The author has provided medical care as an emergency room physician in Detroit General Hospital in Detroit Michigan. The author has provided psychiatric care at Henry Ford Hospital in Detroit Michigan, ARH in Hazard Kentucky, and Antelope Valley Hospital in Lancaster California. The author has provided medical care in prisons in Michigan and California. The author has provided care at Forensic Psychiatric Hospitals including Kalamozoo Psychiatric Hospital, Atascadero State Hospital, and Patton State Hospital. The author has appeared as an expert psychiatric witness in Probate Court, Civil Trials, and Criminal Trials in Michigan, Indiana, Kentucky, and California. The author provides the best practices based on the medical literature currently available. Evidenced based medicine focuses on the lowest effective dose of medication after alternatives to medications have been exhausted by careful consideration of the patient who makes an informed decision as to the treatment.