Information for counsellors about common psychotropic drugs

You may be in the strongest position to:

Medications are commonly prescribed for depression, anxiety, bipolar and psychosis but also for addictions.

Most medications act on the brain and the most common brain target for medications are the monoamine transmitters: Serotonin, noradrenaline and dopamine.

The commonest are serotonin reuptake inhibitors (SSRI) eg sertraline, citalopram

Because they prevent reuptake there is more serotonin around.

There can be benefits in depression and anxiety

Those more likely to benefit are those with the more severe and more persistent symptoms.

Side effects : nausea, sexual, suicide / agitation?

Other similar drugs work on Noradrenaline and Dopamine– often with more side effects eg dry mouth, constipation. (eg amitriptyline)

Diazepam (a benzodiazepine) is an anxiolytic – it works on GABA, a transmitter which is an inhibitor in the brain.

It works quickly and is also sedative – can affect driving (more accidents than other meds) and also memory.

There are issues with tolerance and dependence.

Other short acting benzos are also used to help sleep – eg temazepam

Buspirone and pregabalin may also have benefits for anxiety

Bipolar: mania and depression

The main aim of medication is long term stability.

Lithium (a salt) should be considered but needs to be taken carefully and monitored.

Toxicity and rebound issues

Antidepressants may not be effective or even be destabilising

Antipsychotic drugs act to block dopamine

Olanzapine risperidone quetiapine

Side effects on movements and appetite / weight and sedation

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