A psychotropic describes any drug that affects behavior, mood, thoughts, or perception. This can include medications for anxiety and depression as well as antipsychotics, among others.
Psychotropic is an umbrella term for a lot of different drugs, including prescription and recreational drugs.
Mental health and well-being affect our daily lives. Psychotropic medications can be an important part of the tools available to help keep us well.
According to the
Psychotropics are a broad category of drugs that are prescribed to treat many different conditions. Some conditions psychotropics treat include:
- anxiety
- depression
- schizophrenia
- bipolar disorder
- sleep disorders
They work by adjusting levels of brain chemicals or neurotransmitters, such as:
- dopamine
- gamma-aminobutyric acid (GABA)
- norepinephrine
- serotonin
There are five major classes of legal psychotropic medications:
- anti-anxiety agents
- antidepressants
- antipsychotics
- mood stabilizers
- stimulants
Some can cause very serious side effects, and healthcare professionals may set up special monitoring requirements.
The type or class of medication a doctor prescribes depends on the individual and specific symptoms. Some medications require regular use for several weeks to see benefits.
Each class works differently, but they also have some similarities. Let’s look closer at psychotropic drugs and their uses.
| Class | Examples |
|---|---|
| Anti-anxiety agents | • alprazolam (Xanax) • clonazepam (Klonopin) • diazepam (Valium) • lorazepam (Ativan) |
| Atypical antipsychotics | • aripiprazole (Abilify) • clozapine (Clozaril) • iloperidone (Fanapt) • olanzapine (Zyprexa) • paliperidone (Invega) • quetiapine (Seroquel) • risperidone (Risperdal) • ziprasidone (Geodon) |
| Monoamine oxidase inhibitor (MAOI) antidepressants | • isocarboxazid (Marplan) • phenelzine (Nardil) • tranylcypromine (Parnate) • selegiline (Emsam, Atapryl, Carbex, Eldepryl, Zelapar) |
| Mood stabilizers | • carbamazepine (Carbatrol, Tegretol, Tegretol XR) • divalproex sodium (Depakote) • lamotrigine (Lamictal) • lithium (Eskalith, Eskalith CR, Lithobid) |
| Selective serotonin reuptake inhibitor (SSRI) antidepressants | • citalopram (Celexa) • escitalopram (Lexapro) • fluvoxamine (Luvox) • paroxetine (Paxil) • sertraline (Zoloft) |
| Serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants | • atomoxetine (Strattera) • duloxetine (Cymbalta) • venlafaxine (Effexor XR) • desvenlafaxine (Pristiq) |
| Stimulants | • amphetamine (Adderall, Adderall XR) • dexmethylphenidate (Focalin, Focalin XR) • dextroamphetamine (Dexedrine) • lisdexamfetamine (Vyvanse) • methylphenidate (Ritalin, Metadate ER, Methylin, Concerta) |
| Tricyclic antidepressants | • amitriptyline • amoxapine • desipramine (Norpramin) • imipramine (Tofranil) • nortriptyline (Pamelor) • protriptyline (Vivactil) |
Typical antipsychotics | • chlorpromazine (Thorazine) • fluphenazine (Prolixin) • haloperidol (Haldol) • perphenazine (Trilafon) • thioridazine (Mellaril) |
Always talk with your doctor about the specific symptoms you’re experiencing. They’ll find the best treatment options available to help you feel better.
This includes nonmedication options, such as cognitive behavioral therapy (CBT).
Some medications, such as antipsychotic medications, may take up to
2 weeks to help with symptom relief. It’s important to give the medication a chance to work before discussing the need to stop it with a healthcare professional.
1. Anti-anxiety agents
Anti-anxiety agents, or anxiolytics, can treat different types of anxiety disorders, including social phobia related to public speaking. They can also treat:
- sleep disorders
- panic attacks
- stress
How they work
This class is known as
Side effects
Side effects of BZDs include:
- dizziness
- drowsiness
- confusion
- loss of balance
- memory problems
- low blood pressure
- slow breathing
Caution
These medications may become habit-forming if taken long term. They’re not recommended for more than a few weeks.
2. Atypical antipsychotics
These are the
How they work
These drugs work by blocking brain chemicals dopamine D2 and serotonin 5-HT2A receptor activity.
Doctors also use atypical antipsychotics to treat symptoms of:
- bipolar disorder
- depression
- Tourette syndrome
Side effects
Atypical antipsychotics have some serious side effects. These include an increased risk of:
- diabetes
- high cholesterol levels
- heart muscle–related problems
- involuntary movements, including muscle spasms, tremors
- stroke
Side effects of atypical antipsychotics include:
- dizziness
- constipation
- dry mouth
- blurred vision
- weight gain
- sleepiness
Caution
Aripiprazole (Abilify), clozapine (Clozaril), and quetiapine (Seroquel) have a black box warning for specific safety concerns. There’s a risk of suicidal thoughts and behaviors in people under the age of 18 who take one of these medications.
3. MAOI antidepressants
These drugs are older and aren’t used very often today.
How they work
MAOIs improve symptoms of depression by increasing dopamine, norepinephrine, and serotonin levels in the brain.
Side effects
Side effects of MAOIs include:
- nausea
- vomiting
- dizziness
- diarrhea
- dry mouth
- weight gain
Caution
MAOIs taken with certain foods that have the chemical tyramine can increase blood pressure to dangerous levels. Tyramine is found in many kinds of cheese, pickles, and some wines.
4. Mood stabilizers
Doctors use these drugs to treat depression and other mood disorders, like bipolar disorder.
How they work
The exact way mood stabilizers work isn’t well understood yet. Some researchers believe these medications calm specific areas of the brain that contribute to the mood changes of bipolar disorder and related conditions.
Side effects
Side effects of mood stabilizers include:
- dizziness
- nausea
- vomiting
- tiredness
- stomach problems
Caution
The kidneys remove lithium from the body, so kidney function and levels of lithium must be regularly checked. If you have poor kidney function, your doctor may need to adjust your dose.
5. SSRI antidepressants
SSRIs are mainly used to treat different types of depression. Among them are major depressive disorder and bipolar disorder.
Depression is more than feeling sad for a few days. It’s persistent symptoms that last for weeks at a time. You may also have physical symptoms, like sleep issues, lack of appetite, and body aches.
How they work
SSRIs work by increasing the amount of serotonin available in the brain. SSRIs are the first choice of treatment for many types of depression.
Side effects
Side effects of SSRIs include:
- dry mouth
- nausea
- vomiting
- diarrhea
- poor sleep
- weight gain
- sexual disorders
Caution
Some SSRIs can cause elevated heart rate. Some can increase your risk for bleeding if you’re also using blood thinning medications, such as nonsteroidal anti-inflammatory drugs like aspirin or warfarin (Coumadin, Jantoven).
6. SNRI antidepressants
How they work
SNRIs help treat depression but work a bit differently than SSRIs. They increase both serotonin and norepinephrine in the brain to improve symptoms. SNRIs might work better in some people if SSRIs haven’t brought improvement.
Side effects
Side effects of SNRIs include:
- headache
- dizziness
- dry mouth
- nausea
- agitation
- sleep problems
- appetite issues
Caution
These drugs can increase blood pressure and heart rate. Your liver function must be monitored while on these medications as well.
7. Stimulants
These drugs mainly treat attention deficit hyperactivity disorder (ADHD).
How they work
Stimulants increase dopamine and norepinephrine in the brain. The body can develop dependence if used long term.
Side effects
Side effects of stimulants include:
- problems with sleep
- poor appetite
- weight loss
Caution
Stimulants can increase heart rate and blood pressure, so if you have heart or blood pressure problems, they may not be the best option.
8. Tricyclic antidepressants
This is one of the oldest classes of antidepressants still available on the market. They’re reserved for use when newer medications haven’t been effective.
How they work
Tricyclics increase the amount of serotonin and norepinephrine in the brain to improve mood.
Doctors also use tricyclics off-label to treat other conditions. Off-label use means a drug is used for a condition that does not have Food and Drug Administration (FDA) approval for that condition.
Off-label uses for tricyclics include:
- panic disorder
- migraine
- chronic pain
- obsessive-compulsive disorder
Side effects
Side effects include:
- dry mouth
- dizziness
- drowsiness
- nausea
- weight gain
Caution
Certain individuals should avoid tricyclics. This includes people with:
- glaucoma
- enlarged prostate
- thyroid issues
- heart problems
These medications can raise blood sugar. If you have diabetes, you may have to monitor your blood sugar levels carefully and more regularly.
9. Typical antipsychotics
These drugs treat symptoms associated with schizophrenia. They may also be used for other conditions.
How they work
Typical antipsychotics block dopamine in the brain. The first antipsychotic drug in this class, chlorpromazine, was introduced more than
Side effects
Side effects of antipsychotic drugs include:
- blurred vision
- nausea
- vomiting
- trouble sleeping
- anxiety
- drowsiness
- weight gain
- sexual problems
Caution
This class of drugs causes movement-related disorders called extrapyramidal side effects. These can be serious and long lasting. They include:
- tremors
- uncontrolled facial movements
- muscle stiffness
- problems moving or walking
Here are a few drugs and drug classes with boxed warnings. This is not a full list of warnings. Always ask your doctor or pharmacist about specific drug side effects and risks:
- Aripiprazole (Abilify) and quetiapine (Seroquel) are not FDA-approved for use in anyone under 18 years old due to the risk of suicidal thoughts and behavior.
- Antipsychotic medication use in older adults with dementia-related psychosis can increase the risk of death.
- Antidepressants can worsen suicidal thoughts and behavior in children and adolescents.
- Stimulant drugs may cause dependence and addiction.
- Benzodiazepines taken with opioid medications can increase the risk of overdose.
- Clozapine (Clozaril) can cause agranulocytosis, a serious blood disorder. You need to have blood work done to monitor your white blood cell count. It can also cause seizures as well as heart and breathing problems, which can be life threatening.
Special Warnings for Children, Pregnant Adults, and Older Adults
- Children: Some psychotropic drugs have a higher risk of side effects in children and are not FDA approved for use in children. Your doctor will discuss the risks versus benefits of specific medications.
- Pregnancy: There’s limited information on the use of psychotropics during pregnancy. The benefits and risks must be carefully considered for each person and each drug. Certain drugs, such as BZDs and lithium, are harmful during pregnancy. Some SSRIs can increase the risk of birth defects. SNRI use in the 2nd trimester can cause withdrawal symptoms in babies. Your doctor must carefully monitor you and your baby if you’re taking any psychotropics.
- Older adults: Certain drugs can take longer for your body to clear if your liver or kidney system is not working well. You may be taking more medications, which can interact with or increase the risk of side effects or adverse reactions. Your healthcare team may need to adjust your dose. Before starting any new medications, be sure to discuss all your medications, including OTC drugs and supplements, with your healthcare team.
Psychotropic drugs have many interactions with other drugs, food, alcohol, and over-the-counter (OTC) products. Always tell your doctor and pharmacist all the medications and supplements you’re taking to help prevent adverse reactions.
Avoid mixing psychotropic drugs with alcohol. Some classes, like BZDs, antidepressants, and antipsychotic medications, have greater sedating effects when taken with alcohol.
This can create problems with balance, awareness, and coordination. It can also slow or stop your breathing, which may be life threatening.
In addition, stimulant drugs like amphetamines interact with:
- SSRIs
- SNRIs
- MAOIs
- tricyclics
- lithium
BZDs and stimulants are controlled substances because they can cause dependence and have the potential for misuse.
Never share or sell your prescription medications. There are federal penalties, which also apply to state and local laws, for selling or illegally buying these medications.
These medications can also cause dependence and lead to substance use disorders.
If you or a loved one is at risk for self-harm, reach out to the National Suicide Prevention Lifeline at 800-273-TALK for help.
For support and to learn more about substance use disorders, reach out to these organizations:
Psychotropic medications can have serious side effects. In some people, side effects can be severe.
Get emergency treatmentCall 911 or go to your nearest emergency room right away if you have any of these symptoms:
- your symptoms are getting worse (depression, anxiety, mania)
- thoughts of suicide
- panic attacks
- agitation
- restlessness
- insomnia
- increased heart rate and blood pressure
- feeling irritable, angry, violent
- acting impulsively and any other dramatic changes in behavior
- seizures
Psychotropics cover a very large group of drugs that are used to treat many different types of symptoms.
They all work by adjusting neurotransmitter levels to help you feel better.
The medication your doctor prescribes depends on many factors, including your age, other health conditions you may have, other medications you’re using, and your past medication history.
Not all medications work right away; some take time. Patience is important. Talk with your doctor if your symptoms worsen.
Discussing all treatment options, including CBT, with your healthcare professional is helpful in developing the best care plan for you.