Asenapine’s unique advantage is its availability in both sublingual and transdermal patch formulations, making it useful for patients who cannot or prefer not to swallow pills.

Nefazodone was once popular due to its low rate of sexual side effects, but its use has dramatically declined because of rare yet serious hepatic toxicity.

Topiramate is a reasonable off-label choice for alcohol use disorder and antipsychotic-induced weight gain.

Pregabalin is structurally related to gabapentin and is likely more effective for psychiatric disorders, especially generalized anxiety disorder (GAD) and social anxiety disorder. 

Atomoxetine is a nonstimulant attention-deficit/hyperactivity disorder (ADHD) treatment that carries no abuse potential, causes less insomnia and anxiety, and is unlikely to worsen tics.

St. John’s wort may be considered for short-term treatment of mild to moderate depression, especially in patients seeking natural options. However, its extensive drug interaction profile limits broader clinical use.

SAMe is a natural compound involved in neurotransmitter synthesis.

L-methylfolate, the active form of folic acid, is required to synthesize neurotransmitters such as serotonin, dopamine, and norepinephrine.

Valproic acid (VPA) is the go-to antimanic agent for acute manic episodes, featuring faster onset of response and a better adverse effect profile compared to lithium, fewer drug interactions than carbamazepine, and efficacy for rapid cycling and relapse prevention.