Medication can be an effective part of a treatment plan for people with mental illnesses. It can control the acute (immediate) symptoms and prevent relapse of both schizophrenia and mood disorders. However, medication does not cure mental illness – only controls it. Medication has factors to consider such as side effects, time necessary to be effective and cost. For these reasons it may be necessary to try several different medications to find the drug or combination of drugs that is right for you. The dose may also need to be adjusted to make sure the drug is working most effectively.
The following information is meant as a general guide only. There are a wide variety of medications available for the treatment of mental health disorders. It is important to talk to your doctor, pharmacist, and other health care providers about all your medications – including the ones that you may be taking for other conditions. Try to go to the same pharmacist for all your prescriptions. If you experience side effects from any medication, or if you have a medication allergy, talk to both your doctor and pharmacist about it. Talk to your doctor before changing your dose or stopping your medication. Stopping medication suddenly may cause withdrawal effects which often resembles flu-like symptoms.
In Manitoba, your pharmacist is required to discuss with you, in an atmosphere of confidentiality and privacy, the following information about your prescription medication:
- The drug name
- What the drug does
- How and at what time the drug should be taken
- Importance of taking the drug as directed, regularly or when needed
- What to do if the dose is missed
- Common side effects
- Food, drink, other drugs or activities to avoid
- Special storage requirements
Remember that the use of alcohol with any medication is potentially dangerous. Smoking can also affect how the body metabolizes medications. If you smoke, let your doctor know if you plan on quitting.
The following are descriptions of general sub-categories of medications commonly used – many of these medications are used across a range of mental health disorders.
Antipsychosis Medications
Also known as neuroleptics, major tranquilizers, 1st generation antipsychotics (e.g. Haldol), 2nd generation antipsychotics (e.g. olanzapine). These medications are used to treat acute psychotic episodes as well as reduce relapse of conditions such as schizophrenia and bipolar disorder.
These medications are either taken by mouth or given as an intramuscular injection. These medications work best if taken around the same time every day.
Side effects include drowsiness, dizziness, dry mouth, movement problems and stiff muscles. Tardive Dyskinesia (TD) or involuntary movements may occur when they are used for longer periods of time. Managing side effects may be achieved by changing doses, changing medications, or taking medications for movement side effects, for example: benztropine, procyclidine, and trihexyphenidyl.
Antidepressants
Antidepressants are used to treat and control depression. There are many different types of medications that are used as antidepressants. Each group have an effect on different chemicals (neurotransmitters) in the brain that affect mood. Some examples are:
- MAOI’s (Monoamine Oxidase Inhibitors)
- SSRI’s (Selective Serotonin Reuptake Inhibitors)
- SNRI’s (Serotonin-Norepinephrine Reuptake Inhibitors)
- Dual-Action Antidepressants (affect 2 different neurotransmitters)
- Tricyclic Antidepressants
Side effects include dry mouth, blurred vision, difficulty urinating, constipation, sedation, and dizziness. These medications take several weeks to reach their full effect. Antidepressants work in the nervous system, some antidepressants are also used in other conditions such as pain.
Mood Stabilizers
These are used to treat people in the state of great excitement and emotional stress, for example acute mania. Lithium is the most common. Carbamazepine, valproic acid, topiramate, are also used as mood stabilizers because their action is in the nervous system. In some people, these drugs can have fewer side effects. These can take several weeks to work. Regular blood tests are needed for therapeutic effect. It is also important to drink adequate water, especially when taking Lithium.
Side effects include lethargy, trembling, nausea, diarrhea, frequent urination, and mental functioning problems.
Antianxiety Medications
Also known as tranquilizers or sedatives, antianxiety medications are used to relieve the distress of anxiety. Benzodiazepines are most commonly prescribed.
Side effects include sedation, lethargy, depression, difficulty concentrating, and memory problems. Dependency can occur if they are used for long periods of time.
Herbal or Natural Remedies
There are many herbal products that are promoted as natural alternatives to medication. There are also vitamins and supplements that may be taken as supportive nutrients and may help improve symptoms of mental illness.
If you are considering an herbal or natural remedy, tell your doctor and pharmacist that you are considering using the remedy. They will provide information, advise you whether it will be suitable for you or if it will interfere with other medication you are using.
Some commonly used herbal products are:
- SAMe (S-adenosyl-L-methionine)
• St. John’s wort (Hypericum perforatum)
Some commonly used vitamins and supplements are:
- Vitamin D (1000 – 2000IU per day)
- Omega-3 (EPA)
- Vitamin B complex