Common Psychiatric Medications
A comprehensive reference to the medications most commonly used in psychiatry. Understanding what your medication does and how it works is an important part of your treatment.
Covering 51 medications across 5 categories, written by Dr. Shapiro from over 35 years of clinical experience.
For Educational Purposes Only
This medication reference is for general educational information only and is not a substitute for professional medical advice. Always follow your prescriber's instructions regarding your specific medication, dosage, and treatment plan. Never start, stop, or change a medication without consulting your doctor first.
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Antidepressants are among the most commonly prescribed psychiatric medications. While originally developed to treat depression, most of these medications are also extremely helpful for anxiety disorders. They work by adjusting the balance of neurotransmitters—chemical messengers in the brain—that regulate mood, worry, and emotional well-being.
Key Points
- Most antidepressants take 2–4 weeks to begin working and 6–8 weeks for full effect
- Nearly all antidepressants listed below (except Wellbutrin) are also effective for anxiety
- Never stop an antidepressant abruptly—always taper under your doctor’s guidance
- Finding the right antidepressant often requires patience; what works best varies by individual
SSRIs (Selective Serotonin Reuptake Inhibitors)
SSRIs are typically the first choice for depression and anxiety. They work by increasing serotonin availability in the brain and are generally well tolerated.
One of the original SSRIs; also FDA-approved for OCD, panic disorder, and bulimia
Extremely versatile; FDA-approved for depression, anxiety, OCD, PTSD, panic disorder, and PMDD
Effective for depression, anxiety, OCD, panic disorder, and social anxiety
Clean side effect profile; widely used for depression and generalized anxiety
Often considered the cleanest SSRI; excellent for both depression and anxiety
Newer SSRI with partial serotonin agonist activity; may cause fewer sexual side effects
Multimodal antidepressant; may also help with cognitive symptoms of depression. Brand name only.
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
SNRIs boost both serotonin and norepinephrine. They are effective for depression, anxiety, and sometimes chronic pain conditions.
Effective for depression, generalized anxiety, social anxiety, and panic disorder
Also FDA-approved for fibromyalgia and chronic pain conditions
Active metabolite of Effexor; may have fewer drug interactions
Atypical Antidepressants
These work through unique mechanisms different from SSRIs and SNRIs.
Works on dopamine and norepinephrine; minimal sexual side effects and weight gain. The one antidepressant on this list that does NOT significantly help anxiety
Can help with sleep and appetite; often used when insomnia and weight loss are concerns
FDA-approved 2022 — a new class of antidepressant with a novel mechanism of action. The first oral NMDA-targeting antidepressant for major depression. Taken as monotherapy (it replaces the current antidepressant — it is not added on top of one). Works faster than traditional SSRIs (measurable improvement by week 1). A regular pill taken at home — not a controlled substance. Many psychiatrists consider Auvelity as a class switch after two or three SSRI/SNRI antidepressants haven't worked, though the research supports trying it earlier — sometimes after just one or two. Weight-neutral with minimal sexual side effects. Avoided in patients with seizure history, eating disorders, or recent MAOI use.
Despite their name, atypical antipsychotics are used for far more than psychosis. These are some of the most versatile medications in psychiatry. They treat bipolar disorder (both mania and depression), boost the effectiveness of antidepressants in treatment-resistant depression, and help with severe anxiety and irritability. They are called “dopamine blockers” because they all act on dopamine receptors, which is extremely helpful for mood stabilization but can cause certain side effects.
Key Points
- The name “antipsychotic” is misleading—many patients who take them are not psychotic
- All atypical antipsychotics act on dopamine receptors (dopamine blockers)
- Several are FDA-approved to augment antidepressants for treatment-resistant depression
- Most are used to treat both the manic and depressive phases of bipolar disorder
- Metabolic monitoring (weight, blood sugar, cholesterol) is important with these medications
Commonly Prescribed Atypical Antipsychotics
Used for bipolar disorder, depression augmentation, and insomnia at low doses
Very effective for mania and psychosis; weight gain is a common side effect
Unique partial dopamine agonist; less weight gain than most in this class
Weight-neutral; must be taken with food for proper absorption
FDA-approved for bipolar depression; relatively favorable metabolic profile
Effective for bipolar mania, bipolar depression, and schizophrenia. Brand name only.
Newer option for bipolar depression and schizophrenia; generally well tolerated. Brand name only.
Mood stabilizers are the foundation of bipolar disorder treatment. Their primary purpose is to keep mood in the middle—preventing the dangerous highs of mania and the crushing lows of depression. These medications help patients achieve and maintain emotional balance over the long term.
Key Points
- Lithobid (lithium) remains the gold standard mood stabilizer after 70+ years of use
- Lithobid (lithium) is one of the few medications proven to reduce suicide risk
- Some mood stabilizers (Depakote, Tegretol) require blood level monitoring
- Lamictal is especially effective for preventing bipolar depression
Specific Mood Stabilizers
The gold standard; proven to prevent both mania and depression and reduce suicide risk. Requires blood level monitoring
Effective for mania and mood stabilization; also used for seizures and migraine prevention
An anticonvulsant used as a mood stabilizer; available in long-acting (Carbatrol) formulation
Especially effective for bipolar depression; must be started at a very low dose and increased slowly to prevent serious rash
ADHD medications fall into three groups: stimulants based on Ritalin (methylphenidate), stimulants based on Dexedrine (amphetamine), and non-stimulants. Stimulants are the most effective medications for improving focus and attention. Non-stimulants are an alternative for patients who cannot tolerate stimulants or have certain medical conditions, though they are generally not as powerful for attention.
Key Points
- Stimulants are the first-line treatment for ADHD and are effective in about 70–80% of patients
- If one class of stimulant does not work well, the other class often does
- Non-stimulants help with hyperactivity and impulsivity but are usually less effective for attention
- All stimulants are Schedule II controlled substances requiring careful prescribing and monitoring
Concerta/Ritalin (methylphenidate)-Based Stimulants (Ritalin Family)
These medications work primarily by blocking the reuptake of dopamine in the brain.
Immediate-release; lasts 3–4 hours
Intermediate-acting; lasts about 8 hours
The more active form of Concerta/Ritalin (methylphenidate); immediate-release
Extended-release; smooth coverage throughout the day
Unique osmotic delivery system; lasts up to 12 hours
Liquid formulation; ideal for children who cannot swallow pills. Brand name only.
Dissolves on the tongue; no water needed. Brand name only.
Adderall/Vyvanse (amphetamine)-Based Stimulants (Dexedrine Family)
These medications both block dopamine reuptake and increase dopamine release, often providing stronger symptom control.
Immediate-release; one of the original ADHD stimulants
Extended-release capsule formulation
Combination of Adderall/Vyvanse (amphetamine) and Dexedrine (dextroamphetamine); immediate-release
Extended-release; lasts 10–12 hours
Prodrug that is converted to Dexedrine (dextroamphetamine) in the body; smooth onset and offset
Dissolves on the tongue; suitable for patients who cannot swallow pills. Brand name only.
Liquid formulation; flexible dosing for children. Brand name only.
Non-Stimulant ADHD Medications
These are alternatives when stimulants are not appropriate or well tolerated. They are generally not as powerful for attention but can be especially helpful for hyperactivity and impulsivity, particularly in children.
Norepinephrine reuptake inhibitor; takes 4–6 weeks for full effect
Newer non-stimulant; approved for both children and adults. Brand name only.
Alpha-2 agonist; helps with impulsivity and hyperactivity; can also help with tics
Alpha-2 agonist; helps with hyperactivity and can improve sleep
Sleep difficulties are extremely common in psychiatric conditions. Treatment often includes sleep medications alongside therapy for the underlying condition. These range from medications used off-label for their sedating properties to dedicated sleep aids.
Key Points
- Sleep hygiene and behavioral changes should always accompany medication treatment
- Some sleep medications are habit-forming and should be used short-term
- Newer sleep medications like Belsomra and Quviviq work differently than older sleep aids
- Melatonin is available over the counter and can be a helpful starting point
Commonly Used Sleep Medications
Antidepressant used at low doses for sleep; not habit-forming. One of the most commonly prescribed sleep aids in psychiatry
Low-dose antidepressant FDA-approved for insomnia; helps with sleep maintenance. Brand name only.
Alpha-2 agonist; commonly used in children for sleep and ADHD-related insomnia
Over the counter. Natural hormone that helps regulate the sleep-wake cycle; a good first option
Fast-acting sleep aid; generally for short-term use
Can be used longer-term than some other sleep aids
Very short-acting; useful for middle-of-the-night awakenings
Orexin receptor antagonist; works through a different mechanism than traditional sleep aids. Brand name only.
Newest orexin receptor antagonist; helps with both falling and staying asleep. Brand name only.
A Note From Dr. Shapiro
The medications listed above represent the most commonly prescribed psychiatric medications in my practice. There are many other medications used for other psychiatric disorders that are not listed here. Every patient is unique, and the right medication for you depends on your specific condition, symptoms, medical history, and individual response.
I always tell my patients: if a medication makes you uncomfortable for two or three days, stop it and call us. We will figure out what happened and try something different. You are never stuck with something that doesn't feel right. My commitment is to keep working with you until you are dramatically better.
Detailed Medication Guides
Want to learn more? These in-depth guides cover specific medications in detail, including how they work week by week, common side effects, FAQs, and Dr. Shapiro's personal perspective.
Lexapro
(lexapro (escitalopram))
Lithobid
(lithium carbonate)
Wellbutrin
(wellbutrin (bupropion))
Zoloft
(zoloft (sertraline))
Concerta
(concerta/ritalin (methylphenidate))
Lamictal
(lamictal (lamotrigine))
Questions About Your Medication?
Every patient is unique, and medication decisions should always be made with your doctor. If you have questions about your current medication or are considering treatment options, Dr. Shapiro is here to help.
If you're experiencing a psychiatric emergency, call 911 or go to your nearest emergency room.