Lamotrigine
[Lamictal] Best tolerated mood stabilizer, treats and prevents bp-depression; does not treat mania so avoid as monotherapy in bipolar I.
BP Depression
Valproate
[Depakote] Good for bipolar mania/mixed and comorbid anxiety/alcoholism, but poorly tolerated and unsafe in pregnancy.
Amantadine
Similar to ketamine. Treats TD [2] and irritability in TBI [1]. Last-line secret-weapon for bipolar/unipolar depression, OCD, cognition, DMDD, autism, weight-loss
Ramelteon
[Rozerem] Safe hypnotic that may improve depression in bipolar disorder. Think of it as a potent melatonin.
Dextromethorphan
Think of it as low-potency ketamine. Rapid acting as Auvelity in depression, or as monotherapy (3rd line) in bipolar depression. Abuse potential.
Lithium
Best long-term outcomes in bipolar (I or II) and recurrent depression. Prevents suicide. Treats mania, bp-depression and augments antidepressants.
Celecoxib
[Celebrex] NSAID for treatment-resistant unipolar and bipolar depression, works better if inflammation. Well-tolerated short term, but long-term risks.
Modafinils
[Provigil, Nuvigil] Wakefulness-promoting agents FDA approved for fatigue associated with sleep apnea or shift work. Also treats bipolar depression (2), unipolar depression (3), ADHD (3), and cocaine use disorder.
Pramipexole
Dopamine agonist with powerful benefits in unipolar and bipolar depression, also restless leg syndrome.