Best long-term outcomes in bipolar (I or II) and recurrent depression. Prevents suicide. Treats mania, bp-depression and augments antidepressants.
[Depakote] Good for bipolar mania/mixed and comorbid anxiety/alcoholism, but poorly tolerated and unsafe in pregnancy.
A well tolerated option for mania, but third-line due to few trials.
[Rozerem] Safe hypnotic that may improve depression in bipolar disorder. Think of it as a potent melatonin.
[$ Quviviq] Orexin antagonist, improves next-day cognition, low abuse potential, low fall risk. Ideal for elderly.
[$ Dayvigo] Orexin antagonist, improves next-day cognition, low abuse potential, low fall risk. Ideal for elderly.
[$ Belsomra] Orexin antagonist, improves next-day congnition, low abuse potential, low fall risk. Ideal for elderly. However, daridorexant and lemborexant more effective.
[Lunesta]Among the z-hypnotics, has the most benzo-like properties, and can augment antidepressants (short term) in depression and GAD.
[Sonata] Z-hypnotic with the lowest risk of morning sedation.
[Ambien] Potent z-hypnotic.
Although over the counter, the prescription version (hydroxyzine) is safer with fewer anticholinergic risks.
Anti-viral improves cognition in bipolar and schizophrenia but only if herpes HSV+
Zonisamide (Zonegran) Anticonvulsant (glutamate modulation, GABA-ergic; blocks voltage-dependent sodium channels) Features Dosing Start 100 mg/d, raise by 100 mg/d every […]
[$ Ingrezza] For TD [1]
[Keppra] For tardive dyskinesia [2]. Although a seizure med, it improves cognition.
[Tebonin] For TD [2] and age related cognitive decline [2].
[$ Austedo] For TD [1], but valbenazine is a little safer and more effective
[Cialis] Best of the PDE class for sexual dysfunction on SSRI/SNRI [longer half-life allows spontaneity]
Sildenafil(Viagra) Phosphodiesterase type 5 (PDE5) inhibitor Features Dosing Sildenafil citrate 20mg 1 q24hr prn (take 1-4 hr before intercourse), can […]
[Levitra] For sexual dysfunction on SSRI/SSNI in women and men, but tadalifil is better.