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Psychiatric Medications

More serious side effects are extremely rare. However, a very small percentage of people being treated with these medications have aggravation of narrow-angle glaucoma and seizures.

As the bothersome side effects clear, the positive benefits of these medications take hold. Gradually insomnia clears up and energy returns. The person's self-esteem improves and the feelings of hopelessness, helplessness and sadness ease.

MAOIs: Though they are as effective as heterocyclic medications, MAOIs such as isocarboxazid, phenelzine, and tranylcypromine, are prescribed less frequently due to dietary restrictions their use requires. Psychiatrists will sometimes turn to these medications when a person hasn't responded to other anti-depressants. MAOIs also help depressed people whose health conditions--such as heart problems or glaucoma--prevent them from taking other types of medications.

People who take MAOIs should not eat foods such as cheese, beans, coffee, chocolate or other items that contain the amino acid tyramine. This amino acid interacts with MAOIs and causes a severe and life-threatening increase in blood pressure. MAOIs also interact with decongestants and several prescription medications. People using these anti-depressants should always consult their physicians before taking any other drug, and should rigorously follow dietary instructions.

Serotonin-specific agents: Serotonin-specific medicines--such as fluoxetine and sertraline--represent the newest class of medication for people suffering from depression. These medications have less effect on the cardiovascular system and therefore are helpful for depressed people who have suffered a stroke or heart disease. They generally have fewer side effects than other classes of anti-depressants.

However, during the first few days of taking them, patients may feel anxious or nervous, and may suffer sleep disturbances, stomach cramps, nausea, skin rash and, rarely, sleepiness. In extremely rare cases, a person may develop a seizure.


 

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A few patients reported that, though they had no suicidal thoughts before taking fluoxetine, they developed a preoccupation with suicide after medication began. There have also been some reports that a very few patients developed violent behavior after beginning to take fluoxetine. Scientific data do not support these claims, however. No studies have shown that the medication itself caused these preoccupations or behaviors, which are also symptoms of depression.

Bipolar medications

People suffering from bipolar disorder go through phases of severe depression that alternate with periods of feeling normal and/or periods of excessive excitement and activity known as mania. During the manic phase, people have extremely high energy, develop grandiose and unrealistic ideas about their abilities, and commit themselves to unrealistic projects. They may go on spending sprees, for example, buying several luxury cars despite moderate income. They may go for days without sleeping. Their thoughts become increasingly chaotic; they speak rapidly and they may become quite angry if interrupted.

Lithium: The medication of first choice for bipolar illness is lithium, which treats both the manic symptoms in seven to ten days and reduces depressive symptoms when they may develop.

Though it is very effective in controlling the wild thoughts and behaviors of mania, lithium does have some side effects, including tremor, weight gain, nausea, mild diarrhea, and skin rashes. People taking lithium should drink 10 to 12 glasses of water a day to avoid dehydration. Adverse reactions which may develop in a small number of people include confusion, slurred speech, extreme fatigue or excitement, muscle weakness, dizziness, difficulty in walking or sleep disturbances.

Physicians also sometimes prescribe anticonvulsant drugs such as carbamazepine or valproate for people with bipolar disorder, though the FDA has not yet approved them for this purpose. It has been known to cause potentially serious blood disorders in a minority of cases.

Anti-anxiety medications

Anxiety disorders, in addition to generalized anxiety, include such disorders as phobias, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Studies indicate that eight percent of all adults have suffered from a phobia, panic disorder or other anxiety disorder during the preceding six months. For millions of Americans, anxiety disorders are disruptive, debilitating and often the reason for loss of job and serious problems in family relationships.

Often an anxiety disorder, such as a simple phobia or post-traumatic stress disorder, responds well to psychotherapy, support groups and other non-medication treatments. But in severe cases, or with certain diagnoses, a person may require medicine to control the unrelenting and uncontrollable tension and fear that rule their lives.

Psychiatrists can prescribe highly effective medications that relieve the fear, help end the physical symptoms such as pounding heart and shortness of breath, and give people a greater sense of control. Psychiatrists often prescribe one of the benzodiazepines, a group of tranquilizers that can reduce debilitating symptoms and enable a person to concentrate on coping with his or her illness. With a greater sense of control, this person can learn how to reduce the stress that can trigger anxiety, developing new behaviors that will lessen the effects of the anxiety disorder.

Benzodiazepines, such as chlordiazepoxide, and diazepam, and several other medications effectively treat mild to moderate anxiety, but these medications should be taken for short periods. Side effects can include drowsiness, impaired coordination, muscular weakness and impaired memory and concentration, and dependence after long-term use.

Last Updated: 04 July 2016
Reviewed by Harry Croft, MD

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