Haven and Hope
This blog post provides information on the use of psychotropic drugs. A psychotropic drug describes any drug that affects behavior, mood, thoughts, or perception. “Psychotropic” is an umbrella term that can include illicit drugs, which are more commonly known as psychoactive drugs. This blog will focus on prescription psychotropics and their uses.
More than 50 million adults in the United States report serious mental health conditions. Mental health and well-being affect our daily lives. Psychotropic medications can be important tools to keep us well. Drug allergies are rare. Most expected side effects ease or disappear with time but are still important to monitor.
There are five main categories of psychotropic drugs, which treat many different conditions. These five categories are antidepressants, anti-anxiety agents, stimulants, antipsychotics, and mood stabilizers. Each class works a bit differently, but they also have some similarities. One individual drug may be prescribed for a variety of mental health problems. For instance, an antidepressant drug may also be prescribed for anxiety.
Psychotropic drugs are used alone but may work best with other methods such as therapy and cognitive behavioral therapy. Medications are tools, not cures. They enable relief of symptoms so that the individual is able to make better use of therapy and function in the world. They work by altering neurotransmitters in the brain to improve symptoms. With some medications, symptom relief can take two to three weeks, or even longer, so it is important to give the medication a chance to work before stopping it. Medications are always started at the lowest dose and then can be titrated up if needed. This allows the body to adjust to the medication slowly to avoid potential side effects, and if the lowest dose is effective, a larger dose may not be needed.
Let’s look at each of the five categories individually.
Antidepressants steadily increase the amount of serotonin in the brain. Selective serotonin reuptake inhibitors, called SSRIs, help regulate mood, sleep, and other functions. Norepinephrine selective reuptake inhibitors, or SNRIs, gradually increase norepinephrine in the brain. They help people feel awake and alert. Bupropion promotes important brain activity and can be used to treat seasonal affective disorder or to help people quit smoking.
Side effects can include drowsiness, insomnia, constipation, weight gain or loss, sexual problems, tremors, and dry mouth. You may experience all or none of these.
These medications treat an array of anxiety disorders, such as panic attacks, phobias, generalized anxiety, and anxiety-related symptoms. They can include beta blockers, which help treat physical symptoms of anxiety, such as increased heartbeat, nausea, sweating, and trembling.
Side effects can include blurry vision, headaches, fatigue, confusion, and nightmares.
Stimulants help manage unorganized behavior. They are prescribed for people with attention-deficit disorder (ADD) or attention-deficit/hyperactivity disorder (ADHD). They improve concentration and have a calming effect.
Side effects include insomnia, decreased appetite, and subsequent weight loss.
Antipsychotics help manage psychosis, which describes multiple conditions that affect the mind. A psychosis is often indicated by the person becoming separated from reality and experiencing delusions or hallucinations. Antipsychotics help people with psychosis to think more clearly, feel calmer, sleep better, and communicate more effectively. They can also be used to treat ADHD, depression, and bipolar depression.
Side effects include drowsiness, upset stomach, increased appetite, and weight gain. Some antipsychotics need special monitoring and may require frequent lab tests.
Mood stabilizers help regulate extreme emotions. This doesn’t mean they don’t let you feel at all. They simply help you manage your range of emotions. They are used mainly in bipolar disorder. Some require you to monitor your fluid intake and require that regular blood levels be drawn to determine whether the medication is within the normal range.
Side effects include upset stomach (taking them with food often helps), drowsiness, weight gain, dizziness, tremors, blurry vision, and confusion.
As with any medication, taking extra precautions with psychotropic drugs can help prevent unnecessary complications. Avoid alcohol and illicit drugs while taking psychotropic medications. Don’t stop taking them abruptly. This can cause severe side effects. Contact your doctor immediately if you experience adverse allergic reactions such as fever, rashes, difficulty breathing, or similar serious side effects.
Older adults tend to take more medications and have a higher risk of having negative drug reactions due to missing doses or unintentionally overdosing. They also tend to be more sensitive to medications, so proper dosing and frequency are crucial to managing risks. Always refer to your doctors for advice.
Black Box Warnings
The U.S. Food and Drug Administration (FDA) requires boxed warnings for certain medications or classes of medications for three main reasons.
- The risk of a dangerous adverse reaction must be weighed over its benefits before use.
- A dose adjustment might be needed for safe prescribing.
- A specific group of people, such as children or pregnant women, might need special monitoring for safe use.
A few drugs with black box warnings include:
- Aripiprazole (Abilify) and quetiapine (Seroquel) aren’t FDA approved for anyone under the age of 18 due to the risks of suicidal thoughts and behavior.
- Any antipsychotic medication in older adults with dementia-related psychosis can increase the risk of death.
- Antidepressants can worsen suicidal thoughts and behavior in children and adolescents.
- Stimulant drugs may cause dependence and addiction.
- Benzodiazepines taken with opioid medications can increase the risk of overdose.
- Clozapine (Clozaril) can cause agranulocytosis, a serious blood disorder. If you are taking clozapine, you need to have blood work done to monitor your white blood cell count. It can also cause seizures as well as heart and breathing problems, which can be life-threatening.
In summary, psychotropics have benefits that ease the symptoms of mental illness. They are an adjunct to therapy and behavior modification. They are not a cure. Work with your doctor, ask questions, and monitor both the side effects and benefits carefully to live the fullest life possible for you.
Author Barbara F. Rivers is a registered nurse at the O-School. To learn more about the O-School’s day programs, please visit our website. If you have a child or loved one who you believe may benefit from the O-School’s services, please visit our inquiry page or call our Director of Admissions, Kristin Friesen, at 773-420-2891.
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Haven and Hope is a destination for professionals, educators, and parents to learn from O-School experts about the issues facing children and adolescents with a variety of social-emotional challenges and/or autism, and how various aspects of the School’s 21st century therapeutic milieu provides a safe haven and a path to hope for those in need.