Typical antipsychotic medications can also cause additional side effects related to physical movement, such as:. Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia TD. TD causes muscle movements, commonly around the mouth, that a person can't control. TD can range from mild to severe, and in some people, the problem cannot be cured.
Sometimes people with TD recover partially or fully after they stop taking typical antipsychotic medication. People who think that they might have TD should check with their doctor before stopping their medication.
Psychotropic Drug Indications
TD rarely occurs while taking atypical antipsychotics. Antipsychotics may cause other side effects that are not included in this list above. To report any serious adverse effects associated with the use of these medicines, please contact the FDA MedWatch program. For more information about the risks and side effects for antipsychotic medications, please visit Drugs FDA. Mood stabilizers are used primarily to treat bipolar disorder, mood swings associated with other mental disorders, and in some cases, to augment the effect of other medications used to treat depression.
Lithium , which is an effective mood stabilizer, is approved for the treatment of mania and the maintenance treatment of bipolar disorder. A number of cohort studies describe anti-suicide benefits of lithium for individuals on long-term maintenance. Mood stabilizers work by decreasing abnormal activity in the brain and are also sometimes used to treat:.
Anticonvulsant medications are also used as mood stabilizers. They were originally developed to treat seizures, but they were found to help control unstable moods as well. One anticonvulsant commonly used as a mood stabilizer is valproic acid also called divalproex sodium.
Other anticonvulsants used as mood stabilizers include:. Mood stabilizers can cause several side effects, and some of them may become serious, especially at excessively high blood levels. These side effects include:. If a person with bipolar disorder is being treated with lithium, he or she should visit the doctor regularly to check the lithium levels his or her blood, and make sure the kidneys and the thyroid are working normally.
Lithium is eliminated from the body through the kidney, so the dose may need to be lowered in older people with reduced kidney function. Also, loss of water from the body, such as through sweating or diarrhea, can cause the lithium level to rise, requiring a temporary lowering of the daily dose. Although kidney functions are checked periodically during lithium treatment, actual damage of the kidney is uncommon in people whose blood levels of lithium have stayed within the therapeutic range. Mood stabilizers may cause other side effects that are not included in this list.
For more information about the risks and side effects for each individual medication, please see Drugs FDA. Medications for common adult health problems, such as diabetes, high blood pressure, anxiety, and depression may interact badly with anticonvulsants. In this case, a doctor can offer other medication options. Many medications used to treat children and adolescents with mental illness are safe and effective.
However, some medications have not been studied or approved for use with children or adolescents. Still, a doctor can give a young person an FDA-approved medication on an "off-label" basis. This means that the doctor prescribes the medication to help the patient even though the medicine is not approved for the specific mental disorder that is being treated or for use by patients under a certain age. In addition to medications, other treatments for children and adolescents should be considered, either to be tried first, with medication added later if necessary, or to be provided along with medication.
Read more about child and adolescent mental health research. Older adults have a higher risk for experiencing bad drug interactions, missing doses, or overdosing. Older adults also tend to be more sensitive to medications. Even healthy older people react to medications differently than younger people because older people's bodies process and eliminate medications more slowly.
Therefore, lower or less frequent doses may be needed for older adults.
Before starting a medication, older people and their family members should talk carefully with a physician about whether a medication can affect alertness, memory, or coordination, and how to help ensure that prescribed medications do not increase the risk of falls. Sometimes memory problems affect older people who take medications for mental disorders. An older adult may forget his or her regular dose and take too much or not enough. A good way to keep track of medicine is to use a seven-day pill box, which can be bought at any pharmacy.
How antidepressants work
At the beginning of each week, older adults and their caregivers fill the box so that it is easy to remember what medicine to take. Many pharmacies also have pill boxes with sections for medications that must be taken more than once a day. The research on the use of psychiatric medications during pregnancy is limited. The risks are different depending on which medication is taken, and at what point during the pregnancy the medication is taken. While no medication is considered perfectly safe for all women at all stages of pregnancy, this must be balanced for each woman against the fact that untreated serious mental disorders themselves can pose a risk to a pregnant woman and her developing fetus.
Medications should be selected based on available scientific research, and they should be taken at the lowest possible dose. Pregnant women should have a medical professional who will watch them closely throughout their pregnancy and after delivery. Antidepressants, especially SSRIs, are considered to be safe during pregnancy. However, antidepressant medications do cross the placental barrier and may reach the fetus.
Birth defects or other problems are possible, but they are very rare. The effects of antidepressants on childhood development remain under study. Studies have also found that fetuses exposed to SSRIs during the third trimester may be born with "withdrawal" symptoms such as breathing problems, jitteriness, irritability, trouble feeding, or hypoglycemia low blood sugar. Most studies have found that these symptoms in babies are generally mild and short-lived, and no deaths have been reported.
Risks from the use of antidepressants need to be balanced with the risks of stopping medication; if a mother is too depressed to care for herself and her child, both may be at risk for problems. In , the FDA issued a warning against the use of certain antidepressants in the late third trimester. The warning said that doctors may want to gradually taper pregnant women off antidepressants in the third trimester so that the baby is not affected. After a woman delivers, she should consult with her doctor to decide whether to return to a full dose during the period when she is most vulnerable to postpartum depression.
Antidepressants pocket guide download pdf
After the baby is born, women and their doctors should watch for postpartum depression, especially if a mother stopped taking her medication during pregnancy. In addition, women who nurse while taking psychiatric medications should know that a small amount of the medication passes into the breast milk. However, the medication may or may not affect the baby depending s on the medication and when it is taken.
Women taking psychiatric medications and who intend to breastfeed should discuss the potential risks and benefits with their doctors. FDA is also responsible for advancing public health by helping to speed innovations that make medicines more effective, safer, and more affordable and by helping the public get accurate science-based information they need to use medicines and foods to maintain and improve their health.
You can also use the contact information provided below:. FDAs MedWatch program offers several ways to help you stay informed about the medical products are prescribed, administered, or dispensed every day. Get safety alerts delivered to your inbox. To subscribe, join the MedWatch email list.
Learn more about the MedWatch E-list. Unless otherwise specified, NIMH information and publications are in the public domain and available for use free of charge. Citation of the NIMH is appreciated. Hours: a. Skip to content. Mental Health Information. It took Laura five months to withdraw from five drugs, a process that coincided with a burgeoning doubt about a diagnosis that had become a kind of career.
When her aunt Sara updated the rest of the family about Laura, the news was the same: they joked that she had become part of the couch. Her family, Laura said, learned to vacuum around her. Others in her situation might have lost their job and, without income, ended up homeless. It took six months before she felt capable of working part time. Laura had always assumed that depression was caused by a precisely defined chemical imbalance, which her medications were designed to recalibrate.
She began reading about the history of psychiatry and realized that this theory, promoted heavily by pharmaceutical companies, is not clearly supported by evidence. Genetics plays a role in mental disorder, as do environmental influences, but the drugs do not have the specificity to target the causes of an illness.
Wayne Goodman, a former chair of the F. Few studies follow patients who take the medications for more than a year. A decade after the invention of antidepressants, randomized clinical studies emerged as the most trusted form of medical knowledge, supplanting the authority of individual case studies.
For adolescents who go on medications when they are still trying to define themselves, they may never know if they have a baseline, or what it is. Antidepressants are now taken by roughly one in eight adults and adolescents in the U. Industry money often determines the questions posed by pharmacological studies, and research about stopping drugs has never been a priority.
Barbiturates, a class of sedatives that helped hundreds of thousands of people to feel calmer, were among the first popular psychiatric drugs. Although leading medical journals asserted that barbiturate addiction was rare, within a few years it was evident that people withdrawing from barbiturates could become more anxious than they were before they began taking the drugs. They could also hallucinate, have convulsions, and even die. Valium and other benzodiazepines were introduced in the early sixties, as a safer option.
By the seventies, one in ten Americans was taking Valium. Selective serotonin reuptake inhibitors, or S. There had been other drugs used as antidepressants, but they had often been prescribed cautiously, because of concerns about their side effects. Concerns about withdrawal symptoms emerged shortly after S. A third of the patients said they felt suicidal, and four were admitted to a hospital. One had an abortion, because she no longer felt capable of going through with the pregnancy.
Internal records of pharmaceutical manufacturers show that the companies have been aware of the withdrawal problem. At a panel discussion in , Eli Lilly invited seven experts to develop a definition of antidepressant withdrawal. Guy Chouinard, a retired professor of psychiatry at McGill and at the University of Montreal, who served as a consultant for Eli Lilly for ten years and did one of the first clinical trials of Prozac, told me that when S.
Chouinard is considered one of the founders of psychopharmacology in Canada. When he reinstated their medication, their symptoms began to resolve, usually within two days. Most people who discontinue antidepressants do not suffer from withdrawal symptoms that last longer than a few days.
Some experience none at all. Giovanni Fava, a professor of psychiatry at the University of Buffalo, has devoted much of his career to studying withdrawal and has followed patients suffering from withdrawal symptoms a year after stopping antidepressants. A paper published last month in a journal he edits, Psychotherapy and Psychosomatics , reviewed eighty studies and found that in nearly two-thirds of them patients were taken off their medications in less than two weeks.
To some degree, that makes sense: no one wants to deter people from taking drugs that may save their life or lift them out of disability. In a paper published last month in Lancet Psychiatry , he and a co-author reviewed brain imaging and case studies on withdrawal and argued that patients should taper off antidepressants over the course of months , rather than two to four weeks, as current guidelines advise. Such guidelines are based on a faulty assumption that, if a dose is reduced by half, it will simply reduce the effect in the brain by half.
Three months after Laura stopped all her medications, she was walking down the street in Boston and felt a flicker of sexual desire. The sensation began to occur at random times of day, often in public and in the absence of an object of attraction.
- Giving that Transforms.
- Interaction of Antidepressants with the Serotonin and Norepinephrine Transporters;
- The Challenge of Going Off Psychiatric Drugs.
When she was thirty-one, she began a long-distance relationship with Rob Wipond, a Canadian journalist. Everything was new to her. It felt synthetic. I did it! She felt fortunate that her sexuality had returned in a way that eluded other people who were withdrawing from drugs. Although it is believed that people return to their sexual baseline, enduring sexual detachment is a recurring theme in online withdrawal forums.
Audrey Bahrick, a psychologist at the University of Iowa Counseling Service, who has published papers on the way that S. There was this assumption that the symptoms would resolve once you stop the medication. I just kept thinking, Where is the data? Where is the data? Laura felt as if she were learning the contours of her adult self for the first time. When she felt dread or despair, she tried to accept the sensation without interpreting it as a sign that she was defective and would remain that way forever, until she committed suicide or took a new pill.
Laura tried to find language to describe her emotions and moods, rather than automatically calling them symptoms. She wrote several letters to Dr. Roth, her favorite psychiatrist, requesting her medical records, because she wanted to understand how the doctor had made sense of her numbness and years of deterioration. After a year, Dr. Roth agreed to a meeting. Laura prepared for hours. How do you make sense of that? Roth opened the front door.
She had always loved Dr. By the time Dr. Roth walked into the waiting room, Laura was crying. They hugged and then took their usual positions in Dr. But Laura said that Dr. It was only when Laura left that she realized she had never asked her questions. Laura started a blog, in which she described how, in the course of her illness, she had lost the sense that she had agency. People began contacting her to ask for advice about getting off multiple psychiatric medications.
Some had been trying to withdraw for years. They had developed painstaking methods for tapering their medications, like using grass-seed counters to dole out the beads in the capsules. Laura, who had a part-time job as a research assistant but who still got financial help from her parents, began spending four or five hours a day talking with people on Skype. I needed to know that someone else had gone through it and survived. I know that I would lay down my life for her.
Laura realized that she was spending her entire workday on these conversations. Because she needed to become financially self-reliant, she began charging seventy-five dollars an hour on a sliding scale to talk to people. Few psychiatrists are deeply engaged with these questions, so a chaotic field of consultants has filled the void.
The groups offer instructions for slowly getting off medications—they typically recommend that people reduce their doses by less than ten per cent each month—and a place to communicate about emotional experiences that do not have names. For many people on the forums, it was impossible to separate the biochemical repercussions from the social ones. The medicines worked on their bodies, but they also changed the way people understood their relationships and their social roles and the control they had over elements of their lives.
It has not worked. I am not an angry person—I am gentle, I am affectionate, I am open—but in withdrawal I found that these qualities were less clear. I have had the level of all the antidepressants I've been on three different ones raised at some point. Older classes of antidepressants, such as tricyclics, have fallen out of favor because they tend to have more side effects than the newer classes, such as SSRIs like Prozac , but they do work.
I was on one successfully for ten years. If the newer antidepressants aren't working for you, ask your doctor to try one of the older ones. Having side effects is not a big deal when the antidepressant is working, trust me. Whether you have dysthymia , major depression or atypical depression determines which antidepressant the doctor will start you on. If your doctor prescribed one that isn't a usual choice for your diagnosis, ask why.
There may be a good reason that has to do with another aspect of your health, but it's a good idea to find out why he or she deviated from the norm. I just found out after a few years on Wellbutrin that my two daily doses should be taken only a few hours apart, instead of the twelve hours I assumed was meant by "twice daily.