The phrase “psychotropic drugs” is a technical term for psychiatric medicines that alter chemical levels in the brain which impact mood and behavior.
A yearlong ABC News investigation has been looking at the overuse of these medicines in America’s foster children.
Antipsychotics, antidepressants, ADHD drugs, anti-anxiety medications and mood stabilizers are some of the more commonly used psychotropic drugs in this country.
While doctors aren’t exactly sure how antipsychotics work, most experts believe antipsychotics block specific dopamine receptors in the brain, which are thought to be overactive in patients with symptoms of psychoses, such as hallucinations and delusions. There are limited approvals by the FDA for the use of these drugs for children with schizophrenia, bipolar disorder, and in some cases irritability associated with autism.
The newer antipsychotics, called 2nd generation antipsychotics, have fewer side effects and therefore are much more commonly used than first-generation antipsychotics such as haldol.
Antipsychotics can affect a person’s metabolism, frequently cause significant weight gain and can increase the risk of diabetes.
In addition to tremors, muscle spasms and restlessness, antipsychotics can cause tardive dyskinesia, a permanent and irreversible condition where a person has involuntary movements of the tongue, lip, mouth, and arms and legs.
While less common with newer antipsychotics, each year 5 percent of people on antipsychotics will develop tardive dyskinesia, according to the National Institute of Mental Health.
Many experts are also concerned about the prolonged use of antipsychotics in children, given there are very limited long-term safety studies for their use in children.
List of commonly prescribed 2nd generation antipsychotics:
Antidepressants are used to treat the symptoms of major depressive disorder, which affects between 7 percent and 8 percent of the population. Approximately one-third of adult cases of major depression can be classified as severe, according to the National Institute of Mental Health
Most antidepressants prescribed today belong to the selective serotonin reuptake inhibitor class, or SSRIs, a newer type of antidepressant that specifically works on serotonin levels in the brain. Other antidepressants affect norepinephrine and dopamine levels in the brain, other brain chemicals which affect mood and behavior. Older antidepressants called monoamine oxidase inhibitors, or MAOIs, tend to have more side effects such as dry mouth and constipation, and can have several food interactions with things like wine and cheese.
List of commonly prescribed antidepressants:
All SSRIs carry the most serious FDA warning — a black box warning — alerting doctors and patients about the increased risk of suicidal thinking in children, adolescents and young adults.
This is the exact language found on the package insert of an antidepressant.
WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
See full prescribing information for complete boxed warning.
Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants for Major Depressive Disorder (MDD) and other psychiatric disorders
Other side effects of antidepressants include sleep disturbances, agitation, appetite changes, and sexual dysfunction.
ADHD is one of the most common disorders of childhood. Symptoms of ADHD include hyperactivity, impulsivity and difficulty paying attention or controlling behavior.
Medicines classified as “stimulants” are the most commonly used drugs to treat the symptoms of ADHD. Stimulants are thought to increase the level of a brain chemical called dopamine, which is associated with pleasure, movement, and attention.
The most common side effects associated with stimulant medications include sleep problems and decreased appetite.
List of commonly prescribed stimulants:
In addition to stimulants, non-stimulant medicines are sometimes added to help control the symptoms of ADHD
Anti-anxiety medications are used to help patients who have abnormal levels of anxiety. While anxiety is a normal emotion for many people, levels of anxiety can become excessive and can interfere with normal daily activities.
There are five main types of anxiety disorders: Generalized Anxiety Disorder, Obsessive-Compulsive Disorder- commonly referred to as “OCD,” Panic Disorder, Social Anxiety disorder, and PTSD or Post-Traumatic Stress Disorder.
In addition to antidepressants and certain heart medications called beta-blockers, specific anti-anxiety medications called benzodiazepines are often prescribed for patients with anxiety disorders.
Commonly referred to as “benzos,” they work by targeting a specific receptor in the brain called GABA.
They are usually prescribed for short-periods of time because of a risk of dependency. Other side effects of the benzodiazepenes are drowsiness, blurred vision, and sleep disturbances such as nightmares.
List of commonly prescribed anti-anxiety medications:
Mood stabilizers are most commonly prescribed to treat bipolar disorder, more commonly referred to as manic-depression. Bipolar disorder affects about 3 percent of the population.
Unlike major depressive disorder, where people typically experience depressive symptoms, patients with bipolar disorder have unusual swings in mood — sometimes very high and sometimes very low. Almost half of bipolar cases are diagnosed in people younger than 25.
Lithium, a mood-stabilizing agent, is usually the first line of treatment for bipolar disorder. Seizure medications such as Depakote, Tegretol, Lamictal, and Trileptal are also prescribed as mood stabilizers.
The side effects of mood-stabilizers include suicidal thoughts, thyroid problems, and weight gain.
Finally, medications are just one way to treat mental illness. Most mental health disorders are best treated after a comprehensive evaluation by a trained professional and a combination of various treatment methods which may include medicines.