Psychotropic drugs are medications whose function is to stimulate or inhibit certain neurotransmitters or neurohormones closely related to behavior and psychological aspects. They must be administered solely and exclusively by qualified personnel in the field of mental health (psychiatrists).
It is important to highlight the fact that this type of medication helps in many cases of mental and/or emotional disorders, but that by themselves they do not represent a cure, since their administration must be accompanied by psychotherapy to achieve significant improvement (and in many cases, the cure) of the patients.
The following article has been prepared based on the contributions of Stahl, SM (2002), extracted from , and from Vogel, León, Torres and Crossley (2017) published in .
Types of psychotropic drugs
We find different groups (and subgroups) of psychotropic drugs, according to their nature, characteristics and applications:
Anxiolytics
This type of medication is also known as tranquilizers or sedative-hypnotics, and is responsible for reducing the reactions produced by anxiety and feelings of anguish. All this is thanks to its effects on the neurotransmitter GABA, an amino acid whose function is to reduce nervous activity in the brain, helping to achieve calm and relaxation.
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This type of psychotropic drugs is also usually indicated for the treatment of sleep disorders, thanks to its sedative effects. They are usually available in various presentations, the most common being benzodiazepines that are found with names such as: alprazolam, diazepam, lorazepam, among others.
Its use should be low strict medical surveillance, since these are medications that can cause addiction, both physically and mentally and emotionally. For this reason, constant medical monitoring during consumption is essential. Among the anxiolytics we find:
- Barbiturates: the oldest and, therefore, with the greatest adverse effects.
- Benzodiazepines: they are GABA agonists (they enhance its functioning), and are also used as sedatives or anticonvulsants.
- Short-acting sedative-hypnotics: within this group we find zaleplom, zolpidem and zopiclone, which, like benzodiazepines, act as GABA agonists.
- Buspirone: its mechanism of action focuses on serotonin (it is its agonist), and it is used for cases of generalized anxiety disorder (GAD). It is one of the few anxiolytics that is not related to GABA receptors, and does not cause dependence or withdrawal, although its therapeutic effect may take longer to appear (at least a week).
Antidepressants
One of the most used psychotropic drugs in the world are antidepressants, and as their name indicates, their main function is to help with depressive processes (although it is also used for other pathologies, such as severe anxiety or OCD). This is achieved through synaptic stimulation that promotes neuronal activity.
Among antidepressants we find:
- MAOIs: MonoAmino Oxidase enzyme inhibitors. They were the first to be discovered.
- Tricyclics and tetracyclics: their name comes from their ring-shaped structure.
- SSRIs: Selective Serotonin Reuptake Inhibitors; By inhibiting the reuptake of serotonin, this neurotransmitter is more available in the brain and its presence there is prolonged, which improves the patient’s mood. Currently they are among the most used and effective.
- SNRIs: Selective Norepinephrine Reuptake Inhibitors.
- SNRIs: Dual Serotonin and Norepinephrine Reuptake Inhibitors.
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Antipsychotics
This type of psychotropic drugs are also known as neuroleptics, and are considered major tranquilizers. Its main function is sedation, and it is indicated in cases of a psychiatric nature and for the treatment of psychotic disorders, mainly schizophrenia, or for states of intense agitation.
The most common are olanzapine, haloperidol and risperidone, among others, and they are responsible for reducing and/or eliminating delusions and hallucinations produced by the aforementioned pathologies.
This type of medication usually has considerable adverse effects, so its use must be strictly monitored by medical personnel. Although these types of mental conditions do not usually have a cure and despite their adverse effects, antipsychotics represent the best option for reducing the symptoms and related discomforts.
Within antipsychotics we find two subtypes:
Typical (classic) antipsychotics
They are the first to be manufactured, hence their nomenclature. Its mechanism of action is based on blocking dopamine receptors (the so-called D2 receptors) of the mesolimbic pathway of the brain. This blockade causes a decrease or cessation of the positive symptoms of schizophrenia and psychotic disorders, such as delusions and hallucinations.
But its mechanism of action also affects the rest of the dopaminergic pathways, which generates the adverse effects of these drugs, such as tremors, tardive dyskinesias or restlessness.
Atypical antipsychotics
They are the newest antipsychotics, and they began to be synthesized with the aim of also producing an improvement in the negative symptoms of psychotic disorders (something that typical antipsychotics do not achieve). They work by blocking dopamine and also serotonin, which eliminates the side symptoms of typical antipsychotics.
Euthymizers (mood stabilizers)
Among the euthymizers we find lithium salts or lithium (mainly used for bipolar disorder) and anticonvulsants. Its function is to stabilize the patients’ mood. Its use is usually indicated in the treatment of manic-depressive disorder and bipolar disorder, which are conditions in which the patient presents very noticeable oscillations or changes in their mood.
This type of psychopathology not only affects the mood, but can also affect the energy of those who suffer from it, making it difficult to carry out their daily activities. Among these medications, the most popular are: lithium, carbamazepine and valproic acid.
This type of medication helps stabilize neurotransmitters, thus reducing the oscillation of the symptoms associated with the pathologies it treats.
Types of psychotropic drugs: important information
It is necessary to emphasize the importance of having psychotherapeutic support in any case in which the use of psychotropic drugs is necessary, since in many cases these medications directly affect the associated symptoms, but not the cause.
In other cases, a great improvement in the general condition may be noted and it may even help stabilize any imbalances that may exist at the level of brain chemistry, helping to cure the patient.
However, as in the previous case, it is necessary to have the support of a therapist to learn to recognize the symptoms and acquire strategies to deal with these situations.
The indication of this type of drugs must be carried out solely and exclusively by health personnel dedicated to the study and approach of mental health, that is, by a psychiatrist, who is the specialist in the area. It should not and cannot be indicated by psychologists or other types of doctors who are not specialized in mental health.
Furthermore, during the entire time of use of psychotropic drugs, one must be under constant control with a psychiatrist, who will determine the management of the corresponding doses.
References:
- Stahl, S. M. (2002). Essential psychopharmacology. Neuroscientific bases and clinical applications. Barcelona: Ariel.
- Vogel, M., León, F., Torres, Ry Crossley, N.A. (2017). First and second generation antipsychotics in schizophrenia: efficacy, effectiveness and effect of the dose used. ARS MEDICA, Journal of Medical Sciences42(1), 41-48.