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The Sensible Psychology Dictionary Psychiatric Diagnoses in Plain English

Drugs and medications

In the Introduction to this Sensible Psychology Dictionary, we have stated our position on the medicalization of psychological problems. We think it has gone too far, and does more harm than good.

We do not claim that all drug treatment is wrong and that drugs have no role to play in the treatment of mental illness and psychological difficulties.

However, in our view, treatment protocols rely too heavily on drugs whose benefits are considerably less than claimed, and often not great enough to outweigh the very serious health risks associated with their side effects.

A very wide range of psychoactive medications are regularly prescribed for people suffering from mental illness and psychological problems and these notes are not intended to be a comprehensive guide. There are many resources on the internet giving full details of every drug, its treatment action and possible side effects and interactions.

There is an excellent Medicines Database at Netdoctor.co.uk.
The NHS Choices website also has a Medicines A-Z.
You can find a Drugs & Medications list at drugs.com
And PsychCentral.com has a Medication Library.

The table below gives some basic information about some of the drugs most commonly prescribed for anxiety, depression, psychosis and related problems, and the side effects associated with them.

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)

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Mark Tyrrell

About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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Notes:

  1. Stoschitzky K, Sakotnik A, Lercher P, et al. (1999). “Influence of beta-blockers on melatonin release“. Eur. J. Clin. Pharmacol. 55 (2): 111-5.
  2. See: The Emperor’s New Drugs: Exploding the Antidepressant Myth (Bodley Head, 2009) by Irving Kirsch.
  3. ibid.
  4. Rapoport MJ, Lanctôt KL, Streiner DL (2009). “Benzodiazepine use and driving: a meta-analysis”. J Clin Psychiatry 70
  5. Orriols L, Salmi LR, Philip P (2009). “The impact of medicinal drugs on traffic safety: a systematic review of epidemiological studies“. Pharmacoepidemiol Drug Saf 18 (8): 647-58.
  6. Longo LP, Johnson B (2000). “Addiction: part I. Benzodiazepines-side effects, abuse risk and alternatives“. Am Fam Physician 61 (7): 2121-8.

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