Psychotropic Drugs – Types, Effects, and Risks

According to an assessment using the World Health Organisation’s Assessment Instrument for Mental Health Systems (WHO-AIMS), almost all countries in the Eastern Mediterranean Region have psychotropic drugs on their national essential medicines lists. However, only 36% of primary health care facilities in the region have a regular supply of essential psychotropic drugs.

To support the integration of the consideration of mental health into primary healthcare, countries must ensure a consistent supply of crucial psychotropic medications to all health institutions, including basic health care facilities, as indicated in the regional strategy.

The WHO recently released guidelines for the medical treatment of mental disorders in primary health care to allow nations to adjust their specific needs.

What are psychotropic drugs?

According to Section 2 subsection 23 of the NDPS ACT 1985, ‘Psychotropic substance’ denotes any substance, natural, or synthetic, or any natural material or any salt or preparation of such substance or material included in the list of psychotropic substances specified in the Schedule under this act.

Psychotropic drugs, also known as psychopharmaceutical, psychoactive agent, or psychoactive drug, alter the nervous system function, causing changes in perception, emotion, consciousness, cognition, or behaviour.

These chemicals can be used for medical purposes, recreationally, to increase performance or alter consciousness, as entheogens for ritual, spiritual, or shamanic purposes, or experimentation. Physicians and other healthcare professionals prescribe some types of psychoactive medications with therapeutic value.

Anaesthetics, analgesics, anticonvulsants, antiparkinsonian medicines, and antidepressants, anxiolytics, antipsychotics, and stimulant medications are all examples of medications used to treat neuropsychiatric illnesses.

Detoxification and rehabilitation programmes for people dependent on or addicted to other psychoactive drugs including psychoactive substances.

Historical background of psychotropic drugs

The use of psychotropic stimulants (mainly plants and mushrooms) can be traced to prehistoric times at least 10,000 years and archaeological facts of cultural use extend back at 5,000 years. For example, in Peruvian society, chewing coca leaves stretched back over 8,000 years.

An aspect of psychoactive drug use that is often overlooked is its medicinal use. People argue that modifying one’s consciousness is as primal as the desire to quench one’s thirst, hunger, or sexual desire.

Supporters of this viewpoint argue that the history of drug use and children’s desire to spin, swing, or slide demonstrates that the need to change one’s mental state is universal.

Many governments worldwide responded to the use of recreational and psychotropic drugs in the twentieth century by outlawing them and making their use, supply, or exchange illegal. Prohibition in the United States was a famous example, as alcohol was made illegal for 13 years.

However, many nations, government officials, and law enforcement officers have concluded that criminalising illicit drug use is not sufficient to stop its use.

In some countries, health services are focusing on harm reduction, in which the use of illicit drugs are neither condoned nor promoted. Still, services and support are offered to ensure that users have access to accurate information and reduce the negative consequences of their use. Such is the case with Portugal’s decriminalisation strategy, which met its primary goal of decreasing the negative health consequences of drug consumption.

Types of psychotropic drugs

Antidepressants, anti-anxiety drugs, stimulants, antipsychotics, and mood stabilisers are the five primary categories of psychotropic drugs.

• Depression is treated with antidepressants.
• Anti-anxiety drugs treat a wide range of anxiety problems.
• Stimulants aid in the management of disordered behaviour.
• Antipsychotics aid in the treatment of psychosis.
• Mood stabilisers aid in the control of intense emotions.

Antidepressants and their side effects

Antidepressants are prescription drugs frequently used to treat depression. Antidepressants are used to treat anxiety, pain, and insomnia, among other things.

Although not approved by the U.S. Food and drug administration for this purpose, antidepressants are sometimes used to treat attention deficit hyperactivity disorder (ADHD) in adults.

The following selective serotonin reuptake inhibitors (SSRIs) are the most often prescribed antidepressants (SSRIs):

• Fluoxetine
• Citalopram
• Sertraline
• Paroxetine
• Escitalopram

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are other types of antidepressants. Venlafaxine and duloxetine are SNRIs similar to SSRIs.

Bupropion is a regularly used antidepressant that differs from both SSRIs and SNRIs in its operation. Bupropion is used to assist people in quitting smoking and treating the seasonal affective disorder.

SSRIs, SNRIs, and bupropion are popular antidepressants because they have fewer adverse effects than previous antidepressants and appear to address a broader range of depression and anxiety disorders.

The FDA lists the following as the most prevalent side effects from these types of psychotropic drugs:

• Vomiting and nausea
• Gaining weight
• Diarrhoea
• Sleepiness
• Sexual issues

Anti-anxiety drugs and their side effects

Anti-anxiety drugs relieve anxiety symptoms such as panic attacks, excessive dread, and worry. Benzodiazepines are the most prevalent anti-anxiety drugs and are used to treat generalised anxiety disorder.

Anxiety disorders can be treated with the following benzodiazepines:

• Clonazepam
• Alprazolam
• Lorazepam

Anti-anxiety drugs, like any other medications, can have severe side effects. Some of these dangers and side effects are dangerous. Drowsiness and dizziness are the most typical adverse effects of benzodiazepine. Below are some more likely negative effects:

• Nausea
• Blurry Vision
• Headache
• Confusion
• Tiredness
• Nightmares

Stimulants and their side effects

Stimulants boost alertness, focus, and energy and elevate blood pressure, heart rate, and breathing. Children, adolescents, and adults with ADHD are frequently prescribed stimulant medicines.

The following stimulants are used for treating ADHD:

• Methylphenidate
• Methylphenidate
• Dextroamphetamine
• Lisdexamfetamine dimesylate

Stimulants are used in treating narcolepsy and, in rare instances, depression. Stimulants can have adverse side effects. The majority of side effects are minor and go away when the dosage is reduced. The following are the most common side effects:

• Trouble falling or staying asleep
• Appetite loss
• Headache and stomach pain

Antipsychotics and its side effects

‘Psychosis’ refers to various mental illnesses with a loss of contact with reality, such as delusions or hallucinations. Psychosis may be a sign of a physical problem like drug addiction or a mental illness like schizophrenia, bipolar disorder, or severe depression (sometimes known as “psychotic depression”). Antipsychotic medications are used for treating psychosis.

Antipsychotic drugs are frequently used in conjunction with other medications to treat delirium, dementia, and mental illnesses, such as:

• ADHD
• Severe depression
• Eating disorders
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• Generalised anxiety disorder

Antipsychotic medications do not cure these diseases. They are required to help with symptom relief and overall quality of life.

Antipsychotics come with a slew of risks and side effects. According to the FDA, antipsychotic medications have the following adverse effects:

• Drowsiness
• Dizziness
• Restlessness
• Gaining weight
• Mouth is parched
• Constipation
• Nausea
• Vomiting
• Blurred vision
• Blood pressure that is too low
• Tics and tremors are uncontrollable motions
• Seizures
• Infection-fighting white blood cells are in short supply

Mood Stabilizers and its Side Effects

Mood stabilisers are generally used to treat bipolar illness, mood swings associated with other mental diseases, and, in some situations, enhance the action of other antidepressant drugs and psychotropic drugs. Lithium is a mood stabiliser and is licenced for the treatment of mania and the maintenance therapy of bipolar disorder. Several cohort studies have found that lithium has anti-suicide advantages for people on long-term maintenance.

Mood stabilisers function by reducing the aberrant brain activity and are occasionally used to treat the following symptoms:

• Depression
• Schizoaffective disorder (SAD)
• Impulse control problems
• Children with certain mental diseases

Mood stabilisers can have various side effects, which can be dangerous, especially if blood levels are too high and can have the following adverse effects:

• Itching and rashes
• Excessive thirst
• Urination regularly
• Hand tremor (shakiness)
• Vomiting and nausea
• Speech slurred
• Fast, sluggish, irregular, or hammering heartbeats
• Blackouts
• Visional shifts
• Seizures
• Hallucinations
• Coordination problems
• Swelling of eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs

How do psychotropic drugs work?

Several psychotropic drugs alter the number of essential chemicals in the brain. Certain neurotransmitters can be increased or decreased to counteract the effect of specific mental health conditions.

Neurotransmitters are chemical messengers that allow your brain cells to communicate. If a person’s neurotransmitters are weak or overactive, they may cause unwanted chemical responses, leading to a mental health problem.

Psychotropic drugs are not a panacea. They can only be used in treating mental illnesses, and they are sometimes most successful in conjunction with psychotherapy.

Are psychotropic drugs addictive?

Except for anxiolytics, stimulants, and hypnotics, most psychotropic drugs are not addictive. Intense desires, obsessions, lack of control, and behaviour to fulfil the addiction are all characteristics of addictive behaviour. Psychotropic drugs do not cause dependence because you do not need to keep raising the dosage to have the same result. Furthermore, they do not cause addiction-related cravings.

When patients stop taking certain medications, they frequently experience transitory withdrawal symptoms (also known as discontinuation syndrome). Dizziness, headaches, lethargy, sweating, nausea, sleeplessness, restlessness, and disturbed mood are all possible symptoms. These symptoms usually start within the first several days after discontinuing or reducing your intake and last around a week.

However, just because you have a brief reaction does not indicate you have formed an addiction.

Risks regarding psychotropic drugs

For certain drugs or classes of pharmaceuticals, FDA mandates certain warnings. There are three primary causes for this:

• Before usage, the risk of a dangerous adverse reaction should be evaluated against the benefits.
• For safe prescription, a dose change may be required.
• For safe use, a particular group of people may require further monitoring, such as youngsters or pregnant women.

Here are some examples of medications with their risk factors. It is not an exhaustive list of medications or risks. Always consult your doctor or pharmacist for information on specific medicine side effects and risks:

• Due to the danger of suicidal thoughts and behaviour, aripiprazole (Abilify) and quetiapine (Seroquel) are not FDA approved for use in anybody under 18 years of age.
• The use of antipsychotic medications in older persons who have dementia-related psychosis can increase the risk of death.
• Antidepressants may exacerbate suicidal thoughts and behaviour in children and adolescents.
• Stimulant medications can develop dependence and addiction.
• When used with opioid drugs, benzodiazepines can increase the risk of overdose.
• Clozapine (Clozaril) has the potential to develop agranulocytosis, a dangerous blood condition. To keep track of the white blood cell level, blood testing should be performed regularly. This condition can trigger seizures and heart and respiratory difficulties, all of which can be fatal.

Conclusion

Medications are essential in the treatment of mental diseases. Therapy and working with families are critical in today’s world. Psychotropic drugs have a wide range of adverse effects, some of which are serious and even life-threatening. When a person with a mental health condition is experiencing various signs and symptoms while on medication, the adverse drug effects should be evaluated in the differential diagnosis. Because of the introduction of psychotropic drugs, the death rate among psychiatric inpatients has reduced considerably. Because of the introduction of psychotropic medications, reports of sudden deaths have reduced.