Psychiatric medication

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 compounds, although some are naturally occurring, or at least naturally derived.

Contents

Administration

Prescription psychiatric medications, like all prescription medications, require a prescription from a physician, 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.[1]

Research

Psychopharmacology studies a wide range of substances with various types of psychoactive properties. The professional and commercial fields of pharmacology 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.

Adverse effects

Psychiatric medications sometimes have adverse effects that may reduce patients' drug compliance. Some of these adverse effects can be further treated by using other medications such as anticholinergics (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.[2]

Types

There are six main groups of psychiatric medications.

Antipsychotics

Antipsychotics are drugs used to treat various symptoms of psychosis, such as those caused by psychotic disorders or schizophrenia. 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 antipsychotics and atypical antipsychotics. Most antipsychotics are available only by prescription.

Common antipsychotics:[4]

Typical antipsychotics

Atypical antipsychotics

Antidepressants

Antidepressants are drugs used to treat clinical depression, 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 inhibitors (SSRIs), and they actively prevent these neurotransmitters 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 antidepressants or SSRIs exacerbate or fail to prevent depression.

Common antidepressants:[5]

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:

Mood stabilizers

In 1949, the Australian John Cade discovered that lithium salts 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:

Stimulants

Stimulants are some of the most widely prescribed drugs today. A stimulant is any drug that stimulates the central nervous system. Adderall, 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:

Anxiolytics & hypnotics

Barbiturates were first used as hypnotics and as anxiolytics, but as time went on, benzodiazepines (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:

See also

References

  1. ^ Murray, Bridget (October 2003). "A Brief History of RxP". APA Monitor. http://www.apa.org/monitor/oct03/rxp.html. Retrieved 4/11/2007. 
  2. ^ Moncrieff, Joanna (23 March 2006). "Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse". Acta Psychiatrica Scandinavica (John Wiley & Sons A/S) 114 (1): 3–13. doi:10.1111/j.1600-0447.2006.00787.x. ISSN 1600-0447. PMID 16774655. http://www3.interscience.wiley.com/journal/118626311/abstract. Retrieved 3 May 2009. 
  3. ^ Schatzberg, A.F. (2000). "New indications for antidepressants". Journal of Clinical Psychiatry 61 (11): 9–17. PMID 10926050. 
  4. ^ "Tardive dyskinesia". http://www.healthatoz.com/healthatoz/Atoz/ency/tardive_dyskinesia.jsp. 
  5. ^ "Monoamine Oxidase Inhibitors". http://www.healthyplace.com/Communities/depression/treatment/antidepressants/maoi.asp. 
  6. ^ Stephen M. Stahl, M.D., Ph.D.; et al. (2004) (pdf). A Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor. Journal of Clinical Psychiatry; 6(04) 159-166 2004 PHYSICIANS POSTGRADUATE PRESS, INC. http://www.psychiatrist.com/pcc/pccpdf/v06n04/v06n0403.pdf. Retrieved 2006-09-02. 

External links