Overview of Common Psychotropic Medications

Karen Berger, PharmD
·11 min read

Medically reviewed by Mary Choy, PharmD

According to the National Institute of Mental Health (NIMH), more than one in five adults (about 20%) in the United States has a mental health condition.

Treatments for mental health conditions are structured around the condition being treated and typically are holistic in nature- including not just medication but also other interventions, such as psychotherapy.

Psychotropic medications are drugs that affect the mind, emotions, and behavior.

The broad categories of psychotropic medications, which we will break down further, include: antidepressants, anti-anxiety medications, antipsychotics, stimulants, and mood stabilizers.

These categories of medications are generally taken orally (by mouth). However, some categories mentioned above have varying dosage forms, such as intramuscular or intravenous (IV) injection.

Continue reading to learn more about these psychotropic medications, including the specific drugs that make up these respective categories, their specific uses, potential side effects, and more.

<p>Grace Cary / Getty Images</p>

Grace Cary / Getty Images

Antidepressants

Antidepressants are prescription medications used to treat major depressive disorder (MDD, depression), a common mental health condition that can make you feel sad, worried, and hopeless and can affect your appetite, sleep, and thoughts.

Beyond the treatment of MDD, some antidepressants can be used to treat anxiety or other mental health conditions, like seasonal affective disorder (SAD).

Categories of antidepressants are differentiated based on how they work; however, generally, antidepressants are thought to increase neurotransmitters and chemicals in the brain, such as serotonin and noradrenaline.

Such actions can improve a person's mood. Furthermore, improving levels of neurotransmitters can also disrupt pain signals sent by nerves.

The following section will detail notable types of antidepressants and the drugs that comprise these categories, including potential side effects.

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are among the most commonly prescribed antidepressants and are often used as a first-line choice of treatment. Although all SSRIs treat MDD, many possess other FDA-approved uses, such as the treatment of generalized anxiety disorder (GAD).

SSRIs work by increasing levels of serotonin.

Examples of commonly prescribed SSRis include Prozac (fluoxetine) and Lexapro (escitalopram).

At times, healthcare providers prescribe medications for a purpose the drug was not initially FDA-approved for. This is called off-label prescribing.

SSRIs are sometimes prescribed off-label for various uses, such as fibromyalgia (widespread muscle pain and tenderness) and migraine prevention.

The following list outlines common SSRIs and their respective indications (FDA-approved uses):

Prozac (fluoxetine) is FDA-approved to treat:

  • MDD

  • Obsessive-compulsive disorder (OCD, having obsessive thoughts that lead to repetitive behaviors or compulsions)

  • Bulimia nervosa (an eating disorder characterized by binge eating, then vomiting, excessively exercising, or fasting)

  • Panic disorder with or without agoraphobia (fear of situations or places that cause panic, helplessness, or embarrassment)

Lexapro (escitalopram) is FDA-approved to treat:

  • MDD

  • Anxiety

Zoloft (sertraline) is FDA-approved to treat:

SSRI-Related Side Effects

Common side effects of SSRIs include:

SNRIs

Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a type of antidepressant that works by increasing levels of both serotonin and norepinephrine in the brain.

Alongside the treatment of MDD, SNRIs hold the capacity to treat (in addition to anxiety disorders) long-term (chronic) pain, especially nerve pain.

Examples of commonly prescribed SNRIs include the following:

Cymbalta (duloxetine) is FDA-approved to treat:

  • MDD

  • Anxiety

  • Diabetic peripheral neuropathic pain (nerve damage associated with diabetes)

  • Fibromyalgia

  • Long-term musculoskeletal pain (pain in the bones, joints, ligaments, tendons, or muscles)

Effexor XR (venlafaxine) is FDA-approved to treat:

  • MDD

  • Anxiety

  • SAD

  • Panic disorder

Pristiq (desvenlafaxine) is FDA-approved to treat:

  • MDD

SNRI-Related Side Effects

Common side effects associated with the use of SNRIs include:

Tricyclic antidepressants

Tricyclic antidepressants (TCAs) are a class of antidepressants that work by increasing serotonin and norepinephrine levels inside the brain.

Because of the potential side effects associated with TCAs, this category of drug is not always a preferred antidepressant, especially in older adults who may be more sensitive to the side effects.

TCAs are sometimes prescribed off-label for conditions like nerve pain, insomnia, or migraine prevention.

Some commonly prescribed TCAs include the following:

Generic amitriptyline is FDA-approved to treat:

  • MDD

Pamelor (nortriptyline) is FDA-approved to treat:

  • MDD

Generic imipramine is FDA-approved to treat:

  • MDD

  • Bedwetting in children 6 years and older

TCA-Related Side Effects

Common side effects associated with the use of TCAs include:

5-HT1A Receptor Agonists

Selective serotonin 1a (5-HT1A) receptor agonists are a new class of antidepressants that selectively target serotonin 1A receptors, which are key in regulating mood and emotions.

Exxua (gepirone) is the first and only FDA-approved 5-HT1A receptor agonist to treat:

  • MDD

5-HT1A Receptor Agonist-Related Side Effects

Common side effects associated with the use of 5-HT1A receptor agonists include:

  • Dizziness

  • Nausea

  • Trouble sleeping

  • Upset stomach



Takeaway

Exxua is the first and only approved antidepressant that selectively targets the serotonin 1a (5-HT1a) receptor. Unlike other antidepressant medications, Exxua does not pose the risks of sexual side effects or weight gain.



Anti-anxiety Medications

SSRI or SNRI antidepressants are often used as a first-line treatment for anxiety, along with therapy.

However, some medications are designated explicitly as anti-anxiety medications, such as benzodiazepines (BZDs).

BZDs work by increasing the activity of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain.

GABA is an inhibitory neurotransmitter that blocks other messages and controls the rate at which information travels throughout the nervous system.

BZDs are classified as controlled substances because they have the potential for abuse and dependence.

The following section will detail notable types of BZDs and the drugs that comprise these categories, including potential side effects.

Commonly Prescribed BZDs

The following lists commonly prescribed BZDs and what they treat:

Xanax (alprazolam) is FDA-approved to treat:

  • Anxiety

  • Panic disorder with or without agoraphobia

Valium (diazepam) is FDA-approved to treat:

Ativan (lorazepam) is FDA-approved to treat:

  • Anxiety

BZD-Related Side Effects

Common side effects associated with the use of BZDs include:

  • Drowsiness

  • Problems with concentration and memory

  • Impaired coordination

  • Double vision

  • Muscle weakness

  • Vertigo

Antipsychotic Medications

Antipsychotic medications are prescription pharmaceuticals used to treat conditions that involve psychosis, a group of symptoms that affects the ability to tell what is real and what is not accurate.

Antipsychotics are a critical part of treating conditions that involve psychosis, such as schizophrenia or bipolar disorder.

Antipsychotic drugs generally work by blocking some of the dopamine receptors in the brain. This reduces the flow of these messages, which can help to reduce psychotic-type symptoms.

There are two types of antipsychotic medications:

  • First-generation antipsychotics (typical antipsychotics) were the first antipsychotics developed and are not as commonly used because they have more side effects than second-generation antipsychotics.

  • Second-generation antipsychotics (atypical antipsychotics) are newer and more preferred drugs because they have fewer side effects.

The following section will detail notable first- and second-generation antipsychotics and the drugs that comprise these categories, including potential side effects.

Commonly Prescribed First-Generation Antipsychotics

Examples of commonly prescribed first-generation antipsychotics include the following:

Adasuve (loxapine) is FDA-approved to treat the following:

  • Schizophrenia

Haldol (haloperidol) is FDA-approved to treat the following:

Commonly Prescribed Second-Generation Antipsychotics

Examples of commonly prescribed second-generation antipsychotics include the following:

Clozaril (clozapine) is FDA-approved to treat the following:

  • Treat severe cases of schizophrenia where the individual has not responded to other medications

  • Lower the risk of repeated suicidal behavior in people with schizophrenia or schizoaffective disorder.

Because Clozaril is associated with severe neutropenia and seizures, it is only available through a restricted program and only prescribed when other medications have not been effective.

Zyprexa (olanzapine) is FDA-approved to treat the following:

Conversely, in comparison to its orally administered form, injectable Zyprexa can be used to treat acute agitation associated with schizophrenia and bipolar-related mania.

Fanapt (iloperidone) is FDA-approved to treat the following:

  • Schizophrenia.

Antipsychotic-Related Side Effects

Antipsychotic drugs may cause extrapyramidal symptoms (EPS) which include:

  • Dystonias, involuntary contractions of opposite muscle groups, especially in the head, face, and neck, resulting in twisting and abnormal postures

  • Akathisia, a constant restless feeling, which generally puts the individual into a near-constant motion

  • Parkinsonism, symptoms are similar to Parkinson's disease, such as slow movement, stiff muscles, and shaking

  • Tardive dyskinesia (TD), uncontrolled/jerky motions of the lower face and extremities, such as grimacing, smacking or puckering the lips, tongue movements, and excess blinking

First-generation antipsychotics are associated with more movement disorders.

Second-generation antipsychotics are also associated with movement disorders but to a lesser extent.

Common side effects associated with the use of antipsychotics include:

Stimulants

Stimulants are prescription medications used to treat neurological conditions, such as attention-deficit hyperactivity disorder (ADHD) and narcolepsy.

Stimulants help increase energy, alertness, and attention. They work on chemicals in the brain called dopamine and norepinephrine.

Stimulants are classified by the DEA as Schedule II drugs, meaning they have a high risk of abuse and dependence.

The following section will detail notable types of stimulants and the drugs that comprise these categories, including potential side effects.

Stimulant Examples

Examples of commonly prescribed stimulants include the following:

Adderall (amphetamine/dextroamphetamine) is FDA-approved to treat:

  • ADHD

  • Narcolepsy

Concerta extended-release (ER, methylphenidate) is FDA-approved to treat:

  • ADHD

Ritalin (methylphenidate) is FDA-approved to treat:

  • ADHD

  • Narcolepsy

Stimulant-Related Side Effects

Common side effects associated with the use of stimulants include:

Mood Stabilizers

Mood stabilizer drugs encompass several categories of pharmaceuticals used to treat bipolar disorder, such as anticonvulsants and antipsychotic medications.

While not completely understood, mood stabilizers are thought to work by affecting neurotransmitters in the brain that may be involved in causing mood swings.

To date, the most commonly used mood stabilizer is lithium.

The following section will detail notable types of mood stabilizers and the drugs that comprise these categories, including potential side effects.

Commonly Prescribed Mood Stabilizers

As referenced above, Lithium is FDA-approved to treat bipolar disorder.

Beyond lithium, a commonly administered mood stabilizer is Depakote (divalproex), which is FDA-approved for the following:

Mood Stabilizer-Related Side Effects

Common side effects associated with the use of mood stabilizers include:

  • Nausea

  • Weight gain

  • Impaired thinking

  • Fatigue

  • Bodily tremors

  • Slurred speech

  • Vomiting

Summary

Psychotropic drugs affect the mind, emotions, and behavior and are commonly used for conditions that include MDD, bipolar disorder, anxiety, and schizophrenia.

The broad classes of psychotropic drugs include antidepressants, anti-anxiety medications, antipsychotics, stimulants, and mood stabilizers.

Notable psychotropic medications include Adderall, Xanax, and Ritalin, among others.

If you believe you or a loved one may benefit from the use of psychotropic medication, consult a healthcare provider, as they can advise on the best route of action forward to address mental disorders that may negatively affect quality of life.

Frequently Asked Questions

How can I safely store orally administered psychotropic medications?

Generally, psychotropic medications should be stored at room temperature (68-77 degrees F), away from direct heat, light, and moisture.

Do not store psychotropic medications in areas susceptible to high moisture levels, such as bathrooms. Keep all medications out of the reach and sight of children and pets.

For the medications that are controlled substances, such as benzodiazepines or stimulants, you should store these where no one can get to them because an overdose or accidental ingestion could be life-threatening or cause death.

Keep track of your medication so you know if any pills are missing.

Do psychotropic medications carry the risk of weight gain with use?

Some psychotropic medications are known for appetite and weight loss, such as stimulants.

Others are more associated with weight gain, and some medications list both weight loss and weight gain as possible side effects.

You can discuss weight changes with your healthcare provider if weight changes are a concern.

Are psychotropic medications advised to be taken for life?

This will vary by medical condition and medication.

Some conditions may only require short-term treatment, while others require long-term or lifelong treatment.

Read the original article on Verywell Health.