ECT
First-line for severe psychotic depression. In other cases of TRD, may prefer over TMS if severe. Also works for bipolar depression.
Weight-Free
TMS
One of the most effective therapies for TRD. Well tolerated, improves cognition and neuroplasticity.
Metformin
First-line for antipsychotic weight gain, works best when started early (also prevents DM, dyslipidemia, prolactinemia)
CBD
[Cannabidiol] This “healthier”strain of cannabis is #1 for cannabis use disorder, but questionable in anxiety and insomnia. Watch for drug interactions.
Magnesium
Improves sleep (with melatonin), bruxism, and essential for liver health in alcohol use disorder.
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.
Ziprasidone
[Geodon] Among best antipsychotics for low weight/diabetes risk. Treats mania/mixed; possibly
helps depression in unipolar and bipolar.
Solriamfetol
[$ Sunosi] Approved for narcolepsy but has bupropion-like properties and may treat ADHD.