American Medical Association Family Medical Guide - American Medical Association [452]
Mood Stabilizers
Doctors prescribe mood stabilizers to even out the manic highs and depressive lows of bipolar disorder. The drug most commonly used to treat bipolar disorder is the mineral lithium. The exact way lithium works is not known, but it lessens symptoms in about 5 to 14 days. Some people with bipolar disorder respond better to anticonvulsant drugs, which are used to treat epileptic seizures (see page 686). In addition to lithium, common mood stabilizers include divalproex, carbamazepine, lamotrigine, gabapentin, and olanzapine.
Medications for Anxiety Disorders
Antianxiety medications have a calming and relaxing effect on people with anxiety disorders. Most antianxiety drugs fall into two classes—benzodiazepines and azaspirones. Many doctors also prescribe antidepressants for people who have panic attacks.
Benzodiazepines
Benzodiazepines produce a calming effect by depressing the central nervous system. They can be habit-forming, so doctors usually prescribe them for only brief periods or intermittently. Other than drowsiness, side effects are few, but withdrawal can occur if the person suddenly stops taking the drug. Commonly prescribed benzodiazepines include chlordiazepoxide, alprazolam, clonazepam, diazepam, lorazepam, and clorazepate.
Azaspirones
Azaspirones are a class of drugs that is usually prescribed for generalized anxiety disorder. Buspirone is the most frequently prescribed medication of this type.
Medications for Psychosis
Antipsychotic medications are used to treat the symptoms of psychosis, principally schizophrenia. Doctors consider a number of factors—including age, weight, and the severity of the condition—when deciding which antipsychotic drug to prescribe because each one has its own level of potency and side effects.
Antipsychotics
People vary in how they respond to antipsychotic drugs and in how fast their symptoms improve. It is not clear how these medications work, but they have tranquilizing properties; they may work by interfering with the activity of dopamine (a chemical messenger in the brain). Sometimes these drugs completely reverse the psychosis after treatment. In other cases, medications have to be taken indefinitely. Weight gain is a common side effect of antipsychotic medications, but a potentially long-term effect is the appearance of involuntary movements. Examples of antipsychotic medications include chlorpromazine, thioridazine, molindone, trifluoperazine, fluphenazine, perphenazine, and haloperidol.
Newer Antipsychotics
Although the exact way in which the newer, atypical antipsychotic medications work is not fully understood, they seem to have an effect on dopamine and serotonin, two neurotransmitters (chemical messengers) in the brain. Examples include clozapine, olanzapine, risperidone, and ziprasidone.
Treatment
Treatment of depression usually is a combination of medication and some form of psychotherapy. The form of therapy most frequently used to treat depression is cognitive-behavioral therapy, which can help you learn the underlying cause of your depression, develop skills to cope, and teach you how to transform your negative ways of thinking and behaving into more positive ones. Some depressed people also benefit from interpersonal therapy, which helps them learn how to interact more effectively with other people.
Antidepressant medications (see previous page) such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) work by evening out the balance of the brain chemicals serotonin, norepinephrine, and dopamine. These medications can have unpleasant side effects such as dry mouth, drowsiness, constipation, headaches, nausea, or insomnia, but these side effects subside as your body adjusts to the medication. Newer antidepressants, called selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs), are as effective as the older drugs but with fewer side effects. You will have to take an antidepressant