Content
• New Binge Eating (Adolescent) and Bulimia (Adolescent) content.
• Updates to Depressive Disorder (including multiple subtypes), Autism, Alcohol Use Disorder (antepartum), and Antipsychotic Management.
• Expanded and refreshed SORT tables across many disorders.
• Medication updates, including search by brand name.
Performance & Stability Improvements
• Fixed medication switching issues and content-related crashes.
• Improved error reporting and diagnostic support. 8.7 Mar 14 New clinical decision support tools are now available for Dementia and Adolescent Tobacco Use Disorder.
Additionally, Perinatal Opioid Use Disorder, Alcohol Use Disorder, and Adolescent Stimulant Use Disorder have all been updated to reflect the latest best practices. 8.6 04/22/2025 Updated adolescent section. 8.5 04/05/2024 New age grouping for Adolescents!
Adolescent Tools include Opioid Use Disorder, Anorexia Nervosa, Binge Eating & Bulimia Nervosa
Other tools coming soon. 8.4 09/08/2023 General updates and tool refinements. 8.3 08/21/2023 Integrated Special Population calculators to Comprehensive Tool Section
Enhanced Bipolar Decision Logic
Refined language throughout app 8.2 05/19/2023 Updated language on medication warnings and clarified notes for medications. 8.1 02/14/2023 New for Adult: ADHD including special populations
New for Pediatrics: ADHD
New “Resources” section with tools to make clinical prescribing more efficient:
• Antidepressant switching guide
• Mood stabilizer switching guide
• Medical calculators including STOP BANG, Child-Pugh, eGFR, BMI, and clinical opioid withdrawal scale (COWS)
Plus minor fixes 8.0 01/17/2023 New for Adult: ADHD including special populations
New for Pediatrics: ADHD
New “Resources” section with tools to make clinical prescribing more efficient:
• Antidepressant switching guide
• Mood stabilizer switching guide
• Medical calculators including STOP BANG, Child-Pugh, eGFR, BMI, and clinical opioid withdrawal scale (COWS) 7.0 08/30/2022 New for Adult: OCD including special populations
New for Perinatal and Women’s Health: Opioid Use Disorder
New for Substance Use: Opioid Use Disorder and Stimulant Use Disorder 6.0 06/01/2022 New for adults: OCD, Fibromyalgia, eating disorders, Acute Stress Disorder, among others.
New for pediatrics: Autism Spectrum Disorder.
New for Perinatal and Women’s Health: PMDD, sexual interest disorder, among others.
New for Substance Use: benzodiazepine deprescribing, tobacco and alcohol use disorders, among others. 5.0 04/29/2022 Depressive Disorders, Post Traumatic Stress Disorder, Schizophrenia, and Chronic and Acute Insomnia, with special considerations for pediatrics, pregnancy, geriatrics, obesity, cardiac impairment, renal impairment, and hepatic impairment. 4.0 08/19/2021 Chronic and Acute Insomnia, and Schizophrenia with special considerations for obesity, cardiac impairment, renal impairment, and hepatic impairment. Tailored recommendations for Schizophrenia for preconception and antepartum, and Psychosis postpartum and pediatric populations. 3.0 08/13/2021 Generalized Anxiety Disorder, Social Anxiety Disorder, and Panic Disorder with special considerations for obesity, cardiac impairment, renal impairment, and hepatic impairment. Tailored recommendations for GAD for preconception, antepartum, and postpartum. 2.0 06/28/2021 Bipolar decision support, medications, and reference updates. 1.3 04/20/2021 Additional medication notes. 1.2 04/05/2021 Bipolar decision support improvements 1.1 04/02/2021 1.0 03/04/2021
Waco Guide- Psychopharmacology version 8.7
Updated At: 2026-03-14
Changes: Strength of Recommendation (SOR) Now Available
View Strength of Recommendation details directly in the app. SORT tables are now displayed in-app (no PDFs), with clearer layout and improved readability.
Medication Switching & Discontinuation Updates
A new Discontinuation tool has been added alongside Switching. Easily toggle between switching and discontinuation for antidepressants and mood stabilizers. Improved accuracy and clearer medication states.
Expanded Clinical Content
• New Binge Eating (Adolescent) and Bulimia (Adolescent) content.
• Updates to Depressive Disorder (including multiple subtypes), Autism, Alcohol Use Disorder (antepartum), and Antipsychotic Management.
• Expanded and refreshed SORT tables across many disorders.
• Medication updates, including search by brand name.
Performance & Stability Improvements
• Fixed medication switching issues and content-related crashes.
• Improved error reporting and diagnostic support.
Waco Guide- Psychopharmacology version 8.6
Updated At: 2025-04-22
Changes: New clinical decision support tools are now available for Dementia and Adolescent Tobacco Use Disorder.
Additionally, Perinatal Opioid Use Disorder, Alcohol Use Disorder, and Adolescent Stimulant Use Disorder have all been updated to reflect the latest best practices.
Waco Guide- Psychopharmacology version 8.6
Updated At: 2025-04-22
Changes: Apr 22, 2025
Version 8.6
New clinical decision support tools are now available for Dementia and Adolescent Tobacco Use Disorder.
Additionally, Perinatal Opioid Use Disorder, Alcohol Use Disorder, and Adolescent Stimulant Use Disorder have all been updated to reflect the latest best practices.
Waco Guide- Psychopharmacology version 8.5
Updated At: 2024-04-05
Changes: Apr 5, 2024
Version 8.5
Updated adolescent section.
Waco Guide- Psychopharmacology version 8.4
Updated At: 2023-09-08
Changes: Sep 8, 2023
Version 8.4
New age grouping for Adolescents!
Adolescent Tools include Opioid Use Disorder, Anorexia Nervosa, Binge Eating & Bulimia Nervosa
Other tools coming soon.
Waco Guide- Psychopharmacology version 8.3
Updated At: 2023-08-21
Changes: Aug 21, 2023
Version 8.3
General updates and tool refinements.
Waco Guide- Psychopharmacology version 8.2
Updated At: 2023-05-19
Changes: May 19, 2023
Version 8.2
Integrated Special Population calculators to Comprehensive Tool Section
Enhanced Bipolar Decision Logic
Refined language throughout app
Waco Guide- Psychopharmacology version 8.1
Updated At: 2023-02-14
Changes: Feb 14, 2023
Version 8.1
Updated language on medication warnings and clarified notes for medications.
Waco Guide- Psychopharmacology version 6.0
Updated At: 2022-06-01
Changes: Jun 1, 2022 Version 6.0
New for Adult: OCD including special populations
New for Perinatal and Women’s Health: Opioid Use Disorder
New for Substance Use: Opioid Use Disorder and Stimulant Use Disorder
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