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Pharmacological Treatments for Mental Illnesses

Instructor: Amanda Robb

Amanda holds a Masters in Science from Tufts Medical School in Cellular and Molecular Physiology. She has taught high school Biology and Physics for 8 years.

In this lesson, we'll be reviewing some of the pharmacological treatments for common classes of mental illnesses. We'll go over medication for depression, anxiety, and substance abuse.

What Are Pharmacological Treatments?

You notice your friend Jerome has been withdrawn lately. He seems sad and tired all the time. Symptoms like this are characteristic of depression, a mental illness characterized by prolonged feelings of sadness. Drugs, or pharmacological treatments, are also very helpful for some patients in dealing with mental illness. Mental illness changes the way our brain communicates with chemicals called neurotransmitters. Pharmacological treatments try to correct these changes.

Depression

Like Jerome, millions of Americans are affected by depression each year. Luckily, there are several pharmacological treatments that have been shown to alleviate depression.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Serotonin is one of the neurotransmitters in our brain that makes us feel happy. People with depression don't make enough of this chemical, and thus have a hard time feeling happy, even during activities they like. SSRIs increase levels of serotonin, which increases feelings of happiness. Some of the most commonly used antidepressants fall in this category, such as Sertraline (Zoloft), Citalopram (Celexa) and Fluoxetine (Prozac).

Fluoxetine pills
fluoxetine

Norepinephrine-dopamine Reuptake Inhibitors (NDRIs)

Similar to SSRI, NDRIs increase two neurotransmitters, norepinephrine and dopamine. NDRIs, such as the drug Bupropion (Wellbutrin), are typically used to treat other disorders, however they are more recently being used to treat depression.

Tricyclic Antidepressants

Tricyclic antidepressants have more side effects than SSRIs or NDRIs and are generally used if other medications aren't effective. Tricyclic antidepressants increase serotonin and norepinephrine. However, tricyclic antidepressants also affect a variety of other chemicals in the brain, leading to unwanted side effects, such as blurred vision, changes in blood pressure, sexual side effects and others. Amitriptyline (Elavil), and desipramine (Norpramin) are examples of tricyclic antidepressants.

Anxiety

Imagine going to the grocery store. Leaving the house is a complete struggle. You feel so nervous and your heart is racing, although you can't really figure out why the grocery store makes you feel this way. You feel overwhelmed just thinking about it. These feelings are characteristic of generalized anxiety, a mental illness characterized by excessive nervousness and physical symptoms such as dizziness or a rapid heart rate. Although anxiety can be incredibly debilitating, there are pharmacological treatments to help.

Anxiety can be debilitating without treatment
anxiety

Benzodiazepines

Benzodiazepines are medications that decrease global activity in the brain. They work by augmenting a neurotransmitter called GABA (gamma-Aminobutyric acid). During anxiety the nervous system activity is heightened, so, decreasing activity decreases anxiety.

Benzodiazepines, such as diazepam (Valium), alprazolam (Xanax), and lorazepam (Ativan), are all addictive. They are prescribed for acute panic attacks, and not necessarily long term treatment. Taking benzodiazepines with alcohol can be fatal, as both depress activity of the nervous system.

Antidepressants

SSRIs, such as the ones used to treat depression, like escitalopram (Lexapro) and duloxetine (Cymbalta), can be used to treat generalized anxiety disorder, which lasts many months or years, These drugs are usually the first line of treatment for long term anxiety and are not habit forming like benzodiazepines.

Buspirone

Buspirone (Buspar) is a non-addictive anti-anxiety medication. This medication acts as a serotonin reuptake inhibitor in certain parts of the brain and also modulates dopamine signaling, which has been shown to be involved in anxiety disorders.

Substance Abuse

It could start as having a drink after work. After all, you've had a hard day and deserve an extra glass of wine. Soon, two glasses spirals into three, and those weekend drinks turn into an everyday coping skill to relax. Or addiction can start with a medical treatment. Prescription drugs, like oxycodone, prescribed for an injury can lead to a downward spiral of opiate addiction.

Drug addiction alters brain chemistry, causing a person to become dependent on the drug and no longer be in control. Like other mental illnesses involving brain chemistry, drug and alcohol addition can also be treated with pharmacological interventions.

Alcohol

Some people are able to detox from alcohol at home without medical intervention, but with severe alcoholism, medical intervention may be necessary.

Detox

The primary treatment for alcohol detox is benzodiazepines. This medication can be fatal when combined with alcohol, so its important for this treatment to occur under the supervision of a medical professional so the patient does not drink. Benzodiazepines are used to ease withdrawal symptoms, but are not a long term solution to alcoholism.

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