SAMe
For depression, improves liver health, osteoarthritis, but l-methylfolate has a similar mechanism and better evidence.
Treatment Resistant Depression
Acetyl-l-carnitine
[ALC] Depression, especially recurrent/TRD, history of child-trauma, or with medical illness or elderly [2]. Alcohol (mood/memory/cravings) [2]
Acetyl-l-carnitine Read More »
Lamotrigine
[Lamictal] Best tolerated mood stabilizer, treats and prevents bp-depression; does not treat mania so avoid as monotherapy in bipolar I.
Minocycline
[Minocin] Antibiotic/anti-inflammatory with possible benefits in bipolar and unipolar depression; also treats lithium-acne.
Cycloserine
Augments exposure therapy and TMS in low dose, may work for TRD in high dose, but have to get from specialty pharmacy.
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.
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.