Psychiatric disorders drugs used

Filers R. Therapeutic drug monitoring for the treatment of psychiatric disorders. Clinical use and cost effectiveness. Clin Pharmacokinei 1995 29 442-450. 

McCutcheon, V. V., Heath, A. C., Edenberg, H. J., Grucza, R. A., Hesselbrock, V. M., Kramer, J. R., Bierut, L. J., arrd Bucholz, K. D. 2009. Alcohol criteria endorsement arrd psychiatric arrd drug use disorders among DUI offenders Greater severity among women arrd mirltiple offenders. Addictive Behaviors, 34, 432-439. 

Tranquilizers (also called antianxiety drugs) are used to treat a variety of psychiatric disorders which go along with anxiety (anxiety disorders). Serotonin-reuptake inhibitors and the benzodiazepines are the most commonly employed drugs for the treatment of common clinical anxiety disorders. 

Although lithium is not a true antipsychotic drug, it is considered with the antipsychotics because of its use in regulating the severe fluctuations of the manic phase of bipolar disorder (a psychiatric disorder characterized by severe mood swings of extreme hyperactivity to depression). During the manic phase, the person experiences altered thought processes, which can lead to bizarre delusions. The drug diminishes the frequency and intensity of hyperactive (manic) episodes. 

Kilbey, M.M., Breslau, N., and Andreski, P. Cocaine use and dependence in young adults associated psychiatric disorders and personality traits. Drug Alcohol Depend. 29 283, 1992. 

The development of lithium-specific electrodes has assisted greatly in monitoring patient compliance. The toxicity profile of lithium carbonate is now well established and the drug is safely administered and well tolerated. It is of limited use in other psychiatric disorders such as pathological aggression, although additional benefit may also include a reduction in actual or attempted suicide. 

There are, however, subgroups of young adults who may not mature out of drug problems as easily as others. Those who seem to have problems maturing out usually have other problems that preceded the onset of drug use. For instance, researchers have found that young adults who have a history of Conduct Disorder or who have other psychiatric disorders (such as schizophrenia, Bipolar Disorder, depression, Anxiety Disorder, or a major personality disorder) mature out of drug problems at much lower rates than those who do not have these additional problems. 

Another way that professionals assess for psychiatric disorders is to use an inventory that assesses for personality characteristics. The most famous of these inventories is the Minnesota Multiphasic Personality Inventory (MMPI), which is now in its second edition as an instrument. Although the MMPI is actually a personality inventory, as it names suggests, many professionals will use it to spot suspected psychiatric disorders, such as depression, Bipolar Disorder, Schizophrenia, and Anxiety Disorder. The MMPI has several scales to assess common personality traits, such as depression, mania, psychopathic deviance, and even alcohol and drug use (Weed, Butcher, McKenna, Ben-Porath, 1992). 

Baker GB, Prior TI, Coutts RT. 2002. Chirality and drugs used to treat psychiatric disorders. J Psychiatry Neurosci 27 401. 

It is in this context, in which psychosocial treatments have been mobilized and an appropriate treatment setting has been chosen, that medications can be helpful. The use of psychiatric medications to treat substance use in isolation, apart from such a comprehensive treatment plan, sends the wrong message. The substance abuser typically already leans too heavily on substances to either escape or solve problems. We can quickly succumb to the temptation to join in this dependence on substances to resolve all problems. However, in the context of a comprehensive treatment plan, the substance abuser can benefit from psychiatric medication without unduly seeing it as a panacea. Just like the psychosocial treatments, the use of psychiatric medications should be tailored to the individual s specific treatment needs as well. This includes both medications to treat the substance use disorder by detoxification or craving reduction and medications to treat comorbid psychiatric and medical conditions that may be underlying much of the incentive for continued drug use. 

Dopamine activity can be enhanced in one of four main ways. Medications can stimulate dopaminergic nerve cells to release dopamine into the synapse. This is the way that stimulants such as methylphenidate (Ritalin), dextroamphetamine (Dexe-drine), and dextroamphetamine/amphetamine (Adderall) work. In addition, certain drugs of abuse, notably cocaine and methamphetamine, act in part in this way. Providing more of the raw material that nerve cells use to manufacture dopamine can also increase dopamine activity. This is the approach that neurologists use when they prescribe L-DOPA (Sinemet) to patients with Parkinson s disease. Nerve cells convert L-DOPA into dopamine. L-DOPA otherwise has little place in the treatment of psychiatric disorders. Dopamine activity can also be increased by medications that directly stimulate dopamine receptors. Bromocriptine, another medication used to... 

While serious ethical objections have been raised regarding the use of placebos in trials of drugs used in the treatment of psychiatric disorders (largely based on the possibility that the patients may commit suicide if they are inadequately treated, although such patients are usually excluded from placebo controlled trials), all regulatory authorities insist on properly conducted, placebo controlled trials as a basis for registering a new drug. 

Attention deficit hyperactivity disorder (ADHD) For the treatment of ADHD in patients 6 years of age and older. Dexmethylphenidate is indicated as an integral part of a total treatment program for ADHD that may include other measures (eg, psychological, educational, social) for patients with this syndrome. Drug treatment may not be indicated for all patients. Stimulants are not intended for use in the patient who exhibits symptoms secondary to environmental factors or other primary psychiatric disorders, including psychosis. 

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