Varenicline
[Chantix] The most effective therapy for nicotine, generally safe in psychiatric disorders
Sexual-free
Thyroid T4
[Synthroid] Use for hypothyroidism on lithium. For augmentation in depression, T3 is preferred.
Thyroid T3
[Cytomel] For treatment-resistant bipolar/unipolar depression, well-tolerated and may actually improve manic or anxious symptoms
Selegiline
[$ EMSAM] Skin patch MAOI, good to start with (low dose = no food interactions) but not as potent as older MAOIs.
Semaglutide
[$ Ozempic, Wegovy] Medium effective of the GLPs for weight loss (use if BMI >30 or > 27 with complications of obesity).
Esketamine
[$ Spravato] Strong, rapid medication for TRD [2], but works no better than placebo after a month and risky (used to model schizophrenia and autism). Ketamine IV is more effective but isn’t covered by insurance
Maca root
Maca root Sexual dysfunction Female Features Dosing 3,000 mg/d Management $3-10/mth. Has testosterone- and estrogen-like effects EMR Text