Mental Health Medications
A variety of medications are used to treat the symptoms of mental disorders. None of these medications cure the disorder, so they usually need to be taken for a long period of time. Most mental health medications must be taken every day, even if it does not feel like they are needed. Antipsychotic medications can turn off the “voices” heard by some people with schizophrenia and help them to see reality more clearly. Antidepressants can lift the dark moods of depression. The degree of response - ranging from a little relief of symptoms to complete relief - depends on a variety of factors related to the individual and the disorder being treated.
Mental health medications were first introduced in the early 1950s with the antipsychotic chlorpromazine. Other medications have followed. These medications have changed the lives of people with these disorders for the better.
Medications often make other kinds of treatment more effective. Someone who is too depressed to talk may have difficulty communicating during psychotherapy or counseling, but the right medication may improve symptoms so the person can respond. In many cases a combination of psychotherapy and medication can be an effective method of treatment.
A person who is psychotic is out of touch with reality. People with psychosis may hear voices (hallucinations) or have strange and illogical ideas (delusions). Delusions may consist of thinking that others can hear their thoughts, that others are trying to harm them, or that they are a famous person). They may get excited or angry for no apparent reason, or spend a lot of time by themselves, or in bed, sleeping during the day and staying awake at night. The person may neglect appearance and may be hard to talk to. They may be unaware that their condition is an illness. Schizophrenia is an example of a psychosis.
Antipsychotic medications assist in a number of ways. They often calm down the hallucinations and delusions, or at least make them more manageable. Some antipsychotic medications also help the person interact more normally with others. They may become more social and less isolated, and begin to take an interest in their grooming and appearance.
There are a number of antipsychotic medications available, all of which have been shown to be effective in treating schizophrenia. The medications affect the chemicals that allow communication between nerve cells (neurotransmitters). One such neurotransmitter, dopamine, is thought to be involved in schizophrenia symptoms. Many of these medications target dopamine in one way or another.
Some antipsychotic medications are stronger than others. These medications also differ in their side-effect profiles. The early antipsychotic medications, introduced in the 1950s, had unpleasant side effects, such as muscle stiffness, tremor, and abnormal movements. Newer “atypical” antipsychotic medications do not have these side-effects, but may have other, milder side-effects.
The first atypical antipsychotic, clozapine (Clozaril), was introduced in the United States in 1990. It was found to be more effective than conventional or “typical” antipsychotic medications with a lower risk of the movement disorder “tardive dyskinesia”. Patients who are on clozapine must have a blood test every 1 or 2 weeks because it can cause a serious blood disorder. Newer atypical antipsychotic medications do not carry this risk.
Several other atypical antipsychotics have been developed since clozapine was introduced. The first was risperidone (Risperdal), followed by olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), and aripiprazole (Abilify). Each has a unique side effect profile, but in general, these medications cause fewer and milder side effects than the earlier drugs. Most side effects of antipsychotic medications are mild. Many common ones lessen or disappear after the first few weeks of treatment. These include drowsiness, rapid heartbeat, and dizziness when changing position.
Some people gain weight while taking medications and need to pay extra attention to diet and exercise to control their weight. Other side effects may include a decrease in sexual ability or interest, problems with menstrual periods, sunburn, or skin rashes. If a side effect occurs, the doctor should be told. He or she may prescribe a different medication, change the dosage or schedule, or prescribe an additional medication to control the side effects.
Antipsychotic medications can produce unwanted effects when taken with other medications. Be sure that your doctor knows about all other medications that you are taking, including any herbal medications such as St. John’s Wort. If you are prescribed any mental health medication, be sure to read the patient information that accompanies your medication. It will describe the medication, how it should be taken, and side effects to look for.