Propranolol
Augments SSRIs in panic, use for tremor, akathisia, and irritability.
Bipolar-Safe
Metformin
First-line for antipsychotic weight gain, works best when started early (also prevents DM, dyslipidemia, prolactinemia)
Tirzepatide
[$ Mounjaro, Zepbound] Most effective of the GLPs for weight loss (use if BMI >30 or > 27 with complications of obesity).
N-acetylcysteine
[NAC] For low-grade bipolar depression [3], protects kidneys on lithium, trichotillomania [1], cannabis and substance use disorders.
Pimavanserin
[$ Nuplazid] Use for psychosis in Parkinson's disease, has had inconsistent results in other
disorders.
Brexpiprazole
[$ Rexulti] Well tolerated for antipsychotics, treats unipolar-depression, ptsd, but not bp-
depression and not mania.
Aripiprazole
[Abilify] Among the better-tolerated antipsychotics, and best-studied for antidepressant
augmentation [1] (but doesn't treat bp-depression). Schizophrenia [1]
Clozapine
[Clozaril] Use in schizophrenia/schizoaffective after 2 failed antipsychotic trials. Prevents suicide
in psychotic disorders.
Risperidone
[Risperdal] Among most effective antipsychotics for schizophrenia [1]. Mania[3]. Augments
antidepressants in unipolar [3], PTSD [3], OCD [3].