8.1 Medication: Drug therapy for mental health problems

A Family Guide to Concurrent Disorders - Part III: Medication

Outline - Chapter 8: Medication

Drug therapy for mental health problems

Medications are essential to many clients’ treatment programs, but they are not the only treatment. In most cases, medications are more effective if they are combined with some of the interventions that were discussed in Chapter 7.

Often, psychiatric medication will help stabilize people and clarify their thinking so they can focus on treatments such as cognitive-behavioural therapy, group therapy or family-focused therapy.

Types of psychiatric medication

Most mental health medications are used to help restore chemical balance in the brain. This can help to reduce the frequency and severity of symptoms. Medications are divided into four main groups based on the problems that they were developed to treat:

antidepressants
mood stabilizers
anti-anxiety medications / sedatives
antipsychotics.

Medications have a generic (or chemical) name and a brand (or trade) name that is specific to the company that makes the medication. For example, the generic antipsychotic clozapine is sold under the brand name Clozaril. The brand name may change depending on the country in which the medication is marketed.

Figure 8-1: Traditional uses for classes psychiatric medications

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Despite the four distinct classes of psychiatric medications listed above, each type of medication can be used to treat various disorders. For example, a person who takes a mood stabilizer to treat bipolar disorder may also take an antidepressant, anti-anxiety or antipsychotic medication to treat symptoms such as depression, sleep problems, anxiety or psychosis.

Figure 8-2: Alternative uses for classes of psychiatric medications

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Antidepressants

Antidepressants work via a number of different mechanisms, but the end result is to increase the level of communication between nerve cells in the brain. While they were originally used to treat depression, antidepressants are also used to treat chronic pain, bulimia, premenstrual dysphoric disorder, chronic fatigue syndrome and anxiety disorders. In fact, antidepressants, especially the class known as selective serotonin reuptake inhibitors (SSRIs) such as Prozac, are used more often to treat anxiety disorders than are traditional anti-anxiety medications such as Valium.

Mood stabilizers

Mood stabilizers are used to help control mood swings (extreme highs and lows) connected with bipolar disorder, and to prevent further episodes of this condition. Lithium was the ﬁrst mood stabilizer on the market and is still a useful medication. Other medications used to stabilize mood include anticonvulsants, which were developed to treat epilepsy and other seizure disorders.

Treatment of bipolar disorder depends on the individual’s symptoms. Bipolar disorder may also be treated with antidepressants in combination with mood stabilizers.

Anti-anxiety medications / Sedatives

The main group of medications in this class consists of benzodiazepines, such as diazepam (Valium) and lorazepam (Ativan). While they are legitimate medications for treating anxiety and sleep disorders, they can become addictive if used for more than about four weeks; they also have the potential to be abused (see “Medication abuse or dependence,”). An anti-anxiety medication that can be used for a longer period of time is buspirone (BuSpar).

Antipsychotics

Antipsychotics reduce the effect of dopamine in the brain. They are traditionally used to treat schizophrenia and other psychotic disorders. The newer, second-generation antipsychotics are now also being tested as mood stabilizers, anti-anxiety medication and even as a treatment for refractory depression (depression that is difficult to treat).

For more information about psychiatric medications, see:

Medications (published by the National Institute of Mental Health in the U.S., and available online in PDF format by clicking here.
Psychotherapeutic Medications 2006 (published by the Addiction Technology Transfer Center in the U.S. and available online in PDF by clicking here.

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A Family Guide to Concurrent Disorders

Preface

Part I: What are concurrent disorders?

1. Introduction to concurrent disorders

2. Substance use problems

3. Mental health problems

Part II: The impact on families

4. How concurrent disorders affect family life

5. Self-care

6. Stigma

Part III: Treatment