Medication Guide

Understanding your psychiatric medications, their effects, and what to expect during treatment.

Important Notice

This guide is for educational purposes only and does not replace personalized medical advice from your provider. Always discuss any questions or concerns about your medications with your prescriber before making any changes to your treatment.

Antidepressants

Antipsychotics

Mood Stabilizers

Anxiolytics

ADHD

Sleep

Substance Use

Antidepressants

Antidepressants work by balancing neurotransmitters in the brain that affect mood and emotions. They are used to treat depression, anxiety disorders, OCD, and certain chronic pain conditions.

Antidepressants work by balancing neurotransmitters in the brain that affect mood and emotions. They are used to treat depression, anxiety disorders, OCD, and certain chronic pain conditions.

SSRIs

Sertraline (Zoloft) • Escitalopram (Lexapro) • Fluoxetine (Prozac) • Paroxetine (Paxil) • Citalopram (Celexa)

Selective Serotonin Reuptake Inhibitors increase serotonin availability in the brain. First-line treatment for depression and anxiety.

Common Side Effects

Nausea

Headache

Sexual dysfunction

Insomnia

Weight changes

GI upset

SSRIs

Sertraline (Zoloft) • Escitalopram (Lexapro) • Fluoxetine (Prozac) • Paroxetine (Paxil) • Citalopram (Celexa)

Selective Serotonin Reuptake Inhibitors increase serotonin availability in the brain. First-line treatment for depression and anxiety.

Common Side Effects

Nausea

Headache

Sexual dysfunction

Insomnia

Weight changes

GI upset

SSRIs

Sertraline (Zoloft) • Escitalopram (Lexapro) • Fluoxetine (Prozac) • Paroxetine (Paxil) • Citalopram (Celexa)

Selective Serotonin Reuptake Inhibitors increase serotonin availability in the brain. First-line treatment for depression and anxiety.

Common Side Effects

Nausea

Headache

Sexual dysfunction

Insomnia

Weight changes

GI upset

SNRIs

Venlafaxine (Effexor) • Duloxetine (Cymbalta) • Desvenlafaxine (Pristiq) • Levomilnacipran (Fetzima)

Serotonin-Norepinephrine Reuptake Inhibitors affect both serotonin and norepinephrine. Often used when SSRIs are not effective or for chronic pain.

Common Side Effects

Nausea

Dizziness

Sweating

Elevated BP

Dry Mouth

Discontinuation Syndrome

SNRIs

Venlafaxine (Effexor) • Duloxetine (Cymbalta) • Desvenlafaxine (Pristiq) • Levomilnacipran (Fetzima)

Serotonin-Norepinephrine Reuptake Inhibitors affect both serotonin and norepinephrine. Often used when SSRIs are not effective or for chronic pain.

Common Side Effects

Nausea

Dizziness

Sweating

Elevated BP

Dry Mouth

Discontinuation Syndrome

SNRIs

Venlafaxine (Effexor) • Duloxetine (Cymbalta) • Desvenlafaxine (Pristiq) • Levomilnacipran (Fetzima)

Serotonin-Norepinephrine Reuptake Inhibitors affect both serotonin and norepinephrine. Often used when SSRIs are not effective or for chronic pain.

Common Side Effects

Nausea

Dizziness

Sweating

Elevated BP

Dry Mouth

Discontinuation Syndrome

Bupropion (Wellbutrin)

Wellbutrin SR • Wellbutrin XL • Forfivo XL

Norepinephrine-Dopamine Reuptake Inhibitor (NDRI). Unique mechanism with fewer sexual side effects. Also used for smoking cessation.

Common Side Effects

Insomnia

Dry Mouth

Headache

Agitation

Decreased Appetite

Seizure Risk (dose dependent)

Bupropion (Wellbutrin)

Wellbutrin SR • Wellbutrin XL • Forfivo XL

Norepinephrine-Dopamine Reuptake Inhibitor (NDRI). Unique mechanism with fewer sexual side effects. Also used for smoking cessation.

Common Side Effects

Insomnia

Dry Mouth

Headache

Agitation

Decreased Appetite

Seizure Risk (dose dependent)

Bupropion (Wellbutrin)

Wellbutrin SR • Wellbutrin XL • Forfivo XL

Norepinephrine-Dopamine Reuptake Inhibitor (NDRI). Unique mechanism with fewer sexual side effects. Also used for smoking cessation.

Common Side Effects

Insomnia

Dry Mouth

Headache

Agitation

Decreased Appetite

Seizure Risk (dose dependent)

Mirtazapine (Remeron)

Remeron • Remeron SolTab

Noradrenergic and Specific Serotonergic Antidepressant (NaSSA). Helpful for insomnia and appetite stimulation.

Common Side Effects

Sedation

Weight gain

Increased appetite

Dizziness

Mirtazapine (Remeron)

Remeron • Remeron SolTab

Noradrenergic and Specific Serotonergic Antidepressant (NaSSA). Helpful for insomnia and appetite stimulation.

Common Side Effects

Sedation

Weight gain

Increased appetite

Dizziness

Mirtazapine (Remeron)

Remeron • Remeron SolTab

Noradrenergic and Specific Serotonergic Antidepressant (NaSSA). Helpful for insomnia and appetite stimulation.

Common Side Effects

Sedation

Weight gain

Increased appetite

Dizziness

Trazodone

Desyrel • Oleptro

Serotonin antagonist and reuptake inhibitor (SARI). Often used at low doses for insomnia due to sedating properties.

Common Side Effects

Sedation

Dry Mouth

Headache

Orthostatic hypotension

Priapism (rare)

Trazodone

Desyrel • Oleptro

Serotonin antagonist and reuptake inhibitor (SARI). Often used at low doses for insomnia due to sedating properties.

Common Side Effects

Sedation

Dry Mouth

Headache

Orthostatic hypotension

Priapism (rare)

Trazodone

Desyrel • Oleptro

Serotonin antagonist and reuptake inhibitor (SARI). Often used at low doses for insomnia due to sedating properties.

Common Side Effects

Sedation

Dry Mouth

Headache

Orthostatic hypotension

Priapism (rare)

Tricyclic Antidepressants

Amitriptyline (Elavil) • Nortriptyline (Pamelor) • Imipramine (Tofranil) • Doxepin

Older class affecting multiple neurotransmitters. Used for treatment-resistant depression, chronic pain, and migraine prevention.

Common Side Effects

Dry mouth

Constipation

Sedation

Weight gain

Cardiac effects

Urinary retention

Tricyclic Antidepressants

Amitriptyline (Elavil) • Nortriptyline (Pamelor) • Imipramine (Tofranil) • Doxepin

Older class affecting multiple neurotransmitters. Used for treatment-resistant depression, chronic pain, and migraine prevention.

Common Side Effects

Dry mouth

Constipation

Sedation

Weight gain

Cardiac effects

Urinary retention

Tricyclic Antidepressants

Amitriptyline (Elavil) • Nortriptyline (Pamelor) • Imipramine (Tofranil) • Doxepin

Older class affecting multiple neurotransmitters. Used for treatment-resistant depression, chronic pain, and migraine prevention.

Common Side Effects

Dry mouth

Constipation

Sedation

Weight gain

Cardiac effects

Urinary retention

Informed Consent Example for Antidepressants

I understand that: Antidepressant medications typically take 4-6 weeks to reach full therapeutic effect. I should not expect immediate improvement and will continue taking the medication as prescribed even if I do not notice changes right away. Common side effects may include nausea, headache, changes in sleep patterns, sexual dysfunction, and weight changes. Most side effects improve within the first few weeks of treatment. I should not abruptly stop this medication without consulting my provider, as this may cause discontinuation symptoms. When stopping, my dose will be gradually tapered. I will contact my provider immediately if I experience worsening depression, new or increased thoughts of self-harm, unusual changes in behavior, or severe side effects. FDA Warning: Antidepressants may increase suicidal thoughts or behaviors in children, adolescents, and young adults during the initial weeks of treatment. Close monitoring is essential during this period.

Informed Consent Example for Antidepressants

I understand that: Antidepressant medications typically take 4-6 weeks to reach full therapeutic effect. I should not expect immediate improvement and will continue taking the medication as prescribed even if I do not notice changes right away. Common side effects may include nausea, headache, changes in sleep patterns, sexual dysfunction, and weight changes. Most side effects improve within the first few weeks of treatment. I should not abruptly stop this medication without consulting my provider, as this may cause discontinuation symptoms. When stopping, my dose will be gradually tapered. I will contact my provider immediately if I experience worsening depression, new or increased thoughts of self-harm, unusual changes in behavior, or severe side effects. FDA Warning: Antidepressants may increase suicidal thoughts or behaviors in children, adolescents, and young adults during the initial weeks of treatment. Close monitoring is essential during this period.

Informed Consent Example for Antidepressants

I understand that: Antidepressant medications typically take 4-6 weeks to reach full therapeutic effect. I should not expect immediate improvement and will continue taking the medication as prescribed even if I do not notice changes right away. Common side effects may include nausea, headache, changes in sleep patterns, sexual dysfunction, and weight changes. Most side effects improve within the first few weeks of treatment. I should not abruptly stop this medication without consulting my provider, as this may cause discontinuation symptoms. When stopping, my dose will be gradually tapered. I will contact my provider immediately if I experience worsening depression, new or increased thoughts of self-harm, unusual changes in behavior, or severe side effects. FDA Warning: Antidepressants may increase suicidal thoughts or behaviors in children, adolescents, and young adults during the initial weeks of treatment. Close monitoring is essential during this period.

Black Box Warning

Antidepressants may increase suicidal thinking and behavior in children, adolescents, and young adults (ages 18-24) during the first few months of treatment. Close monitoring is required, especially during initial therapy and dose changes.

Black Box Warning

Antidepressants may increase suicidal thinking and behavior in children, adolescents, and young adults (ages 18-24) during the first few months of treatment. Close monitoring is required, especially during initial therapy and dose changes.

Black Box Warning

Antidepressants may increase suicidal thinking and behavior in children, adolescents, and young adults (ages 18-24) during the first few months of treatment. Close monitoring is required, especially during initial therapy and dose changes.

Antipsychotics

Antipsychotic medications are used to treat schizophrenia, bipolar disorder, and severe depression. They work by modifying dopamine and serotonin pathways in the brain.

Antipsychotic medications are used to treat schizophrenia, bipolar disorder, and severe depression. They work by modifying dopamine and serotonin pathways in the brain.

Second-Generation (Atypical)

Aripiprazole (Abilify) • Quetiapine (Seroquel) • Risperidone (Risperdal) • Olanzapine (Zyprexa) • Ziprasidone (Geodon) • Lurasidone (Latuda)

Block dopamine D2 and serotonin 5-HT2A receptors. Lower risk of movement disorders than older antipsychotics. Commonly used for bipolar disorder and as augmentation for depression.

Common Side Effects

Weight gain

Sedation

Metabolic changes

Diabetes risk

Elevated lipids

Akathisia

Second-Generation (Atypical)

Aripiprazole (Abilify) • Quetiapine (Seroquel) • Risperidone (Risperdal) • Olanzapine (Zyprexa) • Ziprasidone (Geodon) • Lurasidone (Latuda)

Block dopamine D2 and serotonin 5-HT2A receptors. Lower risk of movement disorders than older antipsychotics. Commonly used for bipolar disorder and as augmentation for depression.

Common Side Effects

Weight gain

Sedation

Metabolic changes

Diabetes risk

Elevated lipids

Akathisia

Second-Generation (Atypical)

Aripiprazole (Abilify) • Quetiapine (Seroquel) • Risperidone (Risperdal) • Olanzapine (Zyprexa) • Ziprasidone (Geodon) • Lurasidone (Latuda)

Block dopamine D2 and serotonin 5-HT2A receptors. Lower risk of movement disorders than older antipsychotics. Commonly used for bipolar disorder and as augmentation for depression.

Common Side Effects

Weight gain

Sedation

Metabolic changes

Diabetes risk

Elevated lipids

Akathisia

Cariprazine (Vraylar)

Vraylar

Partial agonist at D2 and D3 receptors. FDA-approved for bipolar depression, bipolar mania, and schizophrenia. Unique D3 receptor activity may improve motivation and cognition.

Common Side Effects

Akathisia

Insomnia

Nausea

Restlessness

EPS

Cariprazine (Vraylar)

Vraylar

Partial agonist at D2 and D3 receptors. FDA-approved for bipolar depression, bipolar mania, and schizophrenia. Unique D3 receptor activity may improve motivation and cognition.

Common Side Effects

Akathisia

Insomnia

Nausea

Restlessness

EPS

Cariprazine (Vraylar)

Vraylar

Partial agonist at D2 and D3 receptors. FDA-approved for bipolar depression, bipolar mania, and schizophrenia. Unique D3 receptor activity may improve motivation and cognition.

Common Side Effects

Akathisia

Insomnia

Nausea

Restlessness

EPS

Clozapine (Clozaril)

Clozaril • FazaClo

Reserved for treatment-resistant schizophrenia due to superior efficacy. Requires regular blood monitoring for agranulocytosis risk through REMS program.

Common Side Effects

Sedation

Weight gain

Drooling

Constipation

Seizure risk

Agranulocytosis

Clozapine (Clozaril)

Clozaril • FazaClo

Reserved for treatment-resistant schizophrenia due to superior efficacy. Requires regular blood monitoring for agranulocytosis risk through REMS program.

Common Side Effects

Sedation

Weight gain

Drooling

Constipation

Seizure risk

Agranulocytosis

Clozapine (Clozaril)

Clozaril • FazaClo

Reserved for treatment-resistant schizophrenia due to superior efficacy. Requires regular blood monitoring for agranulocytosis risk through REMS program.

Common Side Effects

Sedation

Weight gain

Drooling

Constipation

Seizure risk

Agranulocytosis

First-Generation (Typical)

Haloperidol (Haldol) • Perphenazine (Trilafon) • Fluphenazine (Prolixin) • Chlorpromazine (Thorazine)

Primarily block dopamine D2 receptors. Effective for psychosis but higher risk of extrapyramidal symptoms and tardive dyskinesia.

Common Side Effects

EPS

Tardive dyskinesia

Rigidity

Tremor

Sedation

Prolactin elevation

First-Generation (Typical)

Haloperidol (Haldol) • Perphenazine (Trilafon) • Fluphenazine (Prolixin) • Chlorpromazine (Thorazine)

Primarily block dopamine D2 receptors. Effective for psychosis but higher risk of extrapyramidal symptoms and tardive dyskinesia.

Common Side Effects

EPS

Tardive dyskinesia

Rigidity

Tremor

Sedation

Prolactin elevation

First-Generation (Typical)

Haloperidol (Haldol) • Perphenazine (Trilafon) • Fluphenazine (Prolixin) • Chlorpromazine (Thorazine)

Primarily block dopamine D2 receptors. Effective for psychosis but higher risk of extrapyramidal symptoms and tardive dyskinesia.

Common Side Effects

EPS

Tardive dyskinesia

Rigidity

Tremor

Sedation

Prolactin elevation

Informed Consent Example for Antipsychotics

I understand that: Antipsychotic medications are prescribed for mood stabilization, psychosis, severe anxiety, or augmentation of antidepressant therapy. These medications may cause metabolic effects including weight gain, elevated blood sugar, and changes in cholesterol levels. Regular monitoring of weight, blood glucose, and lipid panels is required. Movement side effects (extrapyramidal symptoms) such as muscle stiffness, restlessness, tremors, or involuntary movements may occur. I will report any unusual movements immediately. Tardive dyskinesia (TD) is a potentially permanent movement disorder that can develop with long-term use. The risk increases with duration of treatment and cumulative dose. I agree to regular laboratory monitoring as recommended by my provider, including metabolic panels and other indicated tests.

Informed Consent Example for Antipsychotics

I understand that: Antipsychotic medications are prescribed for mood stabilization, psychosis, severe anxiety, or augmentation of antidepressant therapy. These medications may cause metabolic effects including weight gain, elevated blood sugar, and changes in cholesterol levels. Regular monitoring of weight, blood glucose, and lipid panels is required. Movement side effects (extrapyramidal symptoms) such as muscle stiffness, restlessness, tremors, or involuntary movements may occur. I will report any unusual movements immediately. Tardive dyskinesia (TD) is a potentially permanent movement disorder that can develop with long-term use. The risk increases with duration of treatment and cumulative dose. I agree to regular laboratory monitoring as recommended by my provider, including metabolic panels and other indicated tests.

Informed Consent Example for Antipsychotics

I understand that: Antipsychotic medications are prescribed for mood stabilization, psychosis, severe anxiety, or augmentation of antidepressant therapy. These medications may cause metabolic effects including weight gain, elevated blood sugar, and changes in cholesterol levels. Regular monitoring of weight, blood glucose, and lipid panels is required. Movement side effects (extrapyramidal symptoms) such as muscle stiffness, restlessness, tremors, or involuntary movements may occur. I will report any unusual movements immediately. Tardive dyskinesia (TD) is a potentially permanent movement disorder that can develop with long-term use. The risk increases with duration of treatment and cumulative dose. I agree to regular laboratory monitoring as recommended by my provider, including metabolic panels and other indicated tests.

Black Box Warning

Antipsychotics increase mortality in elderly patients with dementia-related psychosis. These medications are not approved for this use. Additionally, metabolic syndrome monitoring is essential during treatment.

Black Box Warning

Antipsychotics increase mortality in elderly patients with dementia-related psychosis. These medications are not approved for this use. Additionally, metabolic syndrome monitoring is essential during treatment.

Black Box Warning

Antipsychotics increase mortality in elderly patients with dementia-related psychosis. These medications are not approved for this use. Additionally, metabolic syndrome monitoring is essential during treatment.

Mood Stabilizers

Mood stabilizers help control the extreme highs (mania) and lows (depression) of bipolar disorder. They work by reducing abnormal brain activity and stabilizing mood fluctuations.

Mood stabilizers help control the extreme highs (mania) and lows (depression) of bipolar disorder. They work by reducing abnormal brain activity and stabilizing mood fluctuations.

Lithium

Lithobid • Eskalith • Lithium Carbonate

Gold standard for bipolar disorder. Exact mechanism unknown but affects multiple neurotransmitter systems. Only medication proven to reduce suicide risk in bipolar disorder.

Common Side Effects

Tremor

Thirst

Frequent urination

Weight gain

Thyroid issues

Kidney effects

Lithium

Lithobid • Eskalith • Lithium Carbonate

Gold standard for bipolar disorder. Exact mechanism unknown but affects multiple neurotransmitter systems. Only medication proven to reduce suicide risk in bipolar disorder.

Common Side Effects

Tremor

Thirst

Frequent urination

Weight gain

Thyroid issues

Kidney effects

Lithium

Lithobid • Eskalith • Lithium Carbonate

Gold standard for bipolar disorder. Exact mechanism unknown but affects multiple neurotransmitter systems. Only medication proven to reduce suicide risk in bipolar disorder.

Common Side Effects

Tremor

Thirst

Frequent urination

Weight gain

Thyroid issues

Kidney effects

Valproate

Depakote • Depakene • Depakote ER

Anticonvulsant that increases GABA levels. Effective for mania and mixed episodes. Also used for migraine prevention and seizure disorders.

Common Side Effects

Nausea

Weight gain

Tremor

Hair loss

Liver effects

Sedation

Valproate

Depakote • Depakene • Depakote ER

Anticonvulsant that increases GABA levels. Effective for mania and mixed episodes. Also used for migraine prevention and seizure disorders.

Common Side Effects

Nausea

Weight gain

Tremor

Hair loss

Liver effects

Sedation

Valproate

Depakote • Depakene • Depakote ER

Anticonvulsant that increases GABA levels. Effective for mania and mixed episodes. Also used for migraine prevention and seizure disorders.

Common Side Effects

Nausea

Weight gain

Tremor

Hair loss

Liver effects

Sedation

Lamotrigine (Lamictal)

Lamictal • Lamictal XR • Lamictal ODT

Anticonvulsant that stabilizes neuronal membranes. Particularly effective for bipolar depression prevention. Requires slow titration to minimize rash risk.

Common Side Effects

Headache

Dizziness

Nausea

Insomnia

Rash (rare but serious)

Blurred vision

Lamotrigine (Lamictal)

Lamictal • Lamictal XR • Lamictal ODT

Anticonvulsant that stabilizes neuronal membranes. Particularly effective for bipolar depression prevention. Requires slow titration to minimize rash risk.

Common Side Effects

Headache

Dizziness

Nausea

Insomnia

Rash (rare but serious)

Blurred vision

Lamotrigine (Lamictal)

Lamictal • Lamictal XR • Lamictal ODT

Anticonvulsant that stabilizes neuronal membranes. Particularly effective for bipolar depression prevention. Requires slow titration to minimize rash risk.

Common Side Effects

Headache

Dizziness

Nausea

Insomnia

Rash (rare but serious)

Blurred vision

Carbamazepine (Tegretol)

Tegretol • Tegretol XR • Equetro

Anticonvulsant that blocks sodium channels. Used for mania and mixed episodes. Significant drug interactions due to enzyme induction.

Common Side Effects

Dizziness

Drowsiness

Nausea

Blood count changes

Hyponatremia

Carbamazepine (Tegretol)

Tegretol • Tegretol XR • Equetro

Anticonvulsant that blocks sodium channels. Used for mania and mixed episodes. Significant drug interactions due to enzyme induction.

Common Side Effects

Dizziness

Drowsiness

Nausea

Blood count changes

Hyponatremia

Carbamazepine (Tegretol)

Tegretol • Tegretol XR • Equetro

Anticonvulsant that blocks sodium channels. Used for mania and mixed episodes. Significant drug interactions due to enzyme induction.

Common Side Effects

Dizziness

Drowsiness

Nausea

Blood count changes

Hyponatremia

Informed Consent Example for Mood Stabilizers

I understand that: Mood stabilizers require regular blood tests to monitor medication levels and check for effects on organs such as the liver, kidneys, and thyroid. I agree to attend all scheduled laboratory appointments. For Lithium: I will maintain consistent salt and fluid intake, avoid dehydration, and report symptoms of toxicity including severe nausea, vomiting, diarrhea, tremor, confusion, or slurred speech immediately. For Valproate: I understand this medication is contraindicated in pregnancy due to risk of birth defects. I will use reliable contraception and inform my provider immediately if pregnancy is suspected. For Lamotrigine: I understand the importance of slow dose titration and will report any rash immediately, as this could indicate a serious skin reaction requiring discontinuation. I will not adjust my dose or stop these medications without consulting my provider, as this may trigger mood episodes.

Informed Consent Example for Mood Stabilizers

I understand that: Mood stabilizers require regular blood tests to monitor medication levels and check for effects on organs such as the liver, kidneys, and thyroid. I agree to attend all scheduled laboratory appointments. For Lithium: I will maintain consistent salt and fluid intake, avoid dehydration, and report symptoms of toxicity including severe nausea, vomiting, diarrhea, tremor, confusion, or slurred speech immediately. For Valproate: I understand this medication is contraindicated in pregnancy due to risk of birth defects. I will use reliable contraception and inform my provider immediately if pregnancy is suspected. For Lamotrigine: I understand the importance of slow dose titration and will report any rash immediately, as this could indicate a serious skin reaction requiring discontinuation. I will not adjust my dose or stop these medications without consulting my provider, as this may trigger mood episodes.

Informed Consent Example for Mood Stabilizers

I understand that: Mood stabilizers require regular blood tests to monitor medication levels and check for effects on organs such as the liver, kidneys, and thyroid. I agree to attend all scheduled laboratory appointments. For Lithium: I will maintain consistent salt and fluid intake, avoid dehydration, and report symptoms of toxicity including severe nausea, vomiting, diarrhea, tremor, confusion, or slurred speech immediately. For Valproate: I understand this medication is contraindicated in pregnancy due to risk of birth defects. I will use reliable contraception and inform my provider immediately if pregnancy is suspected. For Lamotrigine: I understand the importance of slow dose titration and will report any rash immediately, as this could indicate a serious skin reaction requiring discontinuation. I will not adjust my dose or stop these medications without consulting my provider, as this may trigger mood episodes.

Important Warnings

Valproate: Contraindicated in pregnancy due to neural tube defects and developmental disorders. Women of childbearing potential must use effective contraception. Lamotrigine: Risk of Stevens-Johnson Syndrome (SJS) requires slow titration. Discontinue immediately if rash develops. Lithium: Narrow therapeutic index requires regular level monitoring. Toxicity can be life-threatening.

Important Warnings

Valproate: Contraindicated in pregnancy due to neural tube defects and developmental disorders. Women of childbearing potential must use effective contraception. Lamotrigine: Risk of Stevens-Johnson Syndrome (SJS) requires slow titration. Discontinue immediately if rash develops. Lithium: Narrow therapeutic index requires regular level monitoring. Toxicity can be life-threatening.

Important Warnings

Valproate: Contraindicated in pregnancy due to neural tube defects and developmental disorders. Women of childbearing potential must use effective contraception. Lamotrigine: Risk of Stevens-Johnson Syndrome (SJS) requires slow titration. Discontinue immediately if rash develops. Lithium: Narrow therapeutic index requires regular level monitoring. Toxicity can be life-threatening.