Lamictal (lamotrigine) has been approved! The only problem is that few people can quite comprehend what it's been approved for.

Topamax (topiramate), oddly enough, is a derivative of fructose. It is strange that one of the very few psychotropics to cause weight loss is closely related to sugar, but there you have it. It is only approved as adjunctive therapy for seizure treatment by the FDA.

Suddenly, we all have a colleague who is prescribing Trileptal (oxcarbazepine) for bipolar disorder, and who is claiming to have fabulous success.

Suddenly, it seems that everybody and their cousin is asking us if they have bipolar disorder. A few years ago, bipolar disorder was the ignored orphan diagnosis in psychiatry. However, now that various patented molecules have been proven effective, industry money is flying into efforts to publicize the diagnosis, and it's clearly working.

It's an amazing metal. Not only does it treat acute mania, prevent recurrences, and treat refractory depression, but when consumed as LiCl, it tastes pretty good on vegetables. Or at least it did before the 1950s, when it was dropped from the list of acceptable salt-substitutes for hypertensives because of a nasty tendency to cause toxicity.

First thing's first. What's the deal with all the confusing names for Depakote? The basic, irreducible molecule here is valproic acid, also known as valproate, and the brand name of this is "Depakene", not Depakote.

We apologize in advance. But it was inevitable that TCR would eventually have to tackle what may be the most boring topic in all of psychiatry, if not medicine in general: Drug-drug interactions.

Drug interactions are enormously complicated. In tried and true TCR fashion, I have tried to make this topic easier to stomach. Nonetheless, you can skip this article if you make a decision to avoid prescribing the following medications ...

When it comes to Lithium, you can (thankfully) forget all about the P450 enzymes, because they don't touch this salt. Lithium enters the bloodstream, accomplishes its mysterious mood-stabilizing duties, and then is simply whisked out of the body intact by the kidneys via urine. So with Lithium, it's all about kidneys.

Side effect expert Prakash Masand once observed that “the difference between a good clinician and a great clinician is that a great clinician is better at managing side effects.”