Psychiatric Medications Plan (Plan G)

To request Plan G coverage, an individual and their prescriber must complete the

Physicians and nurse practitioners can apply for Plan G on behalf of eligible patients by completing the application and faxing it to the local mental health and substance use centre, Child and Youth Mental Health (CYMH) centre, or the mental health contact at their local health authority:

Special Authority approval

For a list of Plan G drugs that require Special Authority approval, please see the Special Authority drug list. Plan G drugs are indicated as "LCD—Psychiatric Medications Plan".

Plan G regular benefits

The table below lists Plan G regular benefits. PharmaCare fully or partially covers these benefits.

Important: PharmaCare Plan G may not cover all available formulations (e.g., tablet, injection) and strengths (e.g., 5 mg and 10 mg) of the drugs listed below.

If PharmaCare covers a generic version of a drug, PharmaCare generally covers only part of the cost of the brand product. Some generic versions may not be covered under the Low Cost Alternative Program.

This list is intended as a general reference only. It may not reflect the most recent changes to the Plan G formulary.

PharmaCare formularies are not a replacement for professional medical judgment and advice.

Plan G drug formulary
Generic Drug Name Brand Drug Name
alprazolam Xanax®
amantadine Symmetrel®
amitriptyline Elavil®
amitriptyline hydrochloride PMS-Amitriptyline
atenolol Tenormin®
benztropine Bensylate®
bromazepam Lectopam®
bromocriptine Parlodel®
buprenorphine/naloxone Suboxone®
busiprone Buspar®
carbamazepine Tegretol®
chloral hydrate Noctec®
chlordiazepoxide Librium®
chlorpromazine Largactil®
citalopram Celexa®
clomipramine Anafranil®
clonazepam Rivotril®
clonidine Catapres®
clonidine Dixarit®
clorazepate Tranxene®
clozapine Clozaril®
desipramine Norpramin®
dextroamphetamine Dexedrine®
diazepam Valium®
diazepam Vivol®
diphenhydramine injection diphenhydramine injection USP
disulfiram Antabuse®
divalproex Epival®
doxepin Sinequan®
droperidol Inapsine®
escitalopram Cipralex®
fluoxetine FXT 40®
fluoxetine Prozac®
flupenthixol Fluanxol®
flupenthixol decanoate Fluanxol Depot®
fluphenazine Moditen®
fluphenazine decanoate Modecate Concentrate®
fluphenazine decanoate Modecate Injection®
flurazepam Dalmane®
fluvoxamine Luvox®
hydromorphone 8 mg Dilaudid
hydromorphone 8 mg Pms-hydromorphone 
hydromorphone 8 mg Teva-hydromorphone
hydromorphone 8 mg Apo-hydromorphone
imipramine Impril®
imipramine Tofranil®
lamotrigine Lamictal®
levodopa / carbidopa combination tablet Sinemet®
levothyroxine Eltroxin®
levothyroxine Synthroid®
liothyronine Cytomel®
lithium carbonate Carbolith®
lithium carbonate Duralith®
lithium carbonate Lithane®
lorazepam Ativan®
loxapine Loxapac®
maprotiline Ludiomil®
methadone Methadose™, Metadol-D®
methotrimeprazine Nozinan®
methylphenidate Ritalin®
mirtazapine Remeron®
moclobemide Manerix®
morphine (24-hour slow-release) Kadian®
nitrazapam Mogadon®
nortriptyline Aventyl®
oxazepam Serax®
paliperidone Invega®
paroxetine Paxil®
pericyazine Neuleptil®
perphenazine Trilafon®
phenelzine Nardil®
pimozide Orap®
pindolol Visken®
pipotiazine Piportil-L4 Injection®
procyclidine Kemadrin®
propranolol Inderal®
quetiapine Seroquel®
risperidone Risperdal®
sertraline Zoloft®
temazepam Restoril®
tetrabenazine Nitoman®
thiothixene Navane®
tranylcypromine Parnate®
trazodone Desyrel®
triazolam Halcion®
trifluoperazine Stelazine®
trihexyphenidyl Artane®
trimipramine Surmontil®
tryptophan Tryptan®
valproic acid Depakene®
venlafaxine Effexor®
yohimbine Yocan®
zuclopenthixol Clopixol®