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Psychiatric medications have become one of the most commonly prescribed classes of drugs, and are given to people not just for mental health issues, but for a variety of off-label uses. Yet there are serious questions about how well these drugs work (if at all) when it comes to helping people with mental health issues.

How do psychiatric drugs work?

Psychiatric drugs work by altering the hormonal chemistry of the brain, increasing or decreasing certain mood-altering neurotransmitters. Most are reuptake inhibitors, meaning they bind to the parts of nerve cells that normally scoop back up different neurotransmitters such as serotonin or dopamine. This means that once these neurotransmitters are released, the brain can’t soak them back up as well as it normally does, which results in elevated levels of these hormones in the brain.

Since the brain is constantly using these chemicals in small amounts to communicate between nerve cells and perform basic functions, psychiatric drugs are designed to stop those chemicals from being mopped back up, raising levels of a particular neurotransmitter. SSRls increase serotonin, SNRls increase norepinephrine, and most antipsychotics are designed to increase levels of dopamine.

How will psychiatric drugs affect me?

What effects a psychological medication has on a person will obviously depend on the particular drug being administered, and effects can also vary greatly from person to person. Response can be influenced by personality factors, which have deep biological roots in the brain. Researchers in New Zealand have found that personality factors such as novelty-seeking, harm avoidance, and reward dependence are better than medical factors at predicting a person’s response to antidepressant drugs. Japanese scientists have also found that the rate of drug absorption into the bloodstream is faster in highly neurotic volunteers than in less neurotic ones. (Ellison-Rogers, 2009) So there are numerous factors that can influence how a person responds. (See also our information on the side-effects of psychiatric drugs.)

Deciding when to take a psychiatric drug

Drugs to treat mental illness are too casually prescribed in this country. TV hosts like Dr. Drew Pinsky, one of the many malevolent purveyors of bad advice out there, pushes antipsychotic drugs like vitamins whenever he plays pretend psychotherapist on his talk shows. Yet real experts who have actually studied these medications are a lot more reserved when it comes to their use. “I think psychiatric medications are way overprescribed; they’re over used,” says J. Wesley Boyd, M.D., Ph.D. He also notes that “Probably 80 percent of psychiatric medications are prescribed by ob-gyn’s, family practitioners, internalists”–not the kind of people who specialize in mental health issues. (Millea, 2016, p. 154)

Whether or not you decide to take a psychiatric drug is a personal decision you must make with your practitioner, but we will give you one rule: “You should not take psychiatric medication unless you are in psychotherapy,” says Carole Lieberman, M.D., a psychiatrist at UCLA’s Semel Institute for Neuroscience and Human Behavior. “The medication is a Band-Aid to combat the symptoms while you work on the root of the problem.” (Bean, 2013, p. 67) If you aren’t in therapy or otherwise making behavioral or lifestyle changes to deal with the issue, do not take a drug. You’re simply avoiding the problem and creating deeper problems for yourself down the road, because every week that your brain is medicated takes you further and further away from being able to restore a healthy psychology on your own.

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