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, fatigue.
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 [3], works better if inflammation [2]. 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
[Mirapex] Dopamine agonist with powerful benefits in unipolar and bipolar depression, also restless leg syndrome.