Special Message On Medication

This information is provided to help people understand how and why drugs can be used as part of the treatment of mental health problems. It is important for persons who use mental health services to be well informed about medications for mental illnesses, but this file is not a "do-it-yourself" manual. Self-medication can be dangerous. Interpretation of both signs and symptoms of the illness and side effects are jobs for the professional. The prescription and management of medication, in all cases, must be done by a responsible physician working closely with the patient and sometimes the patient's family or other mental health professionals. This is the only way to ensure that the most effective use of medication is achieved with minimum risk of side effects or complications.

Oftentimes an individual is taking more than one medication and at different times of the day. It is essential to take the correct dosage of each medication. An easy way to ensure this is to use a 7-day pill box, available at the prescription counter in any pharmacy, and to fill the box with the proper medications at the beginning of each week.

Introduction

Anyone can develop a mental illness, you, a family member, a friend, or the fellow down the block. Some disorders are mild, while others are serious and long-lasting. These conditions can be helped. One way an important way is with psychotherapeutic medications. Compared to other types of treatment, these medications are relative newcomers in the fight against mental illness. It was only 41 years ago that the first one, chlorpromazine, was introduced. But considering the short time they've been around, psychotherapeutic medications have made dramatic changes in the treatment of mental disorders. People who, years ago, might have spent many years in mental hospitals because of crippling mental illness may now only go in for brief treatment, or might receive all their treatment at an outpatient clinic.

Psychotherapeutic medications also may make other kinds of treatment more effective. Someone who is too depressed to talk, for instance, can't get much benefit from psychotherapy or counseling; but often, the right medication will improve symptoms so that the person can respond better.

Another benefit from these medications is an increased understanding of the causes of mental illness. Scientists have learned a great deal more about the workings of the brain as a result of their investigations into how psycho- therapeutic medications relieve disorders such as psychosis, depression, anxiety, obsessive compulsive disorder, and panic disorder.

Symptom Relief, Not Cure

Just as aspirin can reduce a fever without clearing up the infection that causes it, psychotherapeutic medications act by controlling symptoms. Like most drugs used in medicine, they correct or compensate for some malfunction in the body. Psychotherapeutic medications do not cure mental illness, but they do lessen its burden. In many cases, these medications can help a person get on with life despite some continuing mental pain and difficulty coping with problems. For example, drugs like chlorpromazine can turn off the "voices" heard by some people with schizophrenia and help them to perceive reality more accurately. And antidepressants can lift the dark, heavy moods of depression. The degree of response ranging from little relief of symptoms to complete remission depends on a variety of factors related to the individual and the particular disorder being treated.

How long someone must take a psychotherapeutic medication depends on the disorder. Many depressed and anxious people may need medication for a single period perhaps for several months and then never have to take it again. For some conditions, such as schizophrenia or manic-depressive illness, medication may have to be take indefinitely or, perhaps, intermittently.

Like any medication, psychotherapeutic medications do not produce the same effect in everyone. Some people may respond better to one medication than another. Some may need larger dosages than others do. Some experience annoying side effects, while others do not. Age, sex, body size, body chemistry, physical illnesses and their treatments, diet, and habits such as smoking, are some of the factors that can influence a medication's effect.

Questions for Your Doctor

To increase the likelihood that a medication will work well, patients and their families must actively participate with the doctor prescribing it. They must tell the doctor about the patient's past medical history, other medications being taken, anticipated life changes such as planning to have a baby and, after some experience with a medication, whether it is causing side effects. When a medication is prescribed, the patient or family member should ask the following questions recommended by the U.S. Food and Drug Administration (FDA) and professional organizations:

In this file, medications are described by their generic (chemical) names and in italics by their trade names (brand names used by drug companies). They are divided into four large categories based on the symptoms for which they are primarily used antipsychotic, antimanic, antidepressant, and antianxiety medications. In addition, stimulants used for attention- deficit/ hyperactivity disorder are listed.

An index at the end gives the trade name, and the generic name, of the most commonly prescribed medications and notes the section that contains information about each type.

Treatment evaluation studies have established the efficacy of the medications described here; however, much remains to be learned about these medications. The National Institute of Mental Health, other Federal agencies, and private research groups are sponsoring studies of these medications. Scientists are hoping to improve their understanding of how and why these medications work, how to control or eliminate unwanted side effects, and how to make the medications more effective.

For more detailed information, talk to your doctor or mental health professional, consult your local public library, or write to the pharma- ceutical company that produces the medication or the U.S. Food and Drug Administration, 5600 Fishers Lane, Rockville, MD 20857.