A Brief Overview of Psychiatric Medications and What They Do

By Lucy Gleysteen

From PHN Issue 40, Summer/Fall 2019

Below is a brief overview of psychiatric medications, what they are typically used to treat, their purpose, and common side effects.

Antipsychotics

The primary purpose of antipsychotics is to treat psychosis. Psychosis can involve the presence of delusions or hallucinations. They can also be used in combination with other drugs to treat other conditions.

Used to T reat: Schizophrenia, schizoaffective disorder . Typical antipsychotics can be used in combination with other drugs to treat attention-deficit hyperactivity disorder (ADHD), severe depression, eating disorders, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), generalized anxiety disorder

Typical Antipsychotics

Typical antipsychotics are also known as first generation antipsychotics. Their use has declined over recent years because they have more severe side effects. However, since they are less expensive than atypical antipsychotics, they are still frequently used.

Typical Antipsychotics

• Thorazine (chlorpromazine)
• Trilafon (perphenazine)
• Stelazine (trifluoperazine)
• Serentil (mesoridazine)
• Prolixin (fluphenazine)
• Navane (thiothixene)
• Moban (molindone)
• Mellaril (thioridazine)
• Loxitane (loxapine)
• Haldol (haloperidol)

Side Effects:

• Twisting, repeated movements (dystonia)
• Restlessness
• Tremor, muscles feeling stuck (Parkinsonism)
• Muscles in face and body feeling stiff and moving without being in control (tardive dyskinesia). This can be permanent. You might take a medication like Cogentin to treat these side effects.
• Other common side effects might include drowsiness, dry mouth, or weight gain

Atypical Antipsychotics

These are the most commonly prescribed medications for treating psychosis.

Atypical Antipsychotics

• Abilify (aripiprazole)
• Clozaril (clozapine)
• Geodon (ziprasidone)
• Risperdal (risperidone)
• Seroquel (quetiapine)
• Zyprexa (olanzapine)

Side Effects:

• High blood pressure
• Weight gain
• High cholesterol
• High blood sugar (metabolic syndrome)
• If you are on Clozaril (Clozapine), you need blood work every month to count your white blood cells.

Stimulants

They can help regulate disorganized thought processes. Stimulants increase alertness, attention, and energy.

Used to Treat: Attention-deficit hyperactivity disorder (ADHD)

• Adderall XR (amphetamine)
• Concerta (methylphenidate)
• Dexedrine (amphetamine)
• Evekeo (amphetamine)
• Focalin XR (dexmethylphenidate)
• Quillivant XR (methylphenidate)
• Ritalin (methylphenidate)
• Strattera (atomoxetine hydrochloride)
• Vyvanse (lisdexamfetamine dimesylate)

Side Effects:

• Difficulty falling or staying asleep
• Loss of appetite
• Stomach pain
• Headache

Antidepressants

Antidepressants work by balancing chemicals in the brain called neurotransmitters that affect mood and emotion. They work to improve mood, sleep, appetite, and concentration.

Used to Treat: Primarily used for depression and anxiety. Can also be used to treat insomnia, ADHD, and nerve pain.

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are a commonly prescribed antidepressant. They can ease depression by increasing levels of serotonin in the brain. Serotonin is a neurotransmitter, or chemical messenger in the brain that is believed to have an effect on mood.

SSRIs:

• Celexa (citalopram)
• Lexapro (escitalopram)
• Luvox (fluvoxamine)
• Paxil (paroxetine)
• Prozac (fluoxetine)
• Zoloft (sertraline)

Side Effects:

• Drowsiness
• Nausea
• Dry mouth
• Insomnia
• Diarrhea
• Nervousness
• Dizziness
• Sexual problems (difficulty reaching orgasm or difficulty maintaining an erection)

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs work slowly by increasing the amount of norepinephrine in the brain. Like serotonin, norepinephrine is a neurotransmitter, or chemical messenger in the brain that is believed to have an effect on mood.

SNRIs:

• Pristiq (desvenlafaxine)
• Effexor (venlafaxine)
• Cymbalta (duloxetine)

Side Effects:

• Nausea
• Dry mouth
• Insomnia
• Dizziness
• Sexual problems (difficulty reaching orgasm or difficulty maintaining an erection)

Tricyclics (TCAs)

An earlier form of antidepressants. They are effective but are usually replaced with antidepressants that have fewer side effects. They affect brain chemicals (increasing serotonin and norepinephrine) to ease depression symptoms.

TCAs:

• Anafranil (clomipramine)
• Asendin (amoxapine)
• Elavil (amitriptyline)
• Norpramin (desipramine)
• Pamelor (nortriptyline)
• Sinequan (doxepin)
• Surmontil (trimipramine)
• Tofranil (imipramine)
• Vivactil (protriptyline)

Side Effects:

• Blurred vision
• Dry mouth
• Constipation
• Weight gain or loss
• Low blood pressure
• Rash
• Hives
• Increased heart rate
• Sexual problems

Monoamine Oxidase Inhibitors (MAOIs)

MAOIs target a substance in the brain that decreases serotonin, norepinephrine, and dopamine which are all chemical messengers that are thought to impact mood.

MAOIs

• Emsam (selegiline)
• Marplan (isocarboxazid)
• Nardil (phenelzine)
• Parnate (tranylcypromine)

Side Effects:

• Dry mouth
• Nausea
• Headache
• Drowsiness
• Insomnia
• Dizziness, or light-headedness
• Skin reaction
• Involuntary muscle jerks
• Low blood pressure
• Reduced sexual desire
• Weight gain
• Difficulty starting urine flow
• Muscle cramps
• Prickling or tingling sensations in the skin
• There are many foods you cannot eat if you are taking this medication. Be sure to speak with your prescriber

Benzodiazepines

Benzodiazepines increase the amount of GABA in your brain. GABA is a chemical messenger that decreases unwanted activity in the brain. Benzodiazepines are very addictive. If you have been taking benzodiazepines for a while, you cannot stop abruptly. The withdrawal from benzodiazepines can be deadly.

Used to Treat: Anxiety and panic disorders

Benzodiazepines

• Ativan (lorazepam)
• Klonopin (clonazepam)
• Xanax (alprazolam)

Side Effects:

• Drowsiness
• Confusion
• Dizziness
• Trembling
• Impaired coordination
• Vision problems
• Grogginess
• Feelings of depression
• Headache

Mood Stabilizers

Used to treat intense, repeated shifts in mood. It usually takes several weeks to begin working.

Used to Treat: Bipolar disorder, schizoaffective disorder, borderline personality disorder and sometimes in combination with other medications, used to treat depression

Mood Stabilizers

• Lithium
• Depakote
• Depakene (divalproex sodium, valproic acid, or valproate sodium)
• Lamictal (lamotrigine)
• Tegretol (carbamazepine)

Side Effects:

• Dizziness
• Drowsiness
• Fatigue
• Nausea
• Tremor
• Rash
• Weight gain
• Agitation
• Mood swings
• Loss of coordination
• Abnormal thinking
• Impaired memory and poor concentration

***Lithium can also impact kidney and thyroid function. Lithium can be toxic if there is too much of the drug in your blood stream. If you are taking lithium, you need to get blood work regularly.