Medications
Antipsychotics: A Comprehensive Overview
Antipsychotics control the positive symptoms of psychosis and reliably prevent relapse, primarily by blocking dopamine D2 receptors. They are seriously toxic, largely ineffective against negative and cognitive symptoms, and widely overextended into off-label uses.
14 min readGABAergic Agents
An overview of benzodiazepines, Z-drugs, barbiturates, gabapentinoids, and related agents — fast, effective inhibitory drugs whose very effectiveness is inseparable from tolerance, dependence, and a potentially dangerous withdrawal. Their proper use is a matter of indication and duration.
18 min readGlutamatergic and Rapid-Acting Agents in Psychiatry
An overview of ketamine, esketamine, oral NMDA approaches, the neurosteroids, and the psychedelics — the drugs that broke the weeks-long delayed-onset paradigm by inducing rapid neural plasticity. The science is revolutionary; the deployment environment warrants caution.
17 min readMood Stabilizers
An overview of lithium, the anticonvulsants, and the antipsychotics used in bipolar disorder — genuinely effective, often life-saving drugs for a severe recurrent illness, but a toolkit that is unevenly effective across the illness's phases and weakest against the depressive pole that dominates the burden.
19 min readPsychedelics and Consciousness-Altering Agents: A Comprehensive Overview
Psychedelics are a pharmacologically heterogeneous group that profoundly alter consciousness and appear to share a deeper property of rapidly inducing neural plasticity. They show genuine therapeutic promise alongside serious psychological and physical risks and a trial literature with fundamental methodological problems.
12 min readPsychiatric Medications — A Clinical Guide to the Landscape
A capstone overview of the major psychiatric drug classes — how they relate, the cross-cutting principles that govern them, and a prescribing guide organized by clinical presentation. It frames medication and psychotherapy as colleagues rather than rivals.
29 min readSerotonergic Psychiatric Medications
An overview of SSRIs, SNRIs, the multimodal agents, and the azapirones — their receptors, likely mechanisms, real-world value, and problems. Their average benefit is modest but real, stronger for anxiety disorders than for depression, with burdens that were minimized for two decades.
13 min readStimulants and ADHD Medications: A Comprehensive Overview
Stimulants raise prefrontal dopamine and norepinephrine to produce some of the largest effect sizes in psychiatry for ADHD symptom control. They carry real abuse, cardiovascular, and growth considerations, and the evidence for durable long-term benefit is weaker than the short-term effect.
16 min readSympatholytics in Psychiatry: A Comprehensive Overview
Sympatholytics dampen noradrenergic signaling, treating the autonomic and somatic output of arousal, fear, and dysregulation rather than its affective core. They are clean, non-addictive, symptom-targeted adjuncts whose grandest hypotheses have proven harder to deliver than hoped.
17 min readThe Other Agents: Atypical, Repurposed, and Non-Classical Psychiatric Drugs
This covers the atypical antidepressants (bupropion, mirtazapine, trazodone, the MAOIs) and the growing list of non-psychiatric drugs with psychiatric uses. Together they show that psychiatric illness involves immune, metabolic, endocrine, and learning systems beyond the classic neurotransmitters.
14 min readTricyclic Antidepressants and MAOIs
An overview of the first-generation antidepressants — TCAs and MAOIs — their receptors, mechanisms, and enduring value. They were displaced from first-line use on safety and tolerability, not efficacy, and remain effective but underused for specific patients.