Category: Psychiatry
Antianxiety Drugs (Anxiolytics)
Psychiatry
Antianxiety Drugs (Anxiolytics)
PATIENT INFORMATION ON ANTIANXIETY DRUGS (ANXIOLYTICS)
The name of your medication is benzodiazepines
Use
This medication is used to treat symptoms of anxiety. Anxiety is a universal human response to stress and is considered necessary for effective functioning and coping with daily activities. It may, however, be a symptom of many other disorders, both medical and psychiatric. There are many different types of anxiety and there are many different approaches to treating it. Anxiolytics will help relieve the symptoms of anxiety but will not alter its cause. In usually prescribed doses, they help to calm and sedate the individual; in high doses these drugs may be used to induce sleep.Â
How quickly will the drug start working?
Anxiolytics drugs can reduce agitation and induce calm or sedation usually within an hour. Sometimes they have to be given by injection, or dissolved under the tongue, for a quicker effect.Â
How long should you take this medication?
Anxiety is usually self-limiting; often when the cause of anxiety is treated or eliminated, symptoms of anxiety will decrease. Therefore, anxiolytics are usually prescribed for a limited period of time. Many individuals take the medication only when needed (during periods of excessive stress) rather than on a daily basis.
Tolerance or loss of effectiveness can occur in some individuals if they are used continuously beyond 4 months. If you have been taking the medication for a continuous period of time , the physician may try to reduce the dose of this drug slowly to see if the anxiety symptoms return; if not, the dosage may be further reduced and you may be advised to stop using this medication. Do not increase the dose or stop the drug without consulting with your doctor. Some patients need to use an anxiolytics drug for longer time periods, because of the type of anxiety they may be experiencing. Others require it only from time to time, i.e., PRN or on as need basis.
Side effects
Side effects occur, to some degree, with all medication. They are usually not serious and do not occur in all individuals. Most will decrease or disappear with time. If a side effect continues, continues to your doctor about appropriate treatment
Common side effects that can occur with anxiolytics drugs include:
- Drowsiness and lethargy this problem goes away with time, or when the dose is reduced. Use of other drugs that make you drowsy will worsen the problem. Avoid driving a car or operating machinery if drowsiness persists.
- Muscle in coordination, weakness or dizziness-Inform your doctor; an adjustment in your dosage may be needed.
- Forgetfulness, memory lapses-Inform your doctor.
- Slurred speech-An adjustment in your dosage may be needed.
- Nausea or heartburn-If this happens, take the medication with food.
Less common side effects that you should report to your physician IMMEDIATELYinclude:
- Disorientation, confusion , worsening of your memory, periods of blackouts or amnesia
- Nervousness, excitement or any behavior changes
- In coordination leading to falls
- Skin rash
Let your doctor know as soon as possible if you miss your period or suspect you may be pregnant
Precautions
- Do not increase your dose without consulting your doctor
- Check with your doctor or pharmacist before taking other drugs, including over-the-counter medication such as cold remedies
- This drug may impair the mental and physical abilities required for driving a car or operating machinery. Avoid these activities if you feel drowsy or slowed down.
- This drug may increase the effects of alcohol , making you more sleepy, dizzy and lightheaded
- Do not stop taking the drug suddenly, especially if you have been on the medication for a number of months or have been taking high doses. Anxiolytics need to be withdrawn gradually to prevent withdrawal reactions.
- Avoid excessive consumption of caffeinated beverages (I. e., more than 4 cups of coffee, 6 cups of tea or cola) as it may counteract the beneficial effects of the anxiolytics.
- Store your medication in a clean, dry area at room temperature. Keep all medication out of the reach of children.Â
If you have any questions regarding this medication, do not hesitate to contact your doctor, pharmacist, or nurse
Medical Specialists
Antipsychotic Medications
Psychiatry
Antipsychotic Medications
What are antipsychotic medications?
Antipsychotic medications are a group of medications given for patients who suffer from psychotic symptoms.
Some of the psychotic symptoms are a s follows
- Hallucinations: Â A false perception in the absence of a stimulus. EG: hearing voices when alone, seeing things not there etc
- Delusions: A false belief which is firm. Fixed and unshakable and not accepted by other people from the same cultural background. Eg. Delusions of persecution, delusion of infidelity, grandiose delusions etc
- Difficulty in thinking clearly ( thought disorders)
What are the types of anti psychotic?
Anti psychotics are broadly divided into two groups
A) Â Older or typical antipsychotics like haloperidol, chlorpromazine, trifluoperazine, pimozide etc
B) Â Newer or typical antipsychotics like risperidone, olanzapine, quetiapine, aripiprazole, amisulpride, clozapine etc
The older and the newer medication differ in the side effect profiles.
What are the side effects of antipsychotics?
A) Â Newer antipsychotics:Â Â Some of the side effects of the newer antipsychotics are weight gain, increased appetite, sedation, hypotension, elevates the prolactin levels and cause periods to stop (amenorrhea), restlessness, sexual side effects, can raise the lipid levels. The medications can also impair concentration and have other cognitive issues.
For a complete list of side effects consult your doctor, pharmacology books or the literature given along with the medication.
If you experience any side effects on the medications consult your doctor and he will treat it appropriately or switch to a medication which does not have the particular side effect you are experiencing.
It is also advisable to discuss with your psychiatrist about the side effects before starting the medications so as to get the correct antipsychotic for you. For eg. If you are concerned about the weight gain speak to your psychiatrist and he will put you on a medication which has very less weight gain potential.
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B) Â Older antipsychotics:Â Â Some of the side effects of the older group of medications are tremors (shakes) of the limbs, stiffness, drooling of saliva, slowness in movements, slowing down of thought processes, restlessness, weight gain, sedation, lowers the blood pressure, constipation, dryness of mouth. Long term use of older antipsychotics can cause involuntary movements of the tongue and mouth which appears like the person is constantly chewing something, this is called tardive dyskinesia (TD) which can be difficult to treat.
POINT TO NOTE:Â Â Always weigh the therapeutic benefit with the side effect profile of the medication.
How do antipsychotics work?
Antipsychotics work on chemicals in the rain called neurotransmitters. They work mainly on a chemical called dopamine, which in excess causes psychotic symptoms. The anti psychotic reduces the action of dopamine thereby reducing the symptoms. The newer antipsychotics also act on a chemical called serotonin in the brain and give additional benefit to the patient.
Are there any alternatives to medications for psychosis?
Medications are the best and fastest mode of treatment for psychosis. Alternative forms of treatment like talk therapy will not work when patient is symptomatic, it can be used as an adjunct or add on therapy for psychosis along with medications.
Medical Specialists
Antidepressants
Psychiatry
Antidepressants
What are antidepressants?
Antidepressants are a group of medications which are used to treat depression. They have been available in the market for many decades and new research has lead to more molecules coming to the market for treatment.
How do antidepressants work?
Antidepressants work on certain chemicals in the brain called neurotransmitters thereby helping people suffering from depression.
What are the types of antidepressants?
There are many anti depressants available in the market and they can broadly be divided into the following groups depending upon the chemical it works in the brain
- Serotonin specific reuptake inhibitors (SSRI) : fluoxetine, sertraline, citalopram, escitalopram, fluvoxamine and paroxetine
- Serotonin and nor adrenaline reuptake inhibitors ( SNRI ) : venlafaxin, des –venlafaxin, duloxetine, milnacipran
- Tricyclic antidepressants (TCA): Imipramine, amitryptlyine, doxepin
- Monoamine inhibitors: Â used very infrequently
- Nor adrenalin and serotonin specific re uptake inhibitors  ( NASSA) : mirtazapine
What are the side effects of antidepressants?
The side effects of anti depressants depend upon the group of medication used.
Some of the common side effects are as follows
1. SSRI:  SSRI can cause nausea, vomiting, gastritis, diarrhea, increased sweating, headache, sleep disturbances and at times anxiety.  These side effects normally occur during the initial stages of treatment and most of them subside after a few days. Other side effects like sexual dysfunction and low sodium level can also occur. Contact your doctor if the side effects occur.
For a complete list of side effects consult your doctor, pharmacology books or the literature given along with the medication.
2. SNRI:  It can cause nausea, sleep disturbances, increased sweating, headache, sexual dysfunction and constipation.  Blood pressure can be elevated at higher doses and hence blood pressure must be checked regularly ( venlafaxin)
For a complete list of side effects consult your doctor, pharmacology books or the literature given along with the medication.
3. Tricyclic antidepressants:  Some of the side effects caused by tricyclic anti depressants  are sedation, dry mouth, constipation, blurred vision and a drop in blood pressure .( postural hypotension ) . Â
For a complete list of side effects consult your doctor, pharmacology books or the literature given along with the medication.
4. NASSA:  some of the side effects caused by mirtazapine are sedation, increased appetite, weight gain, and headache.Â
For a complete list of side effects consult your doctor, pharmacology books or the literature given along with the medication.
POINT TO NOTE:  All medications given in allopathy have side effects it does not mean you will certainly get the side effects. Always the side effect profile should be weighed with the therapeutic benefit.  Most side effects can be treated and are not long lasting. Â
How long does the antidepressant take to start working?
Earlier it was commonly believed that antidepressant starts to work after about 2 weeks. However new research shows that the antidepressant effect can start much earlier and even within one week.
How long should a person take antidepressants?
An untreated episode of depression normally lasts for 8-12 months. Hence antidepressants are normally continued for 6 months after you feel better and then gradually stopped.
Are antidepressants addictive?
Anti depressant drugs do not cause addictions like how nicotine, sleeping tablets and alcohol cause. You will not have to go on increasing the dosage to get the desired effect and once the medication has been stopped you will not having craving for the medications.
Some of the antidepressants can cause withdrawal symptoms if stopped abruptly and hence it must be gradually reduced and stopped.
How should I take antidepressants?
Anti depressants is usually started on a low dosage and gradually increased to the optimum dosage depending upon the response the patient has. It is usually increased once in two weeks and hence you should see the psychiatrist once in two weeks for an assessment until you stabilize. DO NOT INCREASE THE DOSAGE BY YOURSELF WITHOUT THE CONSULTATION OF THE DOCTOR.
If you get any side effects it will wear off after a few days, persist with the medication and consult your psychiatrist about the side effects.
Antidepressant should be taken everyday otherwise it will not work.
It is advisable not to drink alcohol along with the antidepressant.
When you are unwell it is advisable for some responsible person to administer the medication. Once you have shown significant improvement you can take over the responsibility of taking your medications.Â
Keep them out of reach from children.
Overdose of anti depressant can be dangerous consult your doctor immediately.
Can I drive when on anti depressants?
Some of the anti depressants can be sedative and make you drowsy and hence it is advisable not to drive when you are drowsy.Â
Will my depression come back?
For some people depression can come back and hence will have to take medications for a longer period of time. Â Such people who get multiple episodes suffer from recurrent depressive disorder and other medication like lithium will be added to their antidepressant. Â In addition to medications talk therapy like cognitive behaviour therapy will help patients.
Medical Specialists