Okay, so, lithium is used to treat bipolar. Metformin is being tested to treat lithium weight gain. Modafinil is sometimes used for treatment resistant depression. And escitalopram is an anti-depressant. All of that, plus the hormones (which some doctors think might help folks with depression), makes me think that the author has a health issue and his biohacking success is actually just reflective of him getting better. I can't see how he could convince a doctor to prescribe these meds otherwise.