Medication for Mental Health Treatment

Key takeaways:

• Mental health medications help regulate and balance brain chemicals responsible for our emotions and thoughts. They may be used alone, but can be more effective when combined with other methods of psychotherapy.

• Individuals may be prescribed antidepressants, antipsychotics, soporifics, sedativesbenzodiazepines, mood stabilizers, anticonvulsants, or stimulants depending on their specific health needs and mental health condition(s). A qualified mental health professional will complete a thorough evaluation to determine what mental health medication is best.

• Many medications come along with side effects, so taking these drugs as directed and remaining closely monitored by a mental health professional is important for personal safety and well-being.

Medication treatment and mental health

Mental health medication regulates and balances the brain chemicals responsible for our thoughts, emotions, and behaviors. ^[3] These medications are used to help improve the well-being and quality of life of those suffering from mental health disorders by regulating emotional and behavioral symptoms. ^[2] Medication can be used to treat mental health conditions, but they may also be taken short-term to help individuals manage stressful life situations.Individuals with mental health conditions may take medication along with therapy, but they may also help individuals manage stressful life situations on a short-term basis.

What is psychopharmacology?

Psychopharmacology is a discipline specializing in medications that treat mental health diagnoses. ^[5] Psychopharmacology may also be referred to as psychiatric medication management.

How often is medication prescribed for mental health conditions?

In 2020, 16.5% of all individuals in the United States took prescription mental health medication. The number of individuals who took these medications varied by age. Data shows people between the ages of 45 and 64 were slightly more likely to be took prescribed mental health medication slightly more than people in other age groups. ^[6]

Mental health conditions that may require medication

Mental health medication may be used to treat many mental health conditions. Some of the most common conditions include: ^[1]

• Anxiety disorders

• Attention-deficit/hyperactivity disorder (ADHD)

• Bipolar disorder

• Eating disorders

• Insomnia

• Mood disorders

• Narcolepsy

• Schizophrenia and other psychotic disorders

• Substance use disorders

Types of mental health medications

We can divide mental health medications into seven categories, based on how they affect the brain and behavior. While most medications are developed to treat a specific condition, they often prove effective in treating others, especially when they have symptoms in common (e.g., antidepressants are sometimes prescribed to treat anxiety).

A mental health or healthcare professional will only prescribe these medications after thorough patient evaluations, allowing them to make the best recommendations for those they treat.

Antidepressants

The primary purpose of antidepressants is to manage low mood and other symptoms of depression and similar mood disorders, such as cyclothymic disorder and dysthymia. ^[5] Antidepressants can also assist with symptoms of PTSD, OCD, anxiety disorders, phobias, and even chronic pain conditions. ^[8] There are seven types of antidepressants mental health professionals may prescribe: ^[7]

• Atypical Antidepressants

• Agomelatine (Valdoxan)

• Bupropion (Wellbutrin)

• Mirtazapine (Remeron)

• Monoamine Oxidase Inhibitors (MAOIs)

• Isocarboxazid (Marplan)

• Moclobemide (Amira)

• Phenelzine (Nardil)

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• NMDA Antagonists

• Esketamine (Spravato)

• Selective Serotonin Reuptake Inhibitors (SSRIs)

• Citalopram (Celexa)

• Escitalopram (Lexapro)

• Fluoxetine (Prozac)

• Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs)

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• Duloxetine (Cymbalta)

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• Milnacipran (Savella)

• Venlafaxine (Effexor)

• Serotonin Modulators

• Nefazodone (Serzone)

• Trazodone (Oleptro)

• Vilazodone (Viibryd)

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• Tricyclic Antidepressants (TCAs)

• Amitriptyline (Elavil)

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• Clomipramine (Anafranil)

• Desipramine (Norpramin)

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Antipsychotics

Antipsychotics (also known as neuroleptics) are used to manage psychotic illnesses such as schizoaffective disorder and schizophrenia. ^[5] Theycan also treat manic episodes associated with bipolar disorders and psychotic episodes in individuals with severe depression. ^{[9] [4]}

Older adults who have behavioral difficulties or delirium associated with dementia may also benefit from antipsychotics. ^[4] These medications are categorized as typical or atypical, based on when they were developed: ^{[8] [10]}

• Atypical antipsychotics (also known as 2nd generation or new antipsychotics)

• Amisulpride (Solian)

• Aripiprazole (Abilify)

• Clozapine (Clozaril)

• Lurasidone (Latuda)

• Risperidone (Risperdal)

• Olanzapine (Zyprexa)

• Quetiapine (Seroquel)

• Paliperidone (Invega)

• Typical antipsychotics (also known as 1st generation or older antipsychotics)

• Chlorpromazine (Thorazine)

• Fluphenazine (Prolixin)

• Haloperidol (Haldol)

• Perphenazine (Trilafon)

• Thioridazine (Mellaril)

• Thiothixene (Navane)

• Trifluoperazine (Stelazine)

Soporifics

Soporifics are intended to help individuals with insomnia that has arisen on its own or as a result of preexisting mental health concerns. While commonly called sleeping pills, these medications may also take the form of injections, liquids, or capsules. ^[11]

The technical term for most soporifics is “hypnotics”. Sedative medications, such as benzodiazepines, were historically used to improve sleep by reducing anxiety, but these carry a high risk of addiction and misuse and are rarely prescribed for insomnia today. ^[5] There are three general forms of sleeping pills: ^{[5] [10]}

• Diphenhydramine (Benadryl)

• Eszopiclone (Lunesta)

• Zaleplon (Sonata)

• Zolpidem (Ambien)

• Zopiclone (Imovane)

• Suvorexant (Belsomra)

Sedatives

Sedative medications act by slowing central nervous system (CNS) activity. The most common types of sedatives are benzodiazepines, but newer medications such as Z-drugs also fall into this category. Sedatives are typically prescribed on a short-term basis for panic disorders, severe anxiety, and sometimes insomnia. ^{[5] [8]} Benzodiazepines are also recommended to help manage the physical effects of acute alcohol withdrawal in hospitalized patients. ^[8] Since these medications may lead to addiction, they are only prescribed temporarily.

Benzodiazepines vary in how quickly they take effect. Some, such as alprazolam (Xanax) and diazepam (Valium), may have an effect in 20 to 60 minutes, while long-acting versions, such as clonazepam (Klonopin) and flurazepam (Dalmane) are slower to take effect but can last up to 16 hours.^[5]

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Mood stabilizers

Mood stabilizers work just as the name suggests: helping balance mood and motivation in people who tend to experience emotional highs and lows or otherwise struggle to regulate their mood. Mood stabilizers are often recommended for individuals who do not find relief from talk therapy or other non-medication treatments. This type of medication may be recommended on its own, but may also be prescribed alongside antipsychotic medications for individuals with bipolar disorder, schizoaffective disorder, or schizophrenia. ^{[1] [5]} The following medications are considered mood stabilizers: ^[8]

• Lamotrigine (Lamictal)

• Lithium (Camcolit)

• Valproic acid (Depakote)

Anticonvulsants

While traditionally intended to manage seizures in individuals with epilepsy, anticonvulsants may also be used for the treatment of mental health concerns. They can be prescribed for severe depression and significant mood swings associated with bipolar disorder. These medications can also assist with symptoms of impulsivity and aggression due to oppositional defiant disorder, intermittent explosive disorder, and similar conditions. ^[10] There is some overlap between mood stabilizers and anticonvulsants, as they target some of the same areas of the brain:

• Carbamazepine (Tegretol)

• Oxcarbazepine (Trileptal)

• Levetiracetam (Keppra)

• Gabapentin (Neurontin)

Stimulants

Stimulant medications boost alertness and energy levels to increase focus. Although it may seem counterintuitive, they are the primary pharmacological treatment for hyperactivity, inattention, and other symptoms of attention-deficit/hyperactivity disorder (ADHD). ^[9] Some mental health professionals also recommend stimulants for the treatment of narcolepsy. ^[4] Stimulant medications include: ^{[5] [10]}

• Dexmethylphenidate (Focalin)

• Dextroamphetamine (Adderall)

• Methylphenidate (Ritalin)

• Lisdexamfetamine (Vyvanse)

Important things to know before starting mental health medication

Mental health medications can be highly effective, but they are not safe or appropriate in every case, and it can be difficult to find the right medication for you. Your healthcare provider may need to adjust dosages or change medications to properly manage your symptoms. It is important to never increase your dose beyond what has been prescribed for you, even if you feel the medication is not working.

Adverse effects

Most medications come with a list of side effects (also known as adverse effects), which range from uncomfortable to extremely severe. Most side effects only appear under specific circumstances or for certain people. These adverse effects are often unrelated to mental health. For example, newer antipsychotic medications may cause glucose intolerance or weight gain. ^[9] These can potentially cause other health problems, such as diabetes and obesity, if they are not addressed and managed on their own.

Adverse effects are not always physical. Individuals under the age of 25 who begin taking antidepressants are at a greater risk of suicidal thoughts and related self-harm behaviors than older individuals. Individuals taking these medications should be monitored especially closely and should disclose any suicidal ideation to their provider immediately. ^[9]

A mental health professional should discuss the risk of any adverse effects with you before you decide to take a certain medication. It is therefore crucial that you are honest about your medical history when exploring medication options to avoid complications. If you decide to proceed, your mental health provider will closely monitor you for any negative effects and adjust your dose or treatment plan accordingly. You should always report any unexpected or adverse effects you experience to the prescribing doctor as soon as you experience them.

Correct dosage

Your prescribing healthcare professional will recommend a medication dosage based on factors like height, weight, and gender, as well as your health history. This dosage may be reduced or increased based on your and your doctor’s observations of mental health symptoms. It may take a while to find the right balance depending on your condition, but it is important not to change the dosage yourself without consulting your doctor. ^[9] The process of finding the right dose for you is known as titration.

Depending on the medication type and your condition, negative symptoms may increase if you miss a dose. Many people assume the best course of action after missing a dose is to take more of their medication with their next dose. This is not safe and can lead to overdose or dependence. Individuals are advised to follow their provider’s medication instructions very closely and should alert them if they miss a dose.

Overdosing

Taking too much of your mental health medication, whether deliberately or by accident, is extremely dangerous and can even be life-threatening. Immediate medical attention and psychiatric follow-up are essential.

This can be especially important when taking SSRIs. Overdosing on SSRI antidepressants, or combining them with other serotonin-affecting drugs, risks serotonin syndrome, a severe and potentially life-threatening condition. ^[7] Serotonin syndrome causes major nervous system symptoms such as high fever, abnormal heartbeat, difficulty breathing, continual fainting, and seizures. Individuals may enter a coma and die if they do not receive medical attention right away.

Comorbidity

Individuals with mental health concerns have a greater risk of conditions like cancer, obesity, liver disease, respiratory conditions, heart disease, and diabetes. ^[9] This makes regular physical health screenings essential for well-rounded, effective psychiatric support. These screenings not only help prevent more serious physical conditions from developing, but also enhance an individual’s well-being.

Getting a prescription

If you feel that mental health medication may be right for you, speak to your provider about getting a prescription. In the event you feel other options or therapy aren’t working or are not helping enough, medication may be a good fit for you. Your provider can offer their professional opinion and determine the next best steps.

Risks of using unprescribed medications

Mental health medications are not safe to take recreationally, which is why they are only available with a prescription. People who take mental health medications of any kind should receive close guidance from a qualified psychiatric professional to ensure their safety and optimal results.

Medication and therapy

For many conditions, especially short-term ones, it is recommended that mental health medications be used alongside other interventions such as talk therapy. For life-long conditions, such as bipolar disorder, therapy may be used at first, but medications will need to continue indefinitely. Many mental health treatment plans consist of psychotherapy, medication, or a combination of these methods. ^[1] The exact mental health treatment someone receives is dependent on their preferences, the life circumstances that brought them to therapy, and any mental health conditions they may have. ^[4]

Knowing which treatment option is right for you

It takes some time to learn what treatments are best for you. For some people, it may be talk therapy alone, while others find more relief from a mix of psychotherapy and mental health medication. Ultimately, it is your decision what you receive and participate in, though your provider is there to support you each step of the way.

Further resources

The National Institute of Mental Health has information about finding providers who can prescribe mental health medication, as well as what to do in the event of a mental health or medical emergency. The Substance Abuse and Mental Health Services Administration (SAMHSA) has similar resources as well as information about mental health and substance use disorder treatment facilities. In addition, the American Association of Psychiatric Pharmacists has compiled fact sheets on many medications for those looking to learn more. You should always seek personal advice from a qualified health professional before taking any medications for your mental health.