Your Guide to Psychotropics - What is important to know

Suffering is part of life.


That being said, there are individual situations and predispositions that can make this suffering unbearable or very difficult to manage. And then some mental disturbance may even arise as the organism's adaptive response (as a connected whole mind-body) to trying to deal with it. This response, intended to protect the person, tends to prolong suffering in the long run and becomes dysfunctional.

Many people, even under severe symptoms of intense psychological distress, are afraid to take some kind of psychiatric medication.

This article intends to present the types of psychotropic drugs most used around the world. The most common usually seek to alleviate the symptoms of anxiety and depression that almost always end up being associated with some mental disorder.

What is a Psychotropic?


Psychotropics differ from other types of medication in that they necessarily act on the central nervous system (CNS). As they affect mental processes, they alter patients' perception, emotions and behavior. These drugs selectively depress or stimulate different CNS actions with the aim of relieving symptoms rather than eliminating them (they do not work as a cure!). Furthermore, most of the changes that a mental disorder imprints on the brain are not known.


Main Types of Psychotropics:

  • Antidepressants

  • Anxiolytics and Hypnotics

  • Antipsychotics

  • Mood Stabilizers


For each drug there are some expected and common adverse effects and others that depend on the individual reaction of each person. The benefit felt with some psychotropic drugs may appear later than the undesirable effects, which can make adherence to the medication more difficult. For each situation, the risks and benefits must be weighed, a decision that you must share with your doctor.


The treatment time with this type of medication varies from six, nine months to a year.


Therapeutic Effects and Side Effects


Psychopharmaceuticals (and drugs in general) act in multiple locations and not just in what is considered to be the most desirable. From a therapeutic point of view, its action tends to give rise to different effects:


  • The desirable ones are called therapeutic effects

  • Undesirables are called side effects, secondary, adverse


Calling the effects of a drug “therapeutic” or “adverse” is simply a matter of convenience - in psychopharmacology there are many cases of drugs whose adverse reactions are “reused” for therapeutic purposes. In fact, this is how many of the medications that we now consider to have desirable effects in alleviating symptoms of mental disorder were “discovered”. For example, a drug that was being created with the intention of being an anesthetic was realized that it had the potential to “relax” the body and stop anxiety reactions in the body, and thus started to be used as an anxiolytic.



Antidepressants


Antidepressants are drugs approved to relieve illnesses such as depression, anxiety, obsessive-compulsive and eating disorders.


Antidepressants increase or prolong the activity of neurotransmitters such as serotonin and norepinephrine, hormones involved in mood regulation. Most antidepressants take 3-4 weeks to have any benefit, although some people may experience it sooner. Of course, people want to feel the effects of medication right away, but antidepressants don't work that way. It is essential to wait and have persistence during the beginning of the treatment.

Anxiolytics and Hypnotics


Anxiolytics and hypnotics, also known as "calming agents" are medications used in specific situations of anxiety or difficulty in sleeping. These include the benzodiazepines. Although they provide immediate relief, they are not directed at the cause of the symptom. These drugs are associated with a risk of dependence, so they should only be used for a short period of time. When taken on a regular basis, they lose their effect, with the need to increase the dose. Important side effects are also known when taken in high doses for a long time, such as memory deficits.


Rivotril is one of the famous benzodiazepines that many people carry in their wallets and take in the face of anguish/emotional distress. It is a substance that turns off the central nervous system, generating an instant sensation of relaxation”, explains psychiatrist Anny Mattos from the University of Rio de Janeiro. A generation of post-Rivotril medications are based on diazepam which increases the release of serotonin, a hormone connected with the feeling of well-being.

Antipsychotics


Antipsychotics, as the name suggests, are medications used to treat psychotic symptoms. These symptoms can be present in a large number of illnesses, such as schizophrenia, bipolar disorder, dementia with psychotic characteristics, among others. These medications are also effective in controlling agitation, disorganized behavior, impulsiveness and aggression.


Mood Stabilizers


Mood stabilizers are medications that help regulate mood, that is, the person's state of mind. They allow you to control extreme mood swings, such as those that occur in people with bipolar disorder.

Mood changes are part of our experiences and we all feel them, however, when they are extreme, they can interfere with our daily functioning, which is why they are considered harmful and are subject to treatment. Examples are episodes of intense depression or extreme euphoria.


The group of mood stabilizers include:

  • Lithium, a medicine extracted from a mineral found in nature

  • Valproic acid, lamotrigine and carbamazepine, also called antiepileptics because they have an effect on the control of epilepsy, in addition to their mood stabilizing effect.


Endnotes:


The decision to use or not a psychotropic drug depends above all on the diagnosis, including any comorbidities. For many disorders, medication is the preferred treatment, such as schizophrenia, bipolar disorder, severe depression, or the management of very constant panic attacks. Other diagnoses, such as specific phobias, generalized anxiety disorder, personality disorders, situational problems or malfunctions, psychotherapy should be the first option and is usually sufficient.

It is always positive to research, read and ask specialized people any questions you may have regarding medication. Express your concerns to your doctor or psychologist and don't be afraid to ask questions.


See below for a short list of medications commonly used for depressive and anxiety symptoms.


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Psychiatric medications for depression


Fluoxetine

It is one of the most used medications for the treatment of depression, anxiety, panic syndrome, bulimia, dysphoria and others. It increases levels of serotonin, the neurotransmitter responsible for regulating mood, well-being, sleep, appetite, among other functions. The recommendation is to take it daily. The positive effects start to manifest within 2 to 6 weeks.


Escitalopram

Indicated for depressed and anxious patients, in addition to those with panic disorder, obsessive-compulsive disorder and social anxiety disorder, it is one of the most recommended medications by doctors. Escitalopram alters concentrations of neurotransmitters in the brain, increasing serotonin levels between neurons. It fights the symptoms of acute depression faster than other medications. Clinical improvement is visible within 2 to 6 weeks. In some cases, the therapeutic action may take as little as four weeks. Although it has side effects, it is one of the safest psychiatric medications.


Mirtazapine

Mirtazapine is a tetracyclic antidepressant that increases the amount of serotonin and norepinephrine, associated with executive functions and physical pain in the neuron. This increase in neurotransmitters leads to improvements in depression symptoms. It is usually faster than other antidepressants. The positive effects start to appear within 2 to 4 weeks. To balance the side effects (increase in weight, drowsiness and sexual dysfunction), it can be used in combination with other medications indicated by the doctor.


Citalopram

This medication is suitable for the treatment of depression, panic and obsessive compulsive disorder. The main effects of citalopram are seen between 2 to 4 weeks after starting use. It works by correcting concentrations of neurotransmitters such as serotonin.

Psychiatric medications for anxiety


Diazepam

It generates symptomatic relief from anxiety and other pathologies associated with generalized anxiety syndrome, also including insomnia and panic syndrome. Diazepam has a calming effect on the body and also works as a sedative. The effect is noticed after 20 minutes of ingestion, and its maximum concentration is reached 30 to 90 minutes later.


Bromazepam

Indicated for anxiety, tension, mood disorders and schizophrenia. In low doses, it reduces tension and anxiety and, in higher doses, it has a sedative and muscle relaxant effect. Its use is only recommended in severe or disabling conditions.


Alprazolam

Alprazolam is used to treat anxiety and panic disorders, with or without agoraphobia. It acts primarily on the central nervous system, so there may be a slight compromise in light reflections and daytime drowsiness. It reduces the manifestation of symptoms such as tension, apprehension, irritability, insomnia, tachycardia, hyperactivity, etc.


Lorazepam

It acts as a generalized anxiety disorder control or daily symptom relief. It can also be used as a complementary medication in the treatment of anxiety in psychotic states and deep depression. It acts on different receptors in different places in the central nervous system, decreasing the generation of nerve stimuli from neurons. In this way, it reduces anxiety.


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