Omega-3 fatty acids form the lipid bilayers of cell membranes, and supplementing our natural dietary supply may have psychological and cardiological benefits.

Lithium is the gold standard for bipolar disorder.

Lamotrigine is a good choice for maintenance treatment of bipolar disorder, especially to prevent depressive episodes.

Equetro is the only FDA-approved formulation of carbamazepine for bipolar disorder, but use of other formulations would result in the same effects at a lower price.

Propranolol has several uses in psychiatry, including performance anxiety, drug-induced tremor, and akathisia.

Prazosin is an alpha-1 antagonist (FDA approved for hypertension) that has become popular as a treatment for insomnia/nightmares associated with post-traumatic stress disorder (PTSD). 

NAC is a glutamate modulator derived from the amino acid cysteine. It’s been tested in many psychiatric conditions, but shows the most promise as an adjunctive treatment to selective serotonin reuptake inhibitors for compulsive behaviors like obsessive-compulsive disorder (OCD), trichotillomania, nail biting, and skin picking.

When a benzodiazepine is appropriate for use (short term; minimal risk of abuse), we consider lorazepam to be a first-line agent.

Lavender essential oil (Silexan) is a well-tolerated, over-the-counter option for mild to moderate generalized anxiety disorder (GAD), supported by studies showing effect sizes comparable to standard treatments.

Gabapentin used to be considered a nonaddictive medication for anxiety and for alcohol dependence, but we now know it may be misused and diverted for its euphoriant effect.