psychiatric drug information
It is important to understand what psychiatric medications can do and what to look for in terms of side-effects. In general, psychiatric medications are extremely safe but that does not mean you may not have a serious reaction or side effect. We are attempting to provide you a quick resource to help guide you in your experience with psychiatric medications. It may help in deciding whether to get help or ride out a side effect. As always, when in doubt, call your doctor or get immediate help.
What medicines can and can't do
- Medications cannot ‘take over your mind’
- They cannot change the way you feel about something. If you love or hate someone or something, that will probably not change
- Medications cannot make you ‘happy’; that’s an ‘inside job’
- Medicines can help ease your worries; possibly give you a better sense of well-being
- Medicines can get you ‘un-depressed’, but that is not the same thing as being ‘happy’
- Medicines can sometimes clear your thoughts and ‘brain-fog’
- They can reduce your reactivity to things but generally don’t change the way you feel about things
A simplified Side effect list
- Examples: Prozac, Zoloft, Paxil, Celexa, Lexapro, Effexor, Fetzima, Luvox, Wellbutrin, Viibryd, Trintellix, Cymbalta, Elavil, and older TCA’s.
- Mild Side Effects include: nausea, vomiting, diarrhea, sexual dysfunction, headache, weight gain, anxiety, dizziness, dry mouth, and trouble sleeping.
- Moderate Side effects include: Abnormal bleeding: SSRI’s used with aspirin, ibuprofen, naproxen and Coumadin can cause increased risk of bleeding. Also, it can lead to low sodium, causing weakness and confusion.
- Severe Side Effects include: Symptoms of serotonin syndrome may include anxiety, restlessness, sweating, muscle spasms, shaking, fever, rapid heartbeat, vomiting, and diarrhea. If this is suspected, go to the ER. This may occur with Tramadol and migraine medications as well.
- Increased suicidal thoughts can occur. These generally stop with cessation of the medication.
- Examples: Benzodiazepines (Valium, Xanax, Ativan, Klonopin, Librium, etc).
- There is significant risk of tolerance (where the initial dose stops working and ever increasing doses are needed for relief), dependence (where a person cannot go a day without the medication because of the risk of withdrawals) and addiction.
- There is significant risk of memory problems, falling, motor problems (coordination), and dementia.
- Examples: Ambien, Lunesta, Restoril, and Benzodiazepines
- See the risks above under ‘Anti-Anxiety Agents’, they are very similar.
- Additionally, the risks of sleepwalking and doing things without remembering you doing them can occur.
- Generally extremely safe
- Problems may be related to the anesthetic properties like sedation, sleepiness, confusion
- Can produce a dissociative state that may be uncomfortable
- Examples: Adderall, Ritalin, Vyvanse, Concerta, Metadate, Dexedrine.
- There is significant risk of tolerance (where the initial dose stops working and ever increasing doses are needed for relief), dependence (where a person cannot go a day without the medication because of the risk of withdrawals) and addiction (using the drug excessively for the purpose of achieving euphoria).
- Stimulants can cause increased BP, heart rate and problems with sleep and impulsive behaviors.
- Examples: Lithium, Depakote, Lamotrigine, Oxcarbamazepine.
- Originally most of them were developed as anti-seizure drugs (except Lithium).
- Lithium: due to limited space, you can look up common SE’s of Lithium. Importantly, most of the side effects are due to blood levels so higher levels tend to cause higher side effects. Some occur over time and may take years (hypothyroidism and kidney problems). A yellow halo around lights is usually an early marker of lithium toxicity. Also, never use NSAIDs (Motrin, ibuprofen, and Naproxen, Meloxicam as they can cause renal failure when taken with Lithium).
- Lamotrigine: Generally extremely safe except for a life threatening allergic reaction. If a severe rash emerges, stop taking the medication and go to the ER. Same goes for severe headaches or confusion.
- Depakote: Generally causes blood abnormalities related to bone marrow suppression. Can also cause weight gain and loss of hair (reverses upon discontinuation). Rarely causes pancreatitis. If you have unbearable, severe pain, stop and go to ER.
- Examples: Haldol, Risperdal, Zyprexa, Seroquel, Abilify, Rexulti, Vraylar, Geodon, Invega, Trilafon, Thorazine.
- Originally developed for the treatment of psychosis associated with schizophrenia, over the decades have helped with other problem in bipolar disorder, depression and in certain cases; anxiety.
- Mild to Moderate SE’s include: weight gain, sedation, loss of motivation, impulsivity.
- Severe SE’s may include: metabolic issues like altering glucose metabolism, increased risk of Diabetes; lipid abnormalities
- NMS Syndrome: symptoms include: high fever, confusion, rigid muscles, variable blood pressure, sweating, and fast heart rate. Complications may include rhabdomyolysis, high blood potassium, kidney failure, or seizures. Untreated, it may lead to death.