10.4 Other Psychiatric Medications

Antipsychotic Medications

Antipsychotic medications are used to treat psychosis, schizophrenia, extreme mania, depression that is resistant to other therapy, and other central nervous system conditions. The symptoms of psychosis generally include delusions, hallucinations, bizarre behaviour, and inappropriate moods. Schizophrenia is the most common form of psychosis, though there are other types and causes, such as drug-induced psychosis. Antipsychotics are sometimes referred to as major tranquilizers because they produce a state of tranquility. Although the medications that were discussed in the section on anti-anxiety medications are referred to as minor tranquilizers, it is important to note that they are actually unrelated to major tranquilizers and work very differently within the body.

All antipsychotics block dopamine receptors in the brain; however, the precise mechanism of action is not clearly known. Conventional antipsychotics, such as haloperidol (Fig. 10.5), block dopamine receptors in certain areas of the central nervous system. These areas are associated with emotions, cognitive function, and motor function, and blockage produces a tranquilizing effect in patients suffering from psychosis. However, several adverse effects are also caused by this dopamine blockade.

Table 10.2. Potential Adverse Effects of Antipsychotic Medications

(Ernstmeyer & Christman, 2020)

Second-generation antipsychotics, also referred to as atypical antipsychotics, have fewer adverse effects. An example of an atypical antipsychotic is risperidone (Risperdal) (Fig. 10.6). Second-generation, or atypical, antipsychotics block specific dopamine 2 receptors and specific serotonin 2 receptors, resulting in fewer adverse effects. Atypical antipsychotics may also cause metabolic changes such as hyperglycemia, hyperlipidemia, and weight gain.

ADHD Medications

Methylphenidate (Ritalin) and amphetamine (Adderall) are examples of central nervous system stimulants that are often used to treat ADHD. Both are thought to block the reuptake of norepinephrine and dopamine into the presynaptic neurons. They can also stimulate the brain and act similarly to amphetamines. These medications have a high potential for abuse and dependence, so they are highly controlled.

Anti-Mania Medications

Mood stabilizers are used to treat bipolar disorder. Lithium (Lithobid) was the first medication used to treat this disorder and is sometimes referred to as an anti-mania drug because it can help control the mania that occurs in bipolar disorder. Lithium alters sodium transport in nerve and muscle cells, but the specific mechanism of action is unknown.

Lithium must be closely monitored and has a narrow therapeutic serum range. Serum sodium levels should also be monitored for potential hyponatremia.

Addiction

• Irritability
• Sleeplessness
• Depressed mood
• Anger
• Cravings
• Sweating
• Nausea and vomiting
• Tremors
• Confusion
• Emotional and physical pain

There are also certain medications that can be used to treat withdrawal from alcohol. Acamprosate (Camprol) and disulfiram (Antabuse) are commonly prescribed but work quite differently than those medications discussed above (Web MD, 2023). Acamprosate helps to reduce cravings, and disulfiram produces nausea, chest pain, and sweating if someone ingests alcohol. Because of the unpleasant symptoms that result when mixing alcohol and disulfiram, those on the medication are inclined to avoid alcohol. 

Table 10.3. Common Psychiatric Medications

(WebMD, 2023)

References

University of Toledo Counseling Center. (2023). Tolerance and withdrawal. https://www.utoledo.edu/studentaffairs/counseling/selfhelp/substanceuse/marijuanatolerancewithdrawal.html#:~:text=tolerance%20is%20a%20physical%20effect,no%20longer%20having%20the%20substance

WebMD. (2023). Drugs and medications A–Z. https://www.webmd.com/drugs/2/index