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Prescriber Checkup

SYLVIA LAGDAN ARNP

3711 PACIFIC AVE SUITE 301

Tacoma | Washington | 98418

(253) 475-7333

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At A Glance: This Prescriber in 2011

Nurse Practitioner, Psychiatric/Mental Health

Self-Reported Primary Specialty

See Other Prescribers With This Specialty in This State »

23,762Medicare Part D Prescriptions Filled, Including Refills

Rank: 1 out of 97

$4.46M Total Retail Price of All Prescriptions

Rank: 1 out of 97

1,017 Patients Receiving at Least One Drug in Part D
12%Patients 65 Years and Older
95% Subsidized Claims for Low-Income Patients

How Does This Prescriber Compare to Peers?

In the same specialty and state. Caveats »

Drugs That Present Special Risks
Costs of Prescribing
Average for
this specialty
in Washington

Narcotics

N/A

Antipsychotics to Seniors

68% of this provider’s 120 patients 65 and older filled at least one prescription for an antipsychotic, compared to an average of 12%.

Risky Drugs to Seniors

7% of this provider’s 2,490 prescriptions for patients 65 and older were for "potentially dangerous" drugs, compared to an average of 2%.

Brand Name Drugs

29% of this provider’s prescriptions were for brand-name drugs, compared to an average of 28%.

Prescription Price

$188 was the average price of a prescription from this provider, compared to $176 among peers.

Prescriptions per Patient

23 is the average number of prescriptions (including refills) per patient, compared to an average of 18.


Another View

This chart shows a different comparison of all providers in this specialty based on their mix of drugs and volume. Providers are grouped by similarity; those least like their peers are farthest to the right. Hover over the bars to see names of other prescribers.

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This Prescriber's Drugs

The table below list this provider’s drugs, the number of prescriptions and how many went to seniors. Drugs are ranked by volume and compared with the rank for all providers in the same specialty and state.

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A

An antipsychotic drug. More » Antipsychotics are frequently given to dementia patients, though it increases their risk of death.

R

A risky drug for seniors. More » The American Geriatrics Society has said this drug is "potentially dangerous" for seniors and might be inappropriate.

N

A narcotic drug. More » Misuse and abuse of narcotics led to some 16,000 overdose deaths in 2010.

10

This provider is among the top 10 prescribers of
this drug in the country.

This provider’s prescriptions for this drug were for more days than those of peers. More » Because of this, his or her prescription count may be lower.

This provider’s prescriptions for this drug were for fewer days than those of peers. More » Because of this, his or her prescription count may be higher.

This Drug's Rank
Drug Name Total Prescriptions Filled
Including Refills
Prescriptions
to 65+
Category For this Prescriber For All Prescribers in
This Specialty in Washington
RISPERIDONE

Treats schizophrenia and ce... +

Treats schizophrenia and certain problems caused by bipolar disorder. More info »

2,375 298 A 10 1 1
SEROQUEL

Treats schizophrenia and sy... +

Treats schizophrenia and symptoms of bipolar disorder (manic-depressive illness). Used together with other medicines to treat major depressive disorder (MDD). More info »

1,560 218 A 2 2
BENZTROPINE MESYLATE

Treats symptoms of Parkinso... +

Treats symptoms of Parkinson's disease or side effects of other drugs. More info »

1,105 124 R 3 4
TRAZODONE HCL

Trazodone is used to treat ... +

Trazodone is used to treat depression. Trazodone is in a class of medications called serotonin modulators. It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. More info »

1,080 98 4 3
ZYPREXA

Treats psychotic mental dis... +

Treats psychotic mental disorders, such as schizophrenia or bipolar disorder (manic-depressive illness). More info »

1,015 80 A 5 7
GEODON

Treats schizophrenia and ce... +

Treats schizophrenia and certain problems caused by bipolar disorder. More info »

792 A 10 6 11
ABILIFY

Treats schizophrenia, bipol... +

Treats schizophrenia, bipolar disorder, and depression. Also treats irritability associated with autism. More info »

782 81 A 7 6
DIVALPROEX SODIUM ER

Treats seizures (epilepsy).... +

Treats seizures (epilepsy). Also used to treat the manic phase of bipolar disorder (manic-depressive illness) and to prevent migraine headaches. Belongs to a class of drugs called anticonvulsants. More info »

762 48 8 12
CITALOPRAM HBR

Citalopram is used to treat... +

Citalopram is used to treat depression. Citalopram is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It is thought to work by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. More info »

715 103 9 8
FLUOXETINE HCL

Fluoxetine (Prozac) is used... +

Fluoxetine (Prozac) is used to treat depression, obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), some eating disorders, and panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks). Fluoxetine (Sarafem) is used to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness. Fluoxetine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. More info »

688 82 10 13
PAROXETINE HCL

Paroxetine tablets, suspens... +

Paroxetine tablets, suspension (liquid), and extended-release (long-acting) tablets are used to treat depression, panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Paroxetine tablets and suspension are also used to treat obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), generalized anxiety disorder (GAD; excessive worrying that is difficult to control), and posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience). Paroxetine extended-release tablets are also used to treat premenstrual dysphoric disorder (PMDD, physical and psychological symptoms that occur before the onset of the menstrual period each month). Paroxetine is in a class of medications called selective serotonin-reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. More info »

669 29 11 24
LITHIUM CARBONATE

Lithium is used to treat an... +

Lithium is used to treat and prevent episodes of mania (frenzied, abnormally excited mood) in people with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). Lithium is in a class of medications called antimanic agents. It works by decreasing abnormal activity in the brain. More info »

651 22 10 12 14
ZOLPIDEM TARTRATE

Zolpidem is used to treat i... +

Zolpidem is used to treat insomnia (difficulty falling asleep or staying asleep). Zolpidem belongs to a class of medications called sedative-hypnotics. It works by slowing activity in the brain to allow sleep. More info »

633 29 13 15
LAMOTRIGINE

Treats certain types of sei... +

Treats certain types of seizures and mood disorders. Often used along with other medicines. More info »

632 56 14 5
DIVALPROEX SODIUM

Treats seizures (epilepsy).... +

Treats seizures (epilepsy). Also used to treat the manic phase of bipolar disorder (manic-depressive illness) and to prevent migraine headaches. Belongs to a class of drugs called anticonvulsants. More info »

575 84 15 16
VENLAFAXINE HCL ER

Venlafaxine is used to trea... +

Venlafaxine is used to treat depression. Venlafaxine extended-release (long-acting) capsules are also used to treat generalized anxiety disorder (GAD; excessive worrying that is difficult to control), social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life), and panic disorder (sudden, unexpected attacks of extreme fear and worry about these attacks). Venlafaxine is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain that help maintain mental balance. More info »

553 95 10 16 20
SERTRALINE HCL

Sertraline is used to treat... +

Sertraline is used to treat depression, obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks), posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). It is also used to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness. Sertraline is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amounts of serotonin, a natural substance in the brain that helps maintain mental balance. More info »

458 44 17 10
BUPROPION HCL SR

Bupropion (Aplenzin, Wellbu... +

Bupropion (Aplenzin, Wellbutrin, Wellbutrin SR, Wellbutrin XL) is used to treat depression. Bupropion (Wellbutrin XL) is also used to treat seasonal affective disorder (SAD; episodes of depression that occur in the fall and winter each year). Bupropion (Zyban) is used to help people stop smoking. Bupropion is in a class of medications called antidepressants. It works by increasing certain types of activity in the brain. More info »

435 20 18 18
CYMBALTA

Treats depression, anxiety,... +

Treats depression, anxiety, diabetic peripheral neuropathy (nerve pain caused by diabetes), fibromyalgia (muscle pain and stiffness), or chronic (long-lasting) pain related to muscles and bones. This medicine is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). More info »

420 40 19 17
HYDROXYZINE PAMOATE

Treats anxiety, tension, ne... +

Treats anxiety, tension, nervousness, nausea, vomiting, allergies, skin rash, hives, and itching. This medicine is an antihistamine. More info »

400 R 20 19
LEXAPRO

Treats severe depression an... +

Treats severe depression and generalized anxiety disorder (GAD). This medicine is a selective serotonin reuptake inhibitor (SSRI). More info »

390 57 21 27
CLOZAPINE

Treats schizophrenia. Also ... +

Treats schizophrenia. Also lowers the risk of suicidal behavior in patients who have schizophrenia or schizoaffective disorder. More info »

353 32 A 22 9
MIRTAZAPINE

Treats depression. +

Treats depression. More info »

346 87 23 21
INVEGA SUSTENNA 297 16 A 24 32
CARBAMAZEPINE

Treats different types of s... +

Treats different types of seizures. Also used to treat nerve pain and bipolar disorder, also known as manic-depressive illness. More info »

292 13 25 38
RISPERDAL CONSTA

Treats schizophrenia and ce... +

Treats schizophrenia and certain problems caused by bipolar disorder. More info »

278 25 A 26 25
PRISTIQ ER 271 27 36
DONEPEZIL HCL

Donepezil is used to treat ... +

Donepezil is used to treat dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and may cause changes in mood and personality) associated with Alzheimer's disease (AD; a brain disease that slowly destroys the memory and the ability to think, learn, communicate and handle daily activities). Donepezil is in a class of medications called cholinesterase inhibitors. It improves mental function (such as memory, attention, social interaction, reasoning and language abilities, and ability to perform activities of daily living) by increasing the amount of a certain naturally occurring substance in the brain. Donepezil may improve the ability to think and remember or slow the loss of these abilities in people who have AD. However, donepezil will not cure AD or prevent the loss of mental abilities at some time in the future. More info »

261 170 28 35
BUSPIRONE HCL

Buspirone is used to treat ... +

Buspirone is used to treat anxiety disorders or in the short-term treatment of symptoms of anxiety. More info »

256 23 29 22
SEROQUEL XR

Treats schizophrenia and sy... +

Treats schizophrenia and symptoms of bipolar disorder (manic-depressive illness). Used together with other medicines to treat major depressive disorder (MDD). More info »

255 45 A 30 30
PRAZOSIN HCL

Prazosin is used alone or i... +

Prazosin is used alone or in combination with other medications to treat high blood pressure. Prazosin is in a class of medications called alpha-blockers. It works by relaxing the blood vessels so that blood can flow more easily through the body. More info »

215 12 10 31 23
OXCARBAZEPINE

Used alone or together with... +

Used alone or together with other medicines to treat seizures caused by epilepsy in adults and children 2 years of age and older. More info »

187 32 29
BUPROPION XL

Bupropion (Aplenzin, Wellbu... +

Bupropion (Aplenzin, Wellbutrin, Wellbutrin SR, Wellbutrin XL) is used to treat depression. Bupropion (Wellbutrin XL) is also used to treat seasonal affective disorder (SAD; episodes of depression that occur in the fall and winter each year). Bupropion (Zyban) is used to help people stop smoking. Bupropion is in a class of medications called antidepressants. It works by increasing certain types of activity in the brain. More info »

176 11 33 28
HALOPERIDOL

Treats symptoms of mental a... +

Treats symptoms of mental and emotional disorders. Helps patients with Tourette's syndrome and children with severe behavior problems, including hyperactivity. More info »

169 19 A 34 26
AMITRIPTYLINE HCL

Amitriptyline is used to tr... +

Amitriptyline is used to treat symptoms of depression. Amitriptyline is in a class of medications called tricyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain that are needed to maintain mental balance. More info »

159 22 R 35 43
PROPRANOLOL HCL

Propranolol is used to trea... +

Propranolol is used to treat high blood pressure, abnormal heart rhythms, heart disease, pheochromocytoma (tumor on a small gland near the kidneys), and certain types of tremor. It is also used to prevent angina (chest pain) and migraine headaches. Propranolol is also used to improve survival after a heart attack. Propranolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure. More info »

155 36 34
OLANZAPINE 149 11 A 10 37 40
NAMENDA

Treats dementia (memory los... +

Treats dementia (memory loss and mental changes) that is a sign of Alzheimer's disease. More info »

141 101 38 39
AMPHETAMINE SALT COMBO

The combination of dextroam... +

The combination of dextroamphetamine and amphetamine is used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age) in adults and children. Dextroamphetamine and amphetamine tablets are also used to treat narcolepsy (a sleep disorder that causes excessive daytime sleepiness and sudden attacks of sleep). The combination of dextroamphetamine and amphetamine is in a class of medications called central nervous system stimulants. It works by changing the amounts of certain natural substances in the brain. More info »

140 39 39 37
CLONIDINE HCL

Clonidine is used alone or ... +

Clonidine is used alone or in combination with other medications to treat high blood pressure. Clonidine is in a class of medications called centrally acting alpha-agonist hypotensive agents. It works by decreasing your heart rate and relaxing the blood vessels so that blood can flow more easily through the body. More info »

127 40 44
VALPROIC ACID

Treats seizures (epilepsy).... +

Treats seizures (epilepsy). Also used to treat mood disorders and prevent migraine headaches. This medicine is an anticonvulsant. More info »

126 31 41 50
THIORIDAZINE HCL

Thioridazine is used to tre... +

Thioridazine is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions) in people who have already been treated with at least 2 other medications and have not been helped or who have experienced severe side effects. Thioridazine is in a group of medications called conventional antipsychotics. It works by decreasing abnormal excitement in the brain. More info »

124 A R 42 51
GABAPENTIN

Treats certain types of sei... +

Treats certain types of seizures. Also treats Restless Legs Syndrome (RLS) and pain caused by shingles (postherpetic neuralgia). More info »

118 43 31
INVEGA

Treats schizophrenia (a men... +

Treats schizophrenia (a mental disorder). Used alone or together with other medicines to treat patients with schizoaffective disorder. More info »

117 A 44 41
ZYPREXA ZYDIS

Treats psychotic mental dis... +

Treats psychotic mental disorders, such as schizophrenia or bipolar disorder (manic-depressive illness). More info »

113 21 A 45 33
DEXTROAMPHETAMINE-AMPHETAMINE 102 46 53
METHYLPHENIDATE HCL

Methylphenidate is used as ... +

Methylphenidate is used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age) in adults and children. Methylphenidate (Ritalin, Ritalin SR, Methylin, Methylin ER) is also used to treat narcolepsy (a sleep disorder that causes excessive daytime sleepiness and sudden attacks of sleep). Methylphenidate is in a class of medications called central nervous system (CNS) stimulants. It works by changing the amounts of certain natural substances in the brain. More info »

89 15 47 54
CLOMIPRAMINE HCL 81 R 48 57
TRIHEXYPHENIDYL HCL

Trihexyphenidyl is used to ... +

Trihexyphenidyl is used to treat the symptoms of Parkinson's disease and tremors caused by other medical problems or drugs. More info »

78 19 R 49 49
FLUVOXAMINE MALEATE

Fluvoxamine is used to trea... +

Fluvoxamine is used to treat obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over) and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Fluvoxamine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance. More info »

77 50 45
OMEPRAZOLE

Treats heartburn, stomach u... +

Treats heartburn, stomach ulcers, gastroesophageal reflux disease (GERD), and conditions that cause your stomach to make too much acid, such as Zollinger-Ellison syndrome, endocrine tumors, and systemic mastocytosis. Also helps heal a damaged esophagus, and helps prevent stomach bleeding in patients who have a serious illness. This medicine may be used in combination with antibiotics to treat ulcers. This medicine is a proton pump inhibitor (PPI). More info »

77 50 58
TOPIRAMATE

Helps control and prevent c... +

Helps control and prevent certain kinds of seizures. Also prevents migraine headaches in adults. More info »

75 52 48
ROPINIROLE HCL

Ropinirole is used alone or... +

Ropinirole is used alone or with other medications to treat the symptoms of Parkinson's disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance), including shaking of parts of the body, stiffness, slowed movements, and problems with balance. Ropinirole is also used to treat restless legs syndrome (RLS or Ekbom syndrome; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down). Ropinirole is in a class of medications called dopamine agonists. It works by acting in place of dopamine, a natural substance in the brain that is needed to control movement. More info »

73 53 62
DEXTROAMPHETAMINE SULFATE 72 54 63
MEDROXYPROGESTERONE ACETATE

Medroxyprogesterone is used... +

Medroxyprogesterone is used to treat abnormal menstruation (periods) or irregular vaginal bleeding. Medroxyprogesterone is also used to bring on a normal menstrual cycle in women who menstruated normally in the past but have not menstruated for at least 6 months and who are not pregnant or undergoing menopause (change of life). Medroxyprogesterone is also used to prevent overgrowth of the lining of the uterus (womb) and may decrease the risk of cancer of the uterus in patients who are taking estrogen. Medroxyprogesterone is in a class of medications called progestins. It works by stopping the growth of the lining of the uterus and by causing the uterus to produce certain hormones. More info »

67 55 64
IMIPRAMINE HCL

Imipramine tablets and caps... +

Imipramine tablets and capsules are used to treat depression. Imipramine tablets are also used to prevent bedwetting in children. Imipramine is in a class of medications called tricyclic antidepressants. It treats depression by increasing the amounts of certain natural substances in the brain that are needed to maintain mental balance. There is not enough information to explain how imipramine prevents bedwetting. More info »

60 R 56 67
LATUDA 59 A 57 46
LUNESTA

Treats insomnia (sleep diso... +

Treats insomnia (sleep disorder). More info »

59 57 68
CARBATROL

Treats different types of s... +

Treats different types of seizures. Also used to treat nerve pain and bipolar disorder, also known as manic-depressive illness. More info »

57 59 70
EQUETRO 56 10 60 71
HALOPERIDOL DECANOATE 54 A 61 42
THIOTHIXENE 53 25 A 62 72
RISPERIDONE ODT 52 A 63 73
About This Data

ProPublica obtained prescribing data from Medicare’s prescription drug benefit, known as Part D, under the Freedom of Information Act. The data for 2011 includes nearly 1.2 billion prescriptions written by 1.6 million doctors, nurses and other providers. This database lists about 364,000 of those providers who wrote 50 or more prescriptions for at least one drug that year. About three-fourths went to patients 65 and older; the rest were for disabled patients. Methodology »

Caveats
  • No comparisons are shown if 10 or fewer prescribers in the state share this specialty.
  • The list of top drugs includes only those for which this provider wrote 50 or more prescriptions, but all prescriptions are counted in the summary totals at the top.
  • The calculation of “Risky Drugs to Seniors” does not include drugs for which a provider wrote 11 or fewer prescriptions because Medicare redacted the information to protect patient privacy.
  • Comparisons do not take into account the medical conditions of patients. Medications for certain conditions do not have generic alternatives, so patients would receive more expensive brand name drugs.
  • This provider's address and specialty information was last updated on Dec. 5, 2007.
  • Comparisons are based on each provider’s current address, not necessarily where he or she worked during the time period covered in this database.
Incorrect Info?

If you are a provider and you believe your address is incorrect, check the listing you created on the National Provider Identifier registry. If you change your listing, send a note to drugs@propublica.org and we will update your information. If you have other questions about this data, send a note to drugs@propublica.org.