According to the APA, a psychotropic or psychoactive drug is “any drug that has significant effects on psychological processes, such as thinking, perception, and emotion”. Licensed healthcare professionals often prescribe psychotropic drugs to alleviate symptoms of various mental health conditions.
In this article, I will discuss psychotropic drugs in detail starting with describing what a psychotropic drug is, what are the different types of psychotropic drugs, and the potential risks and benefits associated with psychotropic drug use. You will learn about how certain psychotropic drugs are used in therapy, what are the side effects of psychotropic drugs, and when it is time to seek help when there is a case of drug misuse.
Psychotropic drugs are often interchanged with the terms psychoactive drugs and psychiatric drugs – people may also refer to them simply as psychotropics.
As stated above, these drugs affect psychological processes or mental processes. This happens when there are alterations of neurotransmitters which then cause changes in one’s “perception, consciousness, cognition or mood and emotions” as defined by the World Health Organization.
These psychoactive drugs can then be further described as medications that impact the chemistry of the brain and therefore, used to treat a wide range of psychological disorders such as bipolar, depression, anxiety, and schizophrenia to name just a few.
In 2017, the British Journal of Clinical Pharmacology published a commentary regarding the ineffective and inaccurate classification used by the ATC (Anatomical Therapeutic Chemical) and consequently highlighted Neuroscience-based Nomenclature (NbN). I will be adhering to the NbN classification system for psychotropic drugs in order to comprehensively and precisely discuss how such drugs work.
Besides the side effects listed below, most psychotropic drugs also come with black box warnings. These black box warnings are intended to alert healthcare providers and patients to the potential for serious or life-threatening risks associated with a medication. Nearly all psychiatric medications have a black box warning of increased suicidal ideation or behavior.
More commonly known as antidepressants, drugs for depression are psychotropic drugs used for altering the levels of the neurotransmitters norepinephrine, serotonin, and dopamine.
Antidepressants help with the chemical imbalance believed to cause depression. This chemical imbalance is the result of the unavailability of the aforementioned neurotransmitters. By inhibiting the reuptake of enzymes as well as antagonizing the receptors, those neurotransmitters then become present again, allowing for the brain to properly send the correct signals.
Drugs for depression are further categorized into the following:
TCAs are used to improve mood by blocking the reuptake of norepinephrine and serotonin. MAOIs are used to reduce symptoms of depression by blocking the enzyme, monoamine oxidase, which breaks down norepinephrine, serotonin, and dopamine. SSRIs are safer and more tolerable alternatives to the previously mentioned antidepressants and these drugs block the reuptake of serotonin. SNRIs are similar to SSRIs except these antidepressants also block the reuptake of norepinephrine.
Depending on the exact prescription and dosage, users may experience any of the following symptoms:
Stimulants are psychotropic drugs used for increasing the levels of dopamine and norepinephrine to aid with therapy. The short-term effects of stimulants are collectively known as the euphoric state since dopamine is associated with the reward system of the body and norepinephrine affects blood pressure, heart rate, and breathing.
Here are some of the common psychotropic drugs that act as stimulants:
Amphetamine (D) and (D.L), Lisdexamfetamine: Weight loss, insomnia.
Methylphenidate: Headache, insomnia, nervousness, decreased appetite
Typically termed antipsychotics, drugs for psychosis affect the neurotransmitters dopamine, serotonin, and norepinephrine. By blocking dopamine, these psychotropic drugs help reduce psychotic symptoms by regulating one’s perception and mood in psychotropic drug therapy.
These antipsychotics have two types: typical and atypical – divided depending on chemical structure and side effects profile. Other terminologies used for typical and atypical are first-generation and second-generation.
First-generation antipsychotics mainly function as antagonists of dopamine receptors hence intake of these psychoactive drugs greatly affects movement.
Second-generation antipsychotics, as compared to the first-generation, do not completely block dopamine which then results in lesser effects on movement. However, these drugs also influence serotonin and norepinephrine. In consequence, not only do atypical psychotics help reduce psychotic symptoms but it also helps in mood regulation.
Depending on the exact prescription and dosage, users may experience any of the following symptoms:
Widely known as anxiolytics, these psychoactive drugs are recognized to affect the neurotransmitters gamma-aminobutyric acid (GABA), serotonin, glutamate, and histamine.
Drugs for anxiety primarily influence the central nervous system (CNS) wherein these drugs work in order to slow down or suppress activities, and thus, promote relaxation aiding in the therapeutic process.
Specified below are known psychotropic drugs for anxiety:
Alprazolam, Chlordiazepoxide, Clonazepam, Clorazepate, Diazepam, Flunitrazepam, Lorazepam, Oxazepam: Sedation, somnolence, ataxia, muscle relaxation, memory deficit
Buspirone: Dizziness, headache, somnolence
Gabapentin: Dizziness, somnolence
Pregabalin: Dizziness, sedation
Hydroxyzine: Sedation
Drugs for insomnia (also known as hypnotics) function similarly to drugs for anxiety from a pharmacotherapeutic perspective wherein these drugs focus on the CNS. Hypnotics depress the CNS and affect the neurotransmitters GABA and melatonin. Due to these effects, one’s body relaxes and falls into a state of drowsiness.
Most hypnotics cause sedation, somnolence, ataxia, muscle relaxation, memory deficit.
Melatonin and Ramelteon have no known adverse side effects.
Psychotropic drugs that prevent relapse are also called mood stabilizers. These mood stabilizers facilitate the release of the neurotransmitter glutamate which helps in mood regulation. In turn, mood swings are reduced due to stabilization which is beneficial in therapy.
You may refer to this list to identify drugs for relapse prevention:
Carbamazepine, Oxcarbazepine: Dizziness, somnolence
Lamotrigine: Dizziness, rash
Valproate: Weight gain, sedation, elevated liver enzymes, hair loss
Lithium: Weight gain, tremor, parathyroid, thyroid, renal dysfunction
Considering the black box warnings accompanying psychotropic drugs, it is essential to work closely with a healthcare professional to monitor and manage any side effects that may occur during the course of treatment. Such is the goal of psychotropic medication management.
Psychoactive drugs are taken under the guidance of a licensed healthcare professional due to potential risks and side effects as well as misuse that could lead to abuse and dependence.
Psychotropic drug misuse refers to the use of said drugs for non-medical purposes. Usually, people who misuse psychotropic drugs take larger doses than prescribed, take these drugs without a prescription, use psychiatric medication to alter their mental state, and at times, combine these drugs with other substances such as alcohol or drugs.
In order for a patient not to engage in psychotropic drug misuse, a healthcare professional should prescribe, monitor, and adjust these medications to optimize their therapeutic benefits and minimize their side effects. To do such a process, the healthcare professional should evaluate the patient’s symptoms and medical history to determine the most appropriate medication(s) to prescribe and monitor the patient’s response to the medication. Any adjustments will be based on the patient’s response and side effect profile.
Patients are also expected to communicate openly about their symptoms, concerns, and any side effects they may be experiencing. Patients should also follow the prescribed dosage and instructions, and never stop taking the medication without consulting their healthcare professionals.
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Rapid and proper intervention can save lives and prevent serious harm. If you or someone you know are experiencing the following symptoms due to psychotropic drugs intake:
It is best to call 911 or proceed to the nearest emergency room for assistance. In the US, there are also several crisis hotlines and helplines that provide support and resources for people experiencing a mental health crisis. These include:
Knowing what psychotropic drugs are and what psychotropic drug use entails is very important. Once you go beyond the awareness that psychotropic drugs alter one’s mental processing, you are able to comprehend why it is significant to grasp which psychoactive drug affects which neurotransmitter.
Through such you may deduce, with the help of a health professional, whether there is the need for you to undergo pharmacotherapy. If you are already taking prescriptions, it may answer the question of whether or not there should be adjustments to be made or if there is the need to halt medications.
If you wish to get in touch with a psychiatrist online and consult whether or not there is a need for you to use psychotropic drugs, you may read through our list of sites that provide online psychiatric services and start from there.