Drugs and medications

Drug

BETA BLOCKERS

Propanolol (Inderal)

Action

Block the stimulating effect of adrenaline and other stress hormones and so can reduce physical symptoms like trembling and sweating

No effect on emotional symptoms of anxiety.

Possible side effects

• poor sleep ⁽¹⁾
• sexual dysfunction
• nausea
• diarrhoea
• fatigue
• dizziness

ANTIDEPRESSANTS

Tricyclic antidepressants
The first type of antidepressants to be manufactured. Now less commonly prescribed than the second generation SSRIs.

Amitriptyline (Elavil, Tryptizol, Laroxyl)

Butriptyline (Evadyne)

Clomipramine (Anafranil)

Demexiptiline (Deparon, Tinoran)

Desipramine (Norpramin, Pertofrane)

Dibenzepin (Noveril, Victoril)

Doxepin (Adapin, Sinequan)

Imipramine (Tofranil, Janimine, Praminil)

Lofepramine (Lomont, Gamanil)

Nortriptyline (Pamelor, Aventyl)

Protriptyline (Vivactil)

Alter the balance of serotonin and norepinephrine in the brain.

The mechanism of action is not fully understood.

• increased body temperature
• constipation
• dry mouth
• dry nose
• blurred vision
• nausea and vomiting
• low blood pressure (hypotension)
• memory impairment
• muscle twitches
• weakness

Selective Serotonin Reuptake Inhibitor antidepressants (SSRIs)

Second generation antidepressants

Citalopram (Celexa)

Escitalopram (Lexapro)

Fluoxetine (Prozac)

Fluvoxamine (Luvox)

Paroxetine (Paxil)

Sertraline (Zoloft)

Venlafaxine (Effexor)

Alter the balance of serotonin (SSRI) and norepinephrine (SNRI) in the brain.

No more effective than placebo in treating depression or social anxiety. ⁽²⁾

Recent research has questioned whether lowering or lifting serotonin levels in the brain actually influence depression. ⁽³⁾

• sexual problems
• anxiety
• sleep disruption
• weight gain
• headache
• dry mouth
• gastrointestinal problems
• nausea
• dizziness
• tremors
• fatigue
• increased risk of suicide (especially in young adults)
• increased risk of loss of bone density in older people

Withdrawal symptoms include:

• depression
• anxiety
• flu like symptoms
• irritability/aggression
• insomnia/nightmares
• nausea and vomiting
• dizziness and loss of coordination
• stomach pains
• tremor and muscle spasms
• electric shock sensations

Atypical antidepressants

Second generation antidepressants tending to have fewer side effects than older tricyclic antidepressants

Bupropion (Wellbutrin)

Venlafaxine (Effexor)

Duloxetine (Cymbalta)

Mirtazapine (Remeron)

Trazodone (Desyrel)

Nefazodone (Serzone)

Target other neurotransmitters either alone or in addition to serotonin. Some of the brain chemicals they affect include norepinephrine and dopamine.

• nausea
• fatigue
• weight gain
• sleepiness
• nervousness
• dry mouth
• blurred vision
• Withdrawal symptoms similar to the SSRI antidepressants

TRANQUILLISERS
Benzodiazepines

Chlordiazepoxide (Librium)

Diazepam (Valium)

Temazepam (Restoril)

Lorazepam (Ativan)

Increase the efficacy of a natural brain chemical (GABA) that reduces neuronal activity, inducing a calming effect.

Sedative and addictive.

• drowsiness
• dizziness
• decreased alertness and concentration
• negative impact on driving skills ^{(4) (5)}
• long term use has been implicated in deterioration of mental and physical health ⁽⁶⁾

ANTIPSYCHOTICS

Typical (first generation)

Chlorpromazine (Thorazine, Largactil)

Fluphenazine (Modecate, Dapotum Injektion, Prolixin)

Haloperidol (Haldol)

Atypical (second generation)

Aripiprazole (Abilify)

Olanzapine (Zyprexa)

Quetiapine (Seroquel)

Risperidone (Risperdal)

Ziprazidone (Geodon)

Both typical and atypical antipsychotics block dopamine activity in the brain. Increased dopamine activity is associated with psychotic symptoms.

Atypical antipsychotics are less likely to generate motor control problems as side effects.

Both types have strong tranquilizing effects.

Most common side effects:

• nasal congestion
• blurred vision
• drowsiness
• nausea
• agitation
• constipation
• light sensitivity
• dizziness
• dry mouth

Less common side effects:

• fever
• swelling of mouth, face, lips, or tongue
• chest pain
• changes in menstrual period
• severe allergic reactions
• visual disturbance
• confusion
• Parkinson-like symptoms – the ‘shakes’
• seizures
• yellowing of skin or eyes
• difficulty swallowing
• difficulty urinating
• involuntary facial movements
• drooling
• inability to move eyes
• muscle spasms
• prolonged or painful erection
• sleeplessness
• changes in breast tissue
• weight gain

(this list is not exhaustive)