Medication

Common medications used for mental health disorders

Common medications used for mental health disorders
Common medication used for mental health disorders — Photo Pexels

While the list is long and varied, read about the most common medications used for mental health disorders.

There are several different types of drugs available to treat mental illnesses. Some of the most commonly used are antidepressants, anti-anxiety, antipsychotic, mood stabilizing, and stimulant medications.

All medications have an approved generic or medical name which are decided on by an expert committee. Most medications have a brand or trade name chosen by the pharmaceutical company who make and sell the medication. So, for example, Lorazepam is the generic name and Ativan is the brand name.

Prescribing medication used for mental health disorders

Doctor prescribing drugs for mental health disorders
Doctor prescribing drugs — photo by Anthony Devlin/PA

Prescribers, dispensers and drug administrators generally use two reference books to help identify the correct diagnosis and the medication used to treat mental health disorders.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by healthcare professionals in the United States. It’s also used in much of the world as the authoritative guide to the diagnosis of mental disorders.

The DSM contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It’s a manual for assessment and diagnosis of mental disorders. It doesn’t include information or guidelines for treatment of any disorder. That said, determining an accurate diagnosis is the first step toward being able to appropriately treat any medical condition. Mental health disorders are no exception.

The British National Formulary (BNF) provides prescribers, pharmacists, and other healthcare professionals with independent up-to-date information about the use of medicines. It includes key information on the selection, prescribing, dispensing and administration of medicines.

The following is a list of the common mental health disorders and the medications used to treat them. This list is not exhaustive and you may be aware of other brand names.

Anxiety

Benzodiazepines work quickly to relieve anxiety
Benzodiazepines work quickly to relieve anxiety

also known as tranquilizers, are the most widely prescribed type of medication for anxiety. Drugs such as

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

work quickly, typically bringing relief within 30 minutes to an hour. That makes them highly effective when taken during a panic attack or another overwhelming anxiety episode. However, they are physically addictive and not recommended for long-term treatment.

  • SSRI antidepressants for anxiety

Many medications originally approved for the treatment of depression are also prescribed for anxiety. In comparison to benzodiazepines, the risk for dependency and abuse is smaller. However, antidepressants take up to 4-6 weeks to begin relieving anxiety symptoms, so they can’t be taken “as needed.” Their use is limited to chronic anxiety problems that require ongoing treatment.

The antidepressants most widely prescribed for anxiety are SSRIs such as

  • Prozac (Fluoxetine)
  • Zoloft (Sertraline)
  • Paxil (Paroxetine, Seroxat)
  • Lexapro (Cipralex, Lexapro)
  • Celexa (Citalopram)
Anxiety and stress
Anxiety and stress

SSRIs have been used to treat generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, and social anxiety disorder. SSRIs have also been know to treat post-traumatic stress disorder.

  • Buspirone (BuSpar)

Buspirone, also known by the brand name BuSpar, is a newer anti-anxiety drug that acts as a mild tranquilizer. It relieves anxiety by increasing serotonin in the brain—as the SSRIs do—and decreasing dopamine. Compared to benzodiazepines, buspirone is slow acting—taking about two weeks to start working.

Bipolar disorder

Bipolar mood swings and mood stabilizers
Bipolar mood swings and mood stabilizers
  • Lithium (Priadel) The first mood stabilizer for bipolar disorder

Mood stabilizers are medications that help control the highs and lows of bipolar disorder. They are the cornerstone of treatment, both for mania and depression. Lithium is the oldest and most well-known mood stabilizer and is highly effective for treating mania. Lithium can also help bipolar depression. However, it is not as effective for mixed episodes or rapid cycling forms of bipolar disorder. Lithium takes from one to two weeks to reach its full effect.

Originally developed for the treatment of epilepsy, anticonvulsants have been shown to relieve the symptoms of mania and reduce mood swings:

  • Valproic acid (Depakote)
  • Carbamazepine (Tegretol)
  • Lamotrigine (Lamictal)
  • Topiramate (Topamax)

Valproic acid, also known as divalproex or valproate, is a highly effective mood stabilizer. Valproic acid is often the first choice for rapid cycling, mixed mania, or mania with hallucinations or delusions. It’s a good bipolar medication option if you can’t tolerate the side effects of lithium.

Borderline Personality Disorder (BPD)

Emotionally unstable personality disorder
Emotionally unstable personality disorder — Photo by Pexels

Also known as emotionally unstable personality disorder (EUPD). Medication isn’t recommended for treating ongoing symptoms of BPD. This is because there aren’t any drugs that are known to be effective. However, you might take medication for other mental health problems you’re experiencing.

In a crisis situation your doctor might prescribe you a sleeping pill or minor tranquilliser to help you feel calmer, However, they shouldn’t prescribe these for longer than a week.

Depression

  • SSRIs
SSRIs are prescribed for depression
SSRIs prescribed for depression — Pexels

The most widely prescribed antidepressants come from a class of medications known as selective serotonin reuptake inhibitors (SSRIs). This include drugs such as:

  • Prozac (Fluoxetine)
  • Zoloft (Sertraline)
  • Paxil (Paroxetine, Seroxat)

SSRIs act on the neurotransmitter serotonin, a brain chemical which helps to regulate mood.

  • SNRIs

As the name suggests, serotonin and inhibitors norepinephrine reuptake (SNRIs) act on the brain chemical norepinephrine as well as serotonin. They include the drugs Pristiq, Cymbalta, Fetzima, and Effexor and may also be used to treat anxiety and depression accompanied by pain.

  • Atypical antidepressants

Atypical antidepressants don’t fit into other classes of antidepressants but target different neurotransmitters to change the brain chemistry and regulate mood. They include

  • Wellbutrin (Bupropion, Zyban)
  • Remeron (Mirtazapine)
  • Desyrel (Oleptro, Trazodone)
  • Serzone (Nefazodone)
  • Viibryd (Vilazodone)
  • Trintellix (Vortioxetine)
  • Older depression drugs

Tricyclic antidepressants (TCAs) and MAOIs (monoamine oxidase inhibitors) are older classes of antidepressants. Their side effects are more severe than those of the newer antidepressants, so they are only prescribed as a last resort after other treatments and medications have failed.

The different cyclic antidepressants that are currently available include:

  • Amitriptyline (Elavil, Endep, Vanatrip)
  • Amoxapine (Asendin)
  • Desipramine (Norpramin)
  • Doxepin (Sinequan, Quitaxon, Aponal)
  • Imipramine (Tofranil)
  • Maprotiline (Ludiomil)
  • Nortriptyline (Pamelor)
  • Protriptyline (Vivactil)
  • Trimipramine (Surmontil)

Some doctors may also prescribe the cyclic drug clomipramine (Anafranil) for treatment of depression

  • Esketamine (Spravato)

The U.S. Food and Drug Administration (FDA) recently approved Esketamine (brand name Spravato) for patients with severe, treatment-resistant depression. Taken as a nasal spray in conjunction with an oral antidepressant, Esketamine may deliver rapid improvement of symptoms for some patients with major depression.

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder may be treated with antidepressants
Post-traumatic stress disorder may be treated with antidepressants

If you’re offered medication for PTSD, this will usually be an antidepressant. While PTSD isn’t the same as depression, this type of medication has been found to help. These four antidepressants in particular:

  • Paroxetine (Aropax, Paxil, Pexeva, Seroxat)
  • Mirtazapine (Remeron, Remeron SolTab)
  • Amitriptyline (Elavil, Endep, Vanatrip)
  • Phenelzine (Nardil)

Some doctors may choose to prescribe other antidepressants for PTSD, such as Sertraline.

Psychosis

See schizophrenia (below)

Schizophrenia

Visual hallucinations in Schizophrenia and antipsychotic drugs
Visual hallucinations in Schizophrenia and antipsychotic drugs

Doctors usually prescribe antipsychotic drugs (also known as neuroleptic drugs or major tranquilisers) to help with schizophreniaschizoaffective disorder, and psychosis.

Antipsychotic drugs tend to fall into one of two categories: first generation (older) antipsychotics and second generation (newer) antipsychotics. Both types can potentially work well, but they differ in the kind of side effects they can cause and how severe these may be.

The main difference between these types is in their side effects. First generation antipsychotics may have more of an effect on your movement than newer ones. Although this does not mean newer generation antipsychotics don’t have any side effects on your movement.

  • Typical (First generation, since 1950’s) antipsychotics
  • Benperidol (Anquil)
  • Chlorpromazine (Largactil)
  • Flupentixol (Depixol)
  • Fluphenazine (Modecate)
  • Haloperidol (Haldol)
  • Levomepromazine (Nozinan)
  • Pericyazine
  • Perphenazine (Fentazin)
  • Pimozide (Orap)
  • Promazine
  • Sulpiride (Dolmatil, Sulpor)
  • Trifluoperazine (Stelazine)
  • Zuclopenthixol (Clopixol)

The second generation of antipsychotics have been used more since the 1990s. Although some of them were developed before then. They have been listed by their generic name with the brand name in brackets.

  • Atypical (Second generation, since 1990’s) antipsychotics
  • Amisulpride (Solian)
  • Aripiprazole (Abilify, Abilify Maintena)
  • Clozapine (Clozaril, Denzapine, Zaponex)
  • Risperidone (Risperdal & Risperdal Consta)
  • Olanzapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Paliperidone (Invega, Xeplion)​
  • Clozapine

works slightly differently to other antipsychotics. It’s sometimes given to people who are treatment resistant. This means other medication hasn’t helped their symptoms. The National Institute for Health and Care Excellence (NICE) says that people with schizophrenia should only be offered clozapine after having tried 2 other drugs.

Clozapine can cause your white blood cell numbers to drop, but this is rare. This could mean that you get infections more easily. If you take clozapine, you will need regular blood tests to make sure your white blood cell count is healthy.

If your white blood cell numbers start dropping, you will be asked to stop taking the medication. You will have another blood test after you have stopped clozapine to make sure they are back to normal. Your doctor might decide to change your dose of clozapine or offer you another type of medication.

Medication doesn’t suit everyone

Psychiatric medication isn't for everyone
Psychiatric medication isn’t for everyone — Image from Pexels

Many people find psychiatric medication useful, either on its own or alongside other treatment like talking therapy, but it’s not suitable for everyone. This is because everyone’s experience of mental health and treatment is different, especially when it comes to medication.

Sometimes patients will have to try several medications because not all of them work in the same way for different people. Some people can’t take the side effects of certain medications and may have to be switched to another one. This can take several months and often people despair at having to wait so long for the medications to work and relieve any symptoms.

Disclosure

I am not a doctor and I’m no longer a medical professional. This blog is intended only to provide general knowledge, and is not intended to serve as medical advice of any sort.

Before deciding to take any drug, it’s important to make sure you have all the facts you need to make an informed choice. Changes in mental health medication should never be made without consulting your healthcare team.

Over to you

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Please feel free to leave any comments, and I’m happy to answer any questions. If you take medication for a mental illness, did you make an informed choice about your meds? If you don’t take medication for your mental illness, how else do you manage?

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