Psychiatric medication
Encyclopedia
A psychiatric medication is a licensed psychoactive drug
taken to exert an effect on the mental state
and used to treat mental disorders. Usually prescribed in psychiatric
settings, these medications are typically made of synthetic
chemical compound
s, although some are naturally occurring, or at least naturally derived.
, such as a psychiatrist
, or a psychiatric nurse practitioner, PMHNP, before they can be obtained. Some U.S. states and territories, following the creation of the prescriptive authority for psychologists movement
, have granted prescriptive privileges to clinical psychologists who have undergone additional specialised education and training in medical psychology
.
and psychopharmacology do not typically focus on psychedelic
or recreational drugs
, and so the majority of studies are conducted on psychiatric medication. While studies are conducted on all psychoactives drugs by both fields, psychopharmacology focuses on psychoactive and chemical interactions with the brain. Physicians who research psychiatric medications are psychopharmacologists, specialists in the field of psychopharmacology.
Recently there have been more studies into the field of psychedelics, this is due to the fact that this overly demonized class of drugs have recently been found, or atleat admitted to, being beneficial in psychiatry.
. Some of these adverse effects can be further treated by using other medications such as anticholinergic
s (antimuscarinics). Some adverse effects, including the possibility of a sudden or severe re-emergence of psychotic features, may appear when the patient stops taking the drug, particularly if a drug is suddenly discontinued instead of slowly tapered off.
. Antipsychotics are also used as mood stabilizers in the treatment of bipolar disorder
, even if no symptoms of psychosis are present. Antipsychotics are sometimes referred to as neuroleptic drugs and some antipsychotics are branded "major tranquilizers".
There are two categories of antipsychotics: typical antipsychotic
s and atypical antipsychotic
s. Most antipsychotics are available only by prescription.
Common antipsychotics:
Typical antipsychotics
Atypical antipsychotics
, and they are also often used for anxiety and other disorders. Most antidepressants will restrain the catabolism of serotonin
or norepinephrine
or both. Such drugs are called selective serotonin reuptake inhibitor
s (SSRIs), and they actively prevent these neurotransmitter
s from dropping to the levels at which depression is experienced. SSRIs will often take 3–5 weeks to have a noticeable effect: the brain struggles to process the flood of serotonin, and reacts by downregulating the sensitivity of the autoreceptors, which can take up to 5 weeks. Bi-functional SSRIs are currently being researched, which will occupy the autoreceptors instead of 'throttling' serotonin. Another type of antidepressant is a monoamine oxidase inhibitor
, which is thought to block the action of MAO
, an enzyme that breaks down serotonin and norepinephrine
. MAOIs are typically only used when tricyclic antidepressant
s or SSRIs exacerbate or fail to prevent depression.
Common antidepressants:
Hallucinogens used for psychiatric medication include:
discovered that lithium salt
s could control mania
, reducing the frequency and severity of manic episodes. This introduced the now popular drug lithium carbonate
to the mainstream public, as well as being the first mood stabilizer to be approved by the U.S. Food & Drug Administration.
Many antipsychotics are used as mood stabilizers as a drugs of choice. In some regions, first resort still remains a classic mood stabilizer such as lithium carbonate.
Many mood stabilizers are from the drug group of anticonvulsants. The mechanism of action of mood stabilizers is not well elucidated nor understood.
Common mood stabilizers:
, a collection of amphetamine
salts, is one of the most prescribed pharmaceuticals in the treatment of attention-deficit hyperactivity disorder
(ADHD). Stimulants can be addictive, and patients with a history of drug abuse are typically monitored closely or even barred from use and given an alternative. Discontinuing treatment without tapering the dose can cause psychological withdrawal symptoms such as anxiety and drug craving. Many stimulants are not physiologically addictive.
Common stimulants:
s were first used as hypnotic
s and as anxiolytic
s, but as time went on, benzodiazepine
s (Lowell Randall and Leo Sternbach, 1957) were developed in the 1960s and 1970s. Eventually they led to billions of doses being consumed annually. Originally thought to be non-dependence forming in therapeutic doses, unlike barbiturates, as prescriptions increased, problems with addiction and dependence came to light. Benzodiazepines have widely supplanted barbiturates for treatment of almost all conditions in developed countries due to a much greater therapeutic ratio and less proclivity for overdose and toxicity.
Common anxiolytics & hypnotics:
Psychoactive drug
A psychoactive drug, psychopharmaceutical, or psychotropic is a chemical substance that crosses the blood–brain barrier and acts primarily upon the central nervous system where it affects brain function, resulting in changes in perception, mood, consciousness, cognition, and behavior...
taken to exert an effect on the mental state
Mental state
* In psychology, mental state is an indication of a person's mental health**Mental status examination, a structured way of observing and describing a patient's current state of mind...
and used to treat mental disorders. Usually prescribed in psychiatric
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
settings, these medications are typically made of synthetic
Chemical synthesis
In chemistry, chemical synthesis is purposeful execution of chemical reactions to get a product, or several products. This happens by physical and chemical manipulations usually involving one or more reactions...
chemical compound
Chemical compound
A chemical compound is a pure chemical substance consisting of two or more different chemical elements that can be separated into simpler substances by chemical reactions. Chemical compounds have a unique and defined chemical structure; they consist of a fixed ratio of atoms that are held together...
s, although some are naturally occurring, or at least naturally derived.
Administration
Prescription psychiatric medications, like all prescription medications, require a prescription from a physicianPhysician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
, such as a psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
, or a psychiatric nurse practitioner, PMHNP, before they can be obtained. Some U.S. states and territories, following the creation of the prescriptive authority for psychologists movement
Prescriptive authority for psychologists movement
The Prescriptive authority for psychologists movement is a public health initiative to give prescriptive authority to psychologists with 2 years of postdoctoral Masters degreed training in clinical psychopharmacology, followed by 1 - 2 years of supervised prescribing, or a Certificate from the...
, have granted prescriptive privileges to clinical psychologists who have undergone additional specialised education and training in medical psychology
Medical psychology
Medical psychology is a very broad field and has been defined in various ways. The Academy of Medical Psychology's definition applies to both the practices of consultation and prescribing in Medical Psychology, when allowed by statutes...
.
Research
Psychopharmacology studies a wide range of substances with various types of psychoactive properties. The professional and commercial fields of pharmacologyPharmacology
Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...
and psychopharmacology do not typically focus on psychedelic
Psychedelic drug
A psychedelic substance is a psychoactive drug whose primary action is to alter cognition and perception. Psychedelics are part of a wider class of psychoactive drugs known as hallucinogens, a class that also includes related substances such as dissociatives and deliriants...
or recreational drugs
Recreational drug use
Recreational drug use is the use of a drug, usually psychoactive, with the intention of creating or enhancing recreational experience. Such use is controversial, however, often being considered to be also drug abuse, and it is often illegal...
, and so the majority of studies are conducted on psychiatric medication. While studies are conducted on all psychoactives drugs by both fields, psychopharmacology focuses on psychoactive and chemical interactions with the brain. Physicians who research psychiatric medications are psychopharmacologists, specialists in the field of psychopharmacology.
Recently there have been more studies into the field of psychedelics, this is due to the fact that this overly demonized class of drugs have recently been found, or atleat admitted to, being beneficial in psychiatry.
Adverse effects
Psychiatric medications sometimes have adverse effects that may reduce patients' drug complianceCompliance (medicine)
In medicine, compliance describes the degree to which a patient correctly follows medical advice...
. Some of these adverse effects can be further treated by using other medications such as anticholinergic
Anticholinergic
An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. An example of an anticholinergic is dicycloverine, and the classic example is atropine....
s (antimuscarinics). Some adverse effects, including the possibility of a sudden or severe re-emergence of psychotic features, may appear when the patient stops taking the drug, particularly if a drug is suddenly discontinued instead of slowly tapered off.
Types
There are six main groups of psychiatric medications.- AntidepressantAntidepressantAn antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. According to Gelder, Mayou &*Geddes people with a depressive illness will experience a therapeutic effect to their mood;...
s, which treat disparate disorders such as clinical depressionClinical depressionMajor depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
, dysthymia, anxietyAnxietyAnxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
, eating disorderEating disorderEating disorders refer to a group of conditions defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual's physical and mental health. Bulimia nervosa, anorexia nervosa, and binge eating disorder are the most common specific...
s and borderline personality disorderBorderline personality disorderBorderline personality disorder is a personality disorder described as a prolonged disturbance of personality function in a person , characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the...
. - StimulantStimulantStimulants are psychoactive drugs which induce temporary improvements in either mental or physical function or both. Examples of these kinds of effects may include enhanced alertness, wakefulness, and locomotion, among others...
s, which treat disorders such as attention deficit hyperactivity disorder and narcolepsyNarcolepsyNarcolepsy is a chronic sleep disorder, or dyssomnia, characterized by excessive sleepiness and sleep attacks at inappropriate times, such as while at work. People with narcolepsy often experience disturbed nocturnal sleep and an abnormal daytime sleep pattern, which often is confused with insomnia...
, and suppress the appetiteAnorexia (symptom)Anorexia is the decreased sensation of appetite...
. - AntipsychoticAntipsychoticAn antipsychotic is a tranquilizing psychiatric medication primarily used to manage psychosis , particularly in schizophrenia and bipolar disorder. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s...
s, which treat psychoses such as schizophreniaSchizophreniaSchizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
and maniaManiaMania, the presence of which is a criterion for certain psychiatric diagnoses, is a state of abnormally elevated or irritable mood, arousal, and/ or energy levels. In a sense, it is the opposite of depression...
. - Mood stabilizerMood stabilizerA mood stabilizer is a psychiatric medication used to treat mood disorders characterized by intense and sustained mood shifts, typically bipolar disorder.-Uses:...
s, which treat bipolar disorderBipolar disorderBipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
and schizoaffective disorderSchizoaffective disorderSchizoaffective disorder is a psychiatric diagnosis that describes a mental disorder characterized by recurring episodes of elevated or depressed mood, or of simultaneously elevated and depressed mood, that alternate with, or occur together with, distortions in perception.Schizoaffective disorder...
. - AnxiolyticAnxiolyticAn anxiolytic is a drug used for the treatment of anxiety, and its related psychological and physical symptoms...
s, which treat anxiety disorderAnxiety disorderAnxiety disorder is a blanket term covering several different forms of abnormal and pathological fear and anxiety. Conditions now considered anxiety disorders only came under the aegis of psychiatry at the end of the 19th century. Gelder, Mayou & Geddes explains that anxiety disorders are...
s. - DepressantDepressantA depressant, or central depressant, is a drug or endogenous compound that depresses the function or activity of a specific part of the brain...
s, which are used as hypnoticHypnoticHypnotic drugs are a class of psychoactives whose primary function is to induce sleep and to be used in the treatment of insomnia and in surgical anesthesia...
s, sedativeSedativeA sedative or tranquilizer is a substance that induces sedation by reducing irritability or excitement....
s, and anesthetics.
Antipsychotics
Antipsychotics are drugs used to treat various symptoms of psychosis, such as those caused by psychotic disorders or schizophreniaSchizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
. Antipsychotics are also used as mood stabilizers in the treatment of bipolar disorder
Bipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
, even if no symptoms of psychosis are present. Antipsychotics are sometimes referred to as neuroleptic drugs and some antipsychotics are branded "major tranquilizers".
There are two categories of antipsychotics: typical antipsychotic
Typical antipsychotic
Typical antipsychotics are a class of antipsychotic drugs first developed in the 1950s and used to treat psychosis...
s and atypical antipsychotic
Atypical antipsychotic
The atypical antipsychotics are a group of antipsychotic tranquilizing drugs used to treat psychiatric conditions. Some atypical antipsychotics are FDA approved for use in the treatment of schizophrenia...
s. Most antipsychotics are available only by prescription.
Common antipsychotics:
Typical antipsychotics
- ChlorpromazineChlorpromazineChlorpromazine is a typical antipsychotic...
(Thorazine) - HaloperidolHaloperidolHaloperidol is a typical antipsychotic. It is in the butyrophenone class of antipsychotic medications and has pharmacological effects similar to the phenothiazines....
(Haldol) - PerphenazinePerphenazinePerphenazine is a typical antipsychotic drug. Chemically, it is classified as a piperazinyl phenothiazine. It has been in clinical use for decades....
(Trilafon) - ThioridazineThioridazineThioridazine is a piperidine typical antipsychotic drug belonging to the phenothiazine drug group and was previously widely used in the treatment of schizophrenia and psychosis...
(Melleril) - ThiothixeneThiothixeneThiothixene is a typical antipsychotic drug of the thioxanthene class used in the treatment of psychoses like schizophrenia. It was introduced on July 24, 1967 by Pfizer.-Chemistry:*Bloom, B. M.; Muren, J. F.; 1967, See also:...
(Navane) - Flupenthixol (Fluanxol)
- TrifluoperazineTrifluoperazineTrifluoperazine is a typical antipsychotic of the phenothiazine chemical class.- Uses :...
(Stelazine)
Atypical antipsychotics
- AripiprazoleAripiprazoleAripiprazole is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression...
(Abilify) - ClozapineClozapineClozapine is an antipsychotic medication used in the treatment of schizophrenia, and is also used off-label in the treatment of bipolar disorder. Wyatt. R and Chew...
(Clozaril) - OlanzapineOlanzapineOlanzapine is an atypical antipsychotic, approved by the FDA for the treatment of schizophrenia and bipolar disorder...
(Zyprexa) - QuetiapineQuetiapineQuetiapine , is an atypical antipsychotic approved for the treatment of schizophrenia, and bipolar disorder....
(Seroquel) - RisperidoneRisperidoneRisperidone is a second generation or atypical antipsychotic, sold under the trade name . It is used to treat schizophrenia , schizoaffective disorder, the mixed and manic states associated with bipolar disorder, and irritability in people with autism...
(Risperdal) - ZiprasidoneZiprasidoneZiprasidone was the fifth atypical antipsychotic to gain FDA approval . In the United States, Ziprasidone is Food and Drug Administration approved for the treatment of schizophrenia, and the intramuscular injection form of ziprasidone is approved for acute agitation in schizophrenic patients...
(Geodon)
Antidepressants
Antidepressants are drugs used to treat clinical depressionClinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
, and they are also often used for anxiety and other disorders. Most antidepressants will restrain the catabolism of serotonin
Serotonin
Serotonin or 5-hydroxytryptamine is a monoamine neurotransmitter. Biochemically derived from tryptophan, serotonin is primarily found in the gastrointestinal tract, platelets, and in the central nervous system of animals including humans...
or norepinephrine
Norepinephrine
Norepinephrine is the US name for noradrenaline , a catecholamine with multiple roles including as a hormone and a neurotransmitter...
or both. Such drugs are called selective serotonin reuptake inhibitor
Selective serotonin reuptake inhibitor
Selective serotonin re-uptake inhibitors or serotonin-specific reuptake inhibitor are a class of compounds typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders. The efficacy of SSRIs is disputed...
s (SSRIs), and they actively prevent these neurotransmitter
Neurotransmitter
Neurotransmitters are endogenous chemicals that transmit signals from a neuron to a target cell across a synapse. Neurotransmitters are packaged into synaptic vesicles clustered beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to...
s from dropping to the levels at which depression is experienced. SSRIs will often take 3–5 weeks to have a noticeable effect: the brain struggles to process the flood of serotonin, and reacts by downregulating the sensitivity of the autoreceptors, which can take up to 5 weeks. Bi-functional SSRIs are currently being researched, which will occupy the autoreceptors instead of 'throttling' serotonin. Another type of antidepressant is a monoamine oxidase inhibitor
Monoamine oxidase inhibitor
Monoamine oxidase inhibitors are a class of antidepressant drugs prescribed for the treatment of depression. They are particularly effective in treating atypical depression....
, which is thought to block the action of MAO
Monoamine oxidase
L-Monoamine oxidases are a family of enzymes that catalyze the oxidation of monoamines. They are found bound to the outer membrane of mitochondria in most cell types in the body. The enzyme was originally discovered by Mary Bernheim in the liver and was named tyramine oxidase...
, an enzyme that breaks down serotonin and norepinephrine
Norepinephrine
Norepinephrine is the US name for noradrenaline , a catecholamine with multiple roles including as a hormone and a neurotransmitter...
. MAOIs are typically only used when tricyclic antidepressant
Tricyclic antidepressant
Tricyclic antidepressants are heterocyclic chemical compounds used primarily as antidepressants. The TCAs were first discovered in the early 1950s and were subsequently introduced later in the decade; they are named after their chemical structure, which contains three rings of atoms...
s or SSRIs exacerbate or fail to prevent depression.
Common antidepressants:
- FluoxetineFluoxetineFluoxetine is an antidepressant of the selective serotonin reuptake inhibitor class. It is manufactured and marketed by Eli Lilly and Company...
(Prozac), SSRI - ParoxetineParoxetineParoxetine is an SSRI antidepressant. Marketing of the drug began in 1992 by the pharmaceutical company SmithKline Beecham, now GlaxoSmithKline...
(Paxil, Seroxat), SSRI - CitalopramCitalopramCitalopram brand names: Celexa, Cipramil) is an antidepressant drug of the selective serotonin reuptake inhibitor class. It has U.S...
(Celexa), SSRI - EscitalopramEscitalopramEscitalopram is an antidepressant of the selective serotonin reuptake inhibitor class. It is approved by the U.S...
(Lexapro), SSRI - SertralineSertralineSertraline hydrochloride is an antidepressant of the selective serotonin reuptake inhibitor class. It was introduced to the market by Pfizer in 1991. Sertraline is primarily used to treat major depression in adult outpatients as well as obsessive–compulsive, panic, and social anxiety disorders in...
(Zoloft), SSRI - DuloxetineDuloxetineDuloxetine is a serotonin-norepinephrine reuptake inhibitor manufactured and marketed by Eli Lilly. It is effective for major depressive disorder and has been shown to be as effective as venlafaxine for generalized anxiety disorder...
(Cymbalta), SNRISNRISNRI may refer to:* Serotonin–norepinephrine reuptake inhibitor* Strategic Naval Research Institute... - VenlafaxineVenlafaxineVenlafaxine is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class. First introduced by Wyeth in 1993, now marketed by Pfizer, it is licensed for the treatment of major depressive disorder , as a treatment for generalized anxiety disorder, and comorbid indications in...
(Effexor), SNRISNRISNRI may refer to:* Serotonin–norepinephrine reuptake inhibitor* Strategic Naval Research Institute... - BupropionBupropionBupropion is an atypical antidepressant and smoking cessation aid. The drug is a non-tricyclic antidepressant and differs from most commonly prescribed antidepressants such as SSRIs, as its primary pharmacological action is thought to be norepinephrine-dopamine reuptake inhibition...
(Wellbutrin), NDRINorepinephrine-dopamine reuptake inhibitorA norepinephrine-dopamine reuptake inhibitor is a drug which acts as a reuptake inhibitor for the neurotransmitters norepinephrine and dopamine by blocking the action of the norepinephrine transporter and the dopamine transporter , respectively... - MirtazapineMirtazapineMirtazapine is a tetracyclic antidepressant used primarily in the treatment of depression. It is also sometimes used as a hypnotic, antiemetic, and appetite stimulant, and for the treatment of anxiety, among other indications...
(Remeron), NaSSA - IsocarboxazidIsocarboxazidIsocarboxazid is an irreversible and nonselective monoamine oxidase inhibitor of the hydrazine chemical class used as an antidepressant and anxiolytic...
(Marplan), MAOI - PhenelzinePhenelzinePhenelzine is a non-selective and irreversible monoamine oxidase inhibitor of the hydrazine class which is used as an antidepressant and anxiolytic...
(Nardil), MAOI
Hallucinogens
Hallucinogens have been used in psychiatric medication in the past, and are currently being reevaluated for several uses. Contrary to their demonized public image, many hallucinogens and psychedelics have shown vastly better potential for actual curing of mental diseases that current medications only temporarily fix and in most cases worsen over time.Hallucinogens used for psychiatric medication include:
- LSDLSDLysergic acid diethylamide, abbreviated LSD or LSD-25, also known as lysergide and colloquially as acid, is a semisynthetic psychedelic drug of the ergoline family, well known for its psychological effects which can include altered thinking processes, closed and open eye visuals, synaesthesia, an...
- PsilocybinPsilocybinPsilocybin is a naturally occurring psychedelic prodrug, with mind-altering effects similar to those of LSD and mescaline, after it is converted to psilocin. The effects can include altered thinking processes, perceptual distortions, an altered sense of time, and spiritual experiences, as well as...
- MescalineMescalineMescaline or 3,4,5-trimethoxyphenethylamine is a naturally occurring psychedelic alkaloid of the phenethylamine class used mainly as an entheogen....
- IbogaineIbogaineIbogaine is a naturally occurring psychoactive substance found in a number of plants, principally in a member of the Apocynaceae family known as Iboga . A hallucinogen with both psychedelic and dissociative properties, the substance is banned in some countries; in other countries it is being used...
- CannabisCannabisCannabis is a genus of flowering plants that includes three putative species, Cannabis sativa, Cannabis indica, and Cannabis ruderalis. These three taxa are indigenous to Central Asia, and South Asia. Cannabis has long been used for fibre , for seed and seed oils, for medicinal purposes, and as a...
- DMTDMTDMT may refer to:In chemical substances:* Dimethyltryptamine, a psychedelic tryptamine* Dimethyl terephthalate, a polyester precursor* Desoxymethyltestosterone, a designer anabolic steroid...
Mood stabilizers
In 1949, the Australian John CadeJohn Cade
For the former Maryland State Senator, see John A. CadeFor the Louisiana Republican state chairman, see John H. Cade, Jr.Dr John Frederick Joseph Cade AO was an Australian psychiatrist credited with discovering the effects of lithium carbonate as a mood stabilizer in the treatment of bipolar...
discovered that lithium salt
Lithium pharmacology
Lithium pharmacology refers to use of the lithium ion, Li+, as a drug. A number of chemical salts of lithium are used medically as a mood stabilizing drug, primarily in the treatment of bipolar disorder, where they have a role in the treatment of depression and particularly of mania, both acutely...
s could control mania
Mania
Mania, the presence of which is a criterion for certain psychiatric diagnoses, is a state of abnormally elevated or irritable mood, arousal, and/ or energy levels. In a sense, it is the opposite of depression...
, reducing the frequency and severity of manic episodes. This introduced the now popular drug lithium carbonate
Lithium carbonate
Lithium carbonate is a chemical compound of lithium, carbon, and oxygen with the formula Li2CO3. This colorless salt is widely used in the processing of metal oxides and has received attention for its use in psychiatry. It is found in nature as the rare mineral zabuyelite.-Properties:Like almost...
to the mainstream public, as well as being the first mood stabilizer to be approved by the U.S. Food & Drug Administration.
Many antipsychotics are used as mood stabilizers as a drugs of choice. In some regions, first resort still remains a classic mood stabilizer such as lithium carbonate.
Many mood stabilizers are from the drug group of anticonvulsants. The mechanism of action of mood stabilizers is not well elucidated nor understood.
Common mood stabilizers:
- Lithium CarbonateLithium carbonateLithium carbonate is a chemical compound of lithium, carbon, and oxygen with the formula Li2CO3. This colorless salt is widely used in the processing of metal oxides and has received attention for its use in psychiatry. It is found in nature as the rare mineral zabuyelite.-Properties:Like almost...
(Carbolith), first and typical mood stabilizer - CarbamazepineCarbamazepineCarbamazepine is an anticonvulsant and mood-stabilizing drug used primarily in the treatment of epilepsy and bipolar disorder, as well as trigeminal neuralgia...
(Tegretol), anticonvulsant and mood stabilizer - OxcarbazepineOxcarbazepineOxcarbazepine is a anticholinergic anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy. It is also used to treat anxiety and mood disorders, and benign motor tics...
(Trileptal), anticonvulsant and mood stabilizer - Valproic acidValproic acidValproic acid is a chemical compound that has found clinical use as an anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy, bipolar disorder, and, less commonly, major depression. It is also used to treat migraine headaches and schizophrenia...
, and Valproic acid salts (Depakine, Depakote), anticonvulsant and mood stabilizer - LamotrigineLamotrigineLamotrigine, marketed in the US and most of Europe as Lamictal by GlaxoSmithKline, is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. It is also used as an adjunct in treating depression, though this is considered off-label usage...
(Lamictal), atypical anticonvulsant and mood stabilizer - GabapentinGabapentinGabapentin is a pharmaceutical drug, specifically a GABA analogue. It was originally developed for the treatment of epilepsy, and currently is also used to relieve neuropathic pain...
, atypical GABAGabâGabâ or gabaa, for the people in many parts of the Philippines), is the concept of a non-human and non-divine, imminent retribution. A sort of negative karma, it is generally seen as an evil effect on a person because of their wrongdoings or transgressions...
-related anticonvulsant and mood stabilizer - PregabalinPregabalinPregabalin is an anticonvulsant drug used for neuropathic pain and as an adjunct therapy for partial seizures with or without secondary generalization in adults. It has also been found effective for generalized anxiety disorder and is approved for this use in the European Union. It was designed...
, atypical GABA-ergic anticonvulsant and mood stabilizer - TopiramateTopiramateTopiramate is an anticonvulsant drug. It was originally produced by Ortho-McNeil Neurologics and Noramco, Inc., both divisions of the Johnson & Johnson Corporation. This medication was discovered in 1979 by Bruce E. Maryanoff and Joseph F. Gardocki during their research work at McNeil...
, GABAGabâGabâ or gabaa, for the people in many parts of the Philippines), is the concept of a non-human and non-divine, imminent retribution. A sort of negative karma, it is generally seen as an evil effect on a person because of their wrongdoings or transgressions...
-receptor related anticonvulsant and mood-stabilizer - OlanzapineOlanzapineOlanzapine is an atypical antipsychotic, approved by the FDA for the treatment of schizophrenia and bipolar disorder...
, atypical antipsychotic and mood stabilizer
Stimulants
Stimulants are some of the most widely prescribed drugs today. A stimulant is any drug that stimulates the central nervous system. AdderallAdderall
Adderall is a brand name of amphetamine salts–based medication used for attention-deficit hyperactivity disorder and narcolepsy. It is a brand-name psychostimulant medication composed of racemic amphetamine aspartate monohydrate, racemic amphetamine sulfate, dextroamphetamine saccharide, and...
, a collection of amphetamine
Amphetamine
Amphetamine or amfetamine is a psychostimulant drug of the phenethylamine class which produces increased wakefulness and focus in association with decreased fatigue and appetite.Brand names of medications that contain, or metabolize into, amphetamine include Adderall, Dexedrine, Dextrostat,...
salts, is one of the most prescribed pharmaceuticals in the treatment of attention-deficit hyperactivity disorder
Attention-deficit hyperactivity disorder
Attention deficit hyperactivity disorder is a developmental disorder. It is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms starting before seven years of age.ADHD is the most commonly studied and...
(ADHD). Stimulants can be addictive, and patients with a history of drug abuse are typically monitored closely or even barred from use and given an alternative. Discontinuing treatment without tapering the dose can cause psychological withdrawal symptoms such as anxiety and drug craving. Many stimulants are not physiologically addictive.
Common stimulants:
- CaffeineCaffeineCaffeine is a bitter, white crystalline xanthine alkaloid that acts as a stimulant drug. Caffeine is found in varying quantities in the seeds, leaves, and fruit of some plants, where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants...
, typical methylxanthine stimulant, found in many edibles worldwide - MethylphenidateMethylphenidateMethylphenidate is a psychostimulant drug approved for treatment of attention-deficit hyperactivity disorder, postural orthostatic tachycardia syndrome and narcolepsy. It may also be prescribed for off-label use in treatment-resistant cases of lethargy, depression, neural insult and obesity...
(Ritalin, Concerta), atypical stimulant - DexmethylphenidateDexmethylphenidateDexmethylphenidate, otherwise known as d-threo-methylphenidate , is the dextrorotatory enantiomer of methylphenidate. It is a norepinephrine-dopamine reuptake inhibitor and releasing agent and thus a psychostimulant, which affects the CNS...
(Focalin), active D-isomer of methylphenidate - DextroamphetamineDextroamphetamineDextroamphetamine is a psychostimulant drug which is known to produce increased wakefulness and focus as well as decreased fatigue and decreased appetite....
(Dexedrine), more active amphetamine isomer - DextroamphetamineDextroamphetamineDextroamphetamine is a psychostimulant drug which is known to produce increased wakefulness and focus as well as decreased fatigue and decreased appetite....
& levoamphetamineAmphetamineAmphetamine or amfetamine is a psychostimulant drug of the phenethylamine class which produces increased wakefulness and focus in association with decreased fatigue and appetite.Brand names of medications that contain, or metabolize into, amphetamine include Adderall, Dexedrine, Dextrostat,...
(Adderall), D,L -Amphetamine salt mix - MethamphetamineMethamphetamineMethamphetamine is a psychostimulant of the phenethylamine and amphetamine class of psychoactive drugs...
(Desoxyn), potent amphetamphetamine-based stimulant - ModafinilModafinilModafinil is an analeptic drug manufactured by Cephalon, and is approved by the U.S. Food and Drug Administration for the treatment of narcolepsy, shift work sleep disorder, and excessive daytime sleepiness associated with obstructive sleep apnea...
(Provigil) , a stimulant related to sildenafil (Viagra)
Anxiolytics & hypnotics
BarbiturateBarbiturate
Barbiturates are drugs that act as central nervous system depressants, and can therefore produce a wide spectrum of effects, from mild sedation to total anesthesia. They are also effective as anxiolytics, as hypnotics, and as anticonvulsants...
s were first used as hypnotic
Hypnotic
Hypnotic drugs are a class of psychoactives whose primary function is to induce sleep and to be used in the treatment of insomnia and in surgical anesthesia...
s and as anxiolytic
Anxiolytic
An anxiolytic is a drug used for the treatment of anxiety, and its related psychological and physical symptoms...
s, but as time went on, benzodiazepine
Benzodiazepine
A benzodiazepine is a psychoactive drug whose core chemical structure is the fusion of a benzene ring and a diazepine ring...
s (Lowell Randall and Leo Sternbach, 1957) were developed in the 1960s and 1970s. Eventually they led to billions of doses being consumed annually. Originally thought to be non-dependence forming in therapeutic doses, unlike barbiturates, as prescriptions increased, problems with addiction and dependence came to light. Benzodiazepines have widely supplanted barbiturates for treatment of almost all conditions in developed countries due to a much greater therapeutic ratio and less proclivity for overdose and toxicity.
Common anxiolytics & hypnotics:
- DiazepamDiazepamDiazepam , first marketed as Valium by Hoffmann-La Roche is a benzodiazepine drug. Diazepam is also marketed in Australia as Antenex. It is commonly used for treating anxiety, insomnia, seizures including status epilepticus, muscle spasms , restless legs syndrome, alcohol withdrawal,...
(Valium), benzodiazepine derivative, anxiolytic - NitrazepamNitrazepamNitrazepam is a type of benzodiazepine drug and is marketed in English-speaking countries under the following brand names: Alodorm, Arem, Insoma, Mogadon, Nitrados, Nitrazadon, Ormodon, Paxadorm, Remnos, and Somnite...
(Mogadon), benzodiazepine derivative, hypnotic - ZolpidemZolpidemZolpidem is a prescription medication used for the short-term treatment of insomnia, as well as some brain disorders. It is a short-acting nonbenzodiazepine hypnotic of the imidazopyridine class that potentiates gamma-aminobutyric acid , an inhibitory neurotransmitter, by binding to GABAA...
(Ambien, Stilnox), an imidazopyridineImidazopyridineThe imidazopyridines are a class of drugs defined by their chemical structure. They are generally GABAA receptor agonists, however recently proton pump inhibitors in this class have been developed as well. Despite usually being similar to them in effect, they are not chemically related to...
, non-benzodiazepine hypnotic - ZopicloneZopicloneZopiclone is a non-benzodiazepine hypnotic agent used in the treatment of insomnia. In the United States, zopiclone is not commercially available, although its active stereoisomer, eszopiclone, is sold under the name Lunesta...
(Imovan), non-benzodiazepine hypnotic ("Z-drug") - ZaleplonZaleplonZaleplon is a sedative/hypnotic, mainly used for insomnia. It is a nonbenzodiazepine hypnotic from the pyrazolopyrimidine class. In terms of adverse effects zaleplon appears to offer little improvement compared to both benzodiazepines and other non-benzodiazepine Z-drugs.Sonata is manufactured by...
(Sonata), non-benzodiazepine hypnotic ("Z-drug") - ChlordiazepoxideChlordiazepoxideChlordiazepoxide, is a sedative/hypnotic drug and benzodiazepine. It is marketed under the trade names Angirex, Klopoxid, Librax , Libritabs, Librium, Mesural, Multum, Novapam, Risolid, Silibrin, Sonimen and Tropium.Chlordiazepoxide was the first benzodiazepine to be synthesised and...
(Librium), benzodiazepine derivative, anxiolytic - AlprazolamAlprazolamAlprazolam is a short-acting anxiolytic of the benzodiazepine class of psychoactive drugs. Alprazolam, like other benzodiazepines, binds to specific sites on the GABAA gamma-amino-butyric acid receptor...
(Xanax), benzodiazepine derivative, anxiolytic - TemazepamTemazepamTemazepam is an intermediate-acting 3-hydroxy benzodiazepine. It is mostly prescribed for the short-term treatment of sleeplessness in patients who have difficulty maintaining sleep...
(Restoril), benzodiazepine derivative - ClonazepamClonazepamClonazepamis a benzodiazepine drug having anxiolytic, anticonvulsant, muscle relaxant, and hypnotic properties. It is marketed by Roche under the trade name Klonopin in the United States and Rivotril in Australia, Brazil, Canada and Europe...
(Klonopin), benzodiazepine derivative - LorazepamLorazepamLorazepam is a high-potency short-to-intermediate-acting 3-hydroxy benzodiazepine drug that has all five intrinsic benzodiazepine effects: anxiolytic, amnesic, sedative/hypnotic, anticonvulsant, antiemetic and muscle relaxant...
(Ativan), benzodiazepine derivative, anxiolytic
See also
- MedicationMedicationA pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
- MedicineMedicineMedicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
- Psychoactive drugPsychoactive drugA psychoactive drug, psychopharmaceutical, or psychotropic is a chemical substance that crosses the blood–brain barrier and acts primarily upon the central nervous system where it affects brain function, resulting in changes in perception, mood, consciousness, cognition, and behavior...
- PsychopharmacologyPsychopharmacologyPsychopharmacology is the scientific study of the actions of drugs and their effects on mood, sensation, thinking, and behavior...
- PsychiatryPsychiatryPsychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...