Education- Other Psychiatric Medications

Benzodiazepines

Other common medications used to treat psychiatric disorders include: Anxiolytics, antipsychotics, mood stabilizers, and stimulants. Please see more information on these medications below. 

Anxiolytic refers to any medication that improves anxiety. The term is not specific to any class of medications. SSRIs, SNRIs, nefazodone (Serzone), mirtazepine (Remeron), buspirone (BuSpar) are effective anxiolytics.

 

The most well know and probably most effective anxiolytics are the benzodiazepines (BZPs). The BZPs work by enhancing the inhibitory effect of GABA receptors. While very effective, the BZPs can be addictive and impair one's judgement and ability to drive.

 

Common side effects: drowsiness, fatigue, confusion, unsteadiness.

 

Examples: diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), clorazepate (Tranxene), oxazepam (Serax), chlordiazepoxide (Librium).

Atypical Antipsychotics

Atypical antipsychotics are relatively new, very complex compounds that have a variety of therapeutic effects. Based on their older cousins, antipsychotics or neuroleptics, atypicals work primarily as dopamine receptor blockers, more specifically the D2 receptor. This accounts for their antipsychotic properties. What makes these medications different from their older cousins is their effect on serotonin receptors, specifically the blocking of the serotonin 2a receptor. By blocking the 2a, atypicals show antidepressant properties as well as antipsychotic and mood-stabilizing properties. Additionally, atypicals are more effective at treating the negative symptoms of schizophrenia than the traditional antipsychotics as well as being less likely to cause neuromuscular side effects that come from unopposed D2 blockade.

 

Atypical antispychotics currently have approval to treat schizophrenia, schizoaffective disorder, bipolar depression and mania, and augmentation for major depression. They can also be effective at treating agitation, anxiety, irritability and insomnia.

 

Common side effects: Weight gain, restlessness, sleepiness, fatigue, headache, elevated blood glucose, elevated lipids.

 

Examples: olanzepine (Zyprexa), risperidal (Risperdal), paliparidone (Invega), quetiapine (Seroquel), ziprazodone (Geodon), clozapine (Clozaril), aripiprazole (Abilify), asenapine (Saphris), lurasidone (Latuda)

Mood Stabilizers

Mood stabilizers refer to medications effective in preventing mood cycling from occurring in people with bipolar disorder. The term does not pertain to a specific class of medications but more so a medication's clinical properties. The original mood stabilizer is lithium. Other mood stabilizers include mostly anticonvulsants such as Depakote, Tegretol, Lamictal. Atypical antipsychotics and benzodiazepines have mood stabilizing properties as well.

Stimulants

Stimulants are generally prescribed to treat attention-deficit hyperactivity disorder (ADHD), narcolepsy, and daytime sleepiness resulting from sleep apnea. They also have a roll as adjunctive treatment in depressive disorders. Amphetamines and methylphenidate act as norepinephrine and dopamine agonists meaning they mimic the action of these naturally occurring neurochemicals in the brain. They enhance attention, wakefulness, energy, motivation, interest, and ability to experience pleasure. Another stimulant modafinil (Provigil) likely works by stimulating the reticular activation system thereby providing wakefulness and improving alertness. Atomoxetine (Strattera) is marketed for ADHD though is actually a reuptake inhibitor of norepinephrine and not a stimulant. It increases norepinephrine levels in the brain by inhibiting the norepinephrine transport pump. By doing so, more norepinephrine is allowed to remain in the synaptic cleft where it facilitates neuronal communication.

 

Examples: dextroamphetamine (Dexedrine), amphetamine-dextroamphetamine (Adderall), methylphenidate (Ritalin, Concerta, Daytrana), dexmethylphenidate (Focalin)

 

Side effects: anxiety, insomnia, elevated blood pressure, sweating, palpatations, elevated heart rate, dry mouth, constipation, tremor, headache, loss of appetite, weight loss, addiction.

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