Carbamazepine
[Equetro] A well tolerated option for bipolar mania and mixed states (but you’ll need to adjust for drug interactions)
Sedating
Valproate
[Depakote] Good for bipolar mania/mixed and comorbid anxiety/alcoholism, but poorly tolerated and unsafe in pregnancy.
Pregabalin
[Lyrica] Approved outside US for generalized and social anxiety disorders [1]. Benzo WD, OCD [3], fibromylagia [1].
Gabapentin
[Neurontin] For social anxiety, stabilizing sleep in alcoholics, RLS, akathisia, non-specific anxiety. Better tolerated than pregabalin but less effective.
Levetiracetam
[Keppra] For mania [3] and tardive dyskinesia [2]. Although a seizure med, it improves cognition.
Zuranolone
[$ Zurzuvae] First-line for post-partum depression, but not for regular depression or post-partum psychosis. Safe in bipolar. 2-week course; benzo-like properties.
Nefazodone
[Serzone] Last-line antidepressant (a less sedating version of trazodone, but liver risks)
Trazodone
Deepens sleep quality in low doses, but under-utlilized as an antidepressant, where it can be very effective and tolerable if dosed at night.
Suvorexant
[$ Belsomra] Orexin antagonist, improves next-day cognition, low abuse potential, low fall risk. Ideal for elderly. However, daridorexant and lemborexant more effective.