Medication for mental health problems
For some people, drugs are a short-term solution used to get them over an immediate crisis. For other people, drugs are an ongoing, long-term treatment that enables them to live with severe and enduring mental health problems.
Many people do not want to stay on medication for years, but it can help some people to lead the kind of lives they want to lead, without relapses and re-admissions to hospital.
Some people are reluctant to take medication at all, and doctors also vary in how often they prescribe it, and in what doses. All kinds of treatment have some placebo effect and some drug trials have found only slight differences between the effects of placebos and active drugs.
Although medication is easier to administer than talking therapies or exercise programmes, for example - which are also effective for many mental health problems - most have side effects and people may have problems when they stop taking the medication. Abuse of medication that has been prescribed to treat a mental health problem can cause additional problems.
It is easy to get confused about mental health medication, partly because there are so many different drugs, partly because new drugs are being introduced all the time, and partly because the same drug may be known by several different names - the trade name, the generic name or the chemical group name.
- The trade name of a drug is the brand name given to it by the manufacturer - for example, Mogadon is the trade name of a drug for insomnia. If more than one company manufacturers the same drug, each will have a different name.
- The generic name of a drug describes the particular chemical family to which the drug belongs. Nitrazepam is the generic name for Mogadon and other such drugs to treat insomnia.
- The chemical group name of a drug describes the larger chemical family to which the drug belongs. For example, nitrazepam belongs to the benzodiazepine family. Other drugs in the benzodiazepine family include diazepam (trade name Valium) and temazepam (trade name Planpak).
Most drugs used in the treatment of mental health problems fall into four main categories: anti-anxiety drugs, anti-depressants, anti-psychotics and mood stabilisers.
Your doctor will consider a number of things when deciding which drug to prescribe.
- Your symptoms. Most drugs are designed to treat particular problems or symptoms, for example anxiety or depression.
- Your reaction to and sensitivity to a particular drug or class of drugs. Some drugs work better for some people than others and it may take some time to find the right medication and the right dose for you. Your doctor should monitor and review the drugs s/he prescribes for you to check their usefulness in controlling symptoms and their side-effects.
- The side effects or risks associated with a particular drug. All drugs have side effects, some of them unpleasant. Some drugs may also carry an associated risk. For example Lithium, which is used to treat bi-polar disorder, can be toxic. It is important that you know about any side effects and risks associated with a particular drug and that you tell your doctor if you detect any changes or difficulties in your tolerance of your prescribed medicine.
- His or her familiarity with or preference for the drug. Some doctors prefer some drugs to others, based on their experience of what works with other patients, or what new research tells them.
- The cost-effectiveness of the drug. Doctors follow the guidance of the National Institute for Clinical Excellence (NICE), which also provides information for the general public on its website.
Questions to ask
You may find it helpful to ask the following questions if your doctor has prescribed you any form of medication.
- What is this drug designed to do? Some drugs may be given to counteract the side effects of other drugs.
- How long will it be before it takes effect? Some drugs take several weeks to have any effect.
- What are the side effects? Some drugs can have unpleasant and worrying side effects.
- How long do I have to take the drug? Some drugs should not be taken for more than a few weeks; some may need to be taken for months or years.
- Do I need to take any precautions? Some drugs should not be taken if you plan to drive and some should not be taken in combination with other drugs.
- Are there any other ways to treat my condition? How effective are they? Alternatives include talking therapies, complementary therapies and exercise on prescription.
You can find out more about individual drugs, correct dosages and side effects from your GP, local hospital pharmacy department or chemist. You can also ask your psychiatrist or mental health team. There is more information on medication on the website of the Royal College of Psychiatrists.