Diphenhydramine
Although over the counter, the prescription version (hydroxyzine) is safer with fewer anticholinergic risks.
Generic
Buspirone
Treats anxiety (GAD). Augments in depression but only if anxious. Also improves sexual dysf, bruxism, irritability, PMDD
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.
Methylphenidate
First-line stimulant (more neuroprotective and safer for mental health than amphetamine). May help apathy in old age but not for depression.
Amphetamine
Amphetamine Stimulant (dopamine-norepinephrine reuptake inhibitor and releaser; serotonin reuptake inhibition) Features Dosing Dextroamphetamine Dextro is the more potent of the
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.
Atomoxetine
Good for ADHD with anxiety, but least effective among FDA options for ADHD. Avoid in bipolar.