Welcome to Back from the Abyss. I'm Dr. Craig Hecock.

Today, a solo episode, the first episode of this season, season four on psychopharmacology.

And this is the 10 best psych meds.

Recently, I did a second opinion on a severely, terribly, chronically depressed young woman,

probably bipolar spectrum depression as well as crippling somatic

anxiety. And she was only taking an SSRI and an amphetamine stimulant, and she actually

has a psychiatric provider. And this, my friends, is not good care. These meds made no sense at all for this young woman, because basically she's taking exactly

zero depression meds, and amphetamine stimulants are well known to increase anxiety, particularly

body or somatic anxiety.

So this, in a number of other recent cases and consults, led me to think that I've got to do another psychopharmacology episode.

And clearly there's some major confusion out there about how and when to use psych meds appropriately.

Now, I love synthesizing and finding the essentials of a complex topic searching for the parsimonious

explanation or understanding so I thought it would be an interesting challenge to

come up with just 10 medications that could effectively treat say 95% or more of

all psychiatric problems that potentially respond to medication.

I originally wanted to limit the list to seven, but this left some critical gaps, so I settled on 10.

To make the list, a medication needed to be very effective, generally safe, well-tolerated, generic.

And if I could come up with a brand-name med that was

significantly more effective and or safer and or better tolerated than a similar generic,

then fine. That med could potentially make the list. But, surprise, surprise, no brand-name meds

made the cut. Oh, one note here about buprenorphin.

Now, buprenorphin or Suboxone didn't make the list, and let me just give you a heads-up why.

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