Overview of Common Psychotropic Medications

Overview of Common Psychotropic Medications

Psychotropic medications are drugs that affect brain function, influencing emotions, behavior, and mental processes. These medications are commonly prescribed for a wide range of mental health conditions and are usually taken orally, although some may be administered via injection (intramuscular or intravenous).

The major categories of psychotropic medications include:

• Antidepressants

• Anti-anxiety medications

• Antipsychotics

• Stimulants

• Mood stabilizers

Antidepressants: Uses and Common Types

Antidepressants are primarily used to treat major depressive disorder (MDD), but they are also effective in managing anxiety disorders, seasonal affective disorder (SAD), and other mental health conditions. These medications function by increasing the levels of neurotransmitters such as serotonin and norepinephrine in the brain, which can help elevate mood and reduce pain signals.

How Long Do Antidepressants Take to Work?

Most antidepressants begin to show noticeable effects within 2 to 4 weeks, but full therapeutic benefits may take up to 6–8 weeks. It’s important to follow a healthcare provider’s guidance and not discontinue use abruptly.

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are among the most commonly prescribed antidepressants. They increase serotonin levels in the brain and are often used as a first-line treatment for depression and anxiety.

Common SSRIs and Their Approved Uses:

• Prozac (Fluoxetine):

  • Major depressive disorder (MDD)

  • Obsessive-compulsive disorder (OCD)

  • Bulimia nervosa

  • Panic disorder

• Lexapro (Escitalopram):

  • Major depressive disorder

  • Generalized anxiety disorder (GAD)

• Zoloft (Sertraline):

  • MDD

  • OCD

  • Panic disorder

  • Post-traumatic stress disorder (PTSD)

  • Social anxiety disorder

  • Premenstrual dysphoric disorder (PMDD)

Common Side Effects of SSRIs:

• Nausea

• Insomnia or drowsiness

• Headache

• Sexual dysfunction

• Excessive sweating

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

SNRIs work by boosting both serotonin and norepinephrine levels. They are often prescribed not only for depression and anxiety but also for chronic pain conditions.

Examples of SNRIs:

• Cymbalta (Duloxetine):

  • MDD

  • GAD

  • Diabetic nerve pain

  • Fibromyalgia

  • Chronic musculoskeletal pain

Note: In October 2024, over 200,000 bottles of duloxetine were recalled due to potential contamination with nitrosamines. Check with your pharmacist or doctor if your prescription is affected.

• Effexor XR (Venlafaxine):

  • MDD

  • GAD

  • Social anxiety disorder

  • Panic disorder

• Pristiq (Desvenlafaxine):

  • MDD

Common Side Effects of SNRIs:

• Anxiety

• Trouble sleeping

• Sexual issues

• Nausea and vomiting

• Dry mouth

• Dizziness

• Constipation

• Sweating

Tricyclic Antidepressants (TCAs)

TCAs are older antidepressants that also work on serotonin and norepinephrine. Due to their side effect profile, they are usually not the first choice for treatment, especially in older adults.

Examples of TCAs:

• Amitriptyline (Generic): MDD

• Pamelor (Nortriptyline): MDD

• Imipramine (Generic):

  • MDD

  • Bedwetting in children over 6 years

Common Side Effects of TCAs:

• Dry mouth

• Blurred vision

• Drowsiness

• Low blood pressure

• Difficulty urinating

• Rapid heart rate

• Weight gain

• Sexual dysfunction

5-HT1A Receptor Agonists

These are newer antidepressants that specifically target serotonin 1A receptors, offering a different mechanism from traditional SSRIs and SNRIs.

Exxua (Gepirone):

• The first FDA-approved 5-HT1A receptor agonist for treating MDD

• Notable for having minimal sexual side effects and no associated weight gain

Common Side Effects:

• Dizziness

• Nausea

• Insomnia

• Upset stomach

Anti-Anxiety Medications

While SSRIs and SNRIs are often prescribed for anxiety, certain medications are specifically designed for rapid relief of acute anxiety symptoms.

Benzodiazepines (BZDs)

BZDs enhance the effect of gamma-aminobutyric acid (GABA), a calming neurotransmitter. These drugs are effective for short-term anxiety relief but carry a risk of dependence and are classified as controlled substances.

Common Benzodiazepines and Their Uses:

• Xanax (Alprazolam):

  • Generalized anxiety disorder

  • Panic disorder

• Valium (Diazepam):

  • Anxiety

  • Alcohol withdrawal

  • Muscle spasms

  • Seizure management (in combination therapy)

• Ativan (Lorazepam):

  • Anxiety

Common Side Effects of BZDs:

• Drowsiness

• Memory problems

• Poor coordination

• Double vision

• Muscle weakness

• Dizziness

Antipsychotic Medications

Antipsychotics are used to treat mental health conditions that involve psychosis, such as schizophrenia and bipolar disorder. They primarily work by blocking dopamine receptors in the brain.

Conditions Treated with Antipsychotics:

• Schizophrenia

• Bipolar disorder

• Severe depression with psychotic features

• Certain anxiety disorders (off-label)