From the Guidelines
Medications for mental illness include several major categories tailored to specific conditions, with selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac, 20-80mg daily) and sertraline (Zoloft, 50-200mg daily) being typically first-line treatments for depression and anxiety disorders. For depression, SSRIs are effective, working by increasing serotonin levels in the brain 1. For anxiety disorders, SSRIs are also effective, along with benzodiazepines like lorazepam (Ativan, 0.5-2mg as needed) for short-term use due to addiction potential.
Some key points to consider when treating mental illness with medications include:
- Bipolar disorder typically requires mood stabilizers such as lithium (600-1200mg daily, with blood level monitoring) or valproate (Depakote, 750-1500mg daily) 1.
- Schizophrenia and psychotic disorders are treated with antipsychotics like risperidone (2-6mg daily) or olanzapine (5-20mg daily) 1.
- Most psychiatric medications require 2-6 weeks for full effect and should be taken consistently, even after symptoms improve.
- Side effects vary by medication class but commonly include nausea, weight changes, and sexual dysfunction.
- These medications work best when combined with therapy, and patients should never stop taking them abruptly without medical supervision as withdrawal symptoms can occur.
- Regular follow-up appointments are essential to monitor effectiveness and adjust dosages as needed.
It's also important to note that medications like selective serotonin re-uptake inhibitors can be used for depression, anxiety, obsessive-compulsive disorder, and other conditions 1. Mood stabilizers can be used for aggression, anger, and emotional dysregulation, while stimulants can be used for attention-deficit hyperactivity disorder.
Overall, the treatment of mental illness with medications should be tailored to the specific condition and individual patient, with careful consideration of potential side effects and the importance of combining medication with therapy. The most recent and highest quality study 1 supports the use of SSRIs as a first-line treatment for depression and anxiety disorders, and highlights the importance of slow up-titration and close monitoring to minimize the risk of adverse effects.
From the FDA Drug Label
ZYPREXA® (olanzapine) is an atypical antipsychotic indicated: As oral formulation for the: Treatment of schizophrenia. Acute treatment of manic or mixed episodes associated with bipolar I disorder and maintenance treatment of bipolar I disorder. Adjunct to valproate or lithium in the treatment of manic or mixed episodes associated with bipolar I disorder. As ZYPREXA and Fluoxetine in Combination for the: Treatment of depressive episodes associated with bipolar I disorder. Treatment of treatment resistant depression.
The medications used to treat mental illness include:
- Olanzapine (ZYPREXA) for the treatment of:
- Schizophrenia
- Manic or mixed episodes associated with bipolar I disorder
- Depressive episodes associated with bipolar I disorder
- Treatment resistant depression
- Fluoxetine (Prozac), although the label does not explicitly state its use for mental illness, it can be inferred that it is used for the treatment of major depressive disorder 2 3
From the Research
Medications for Mental Illness
The following medications are used to treat mental illness:
- Selective serotonin reuptake inhibitors (SSRIs) such as sertraline, fluoxetine, paroxetine, fluvoxamine, and citalopram 4, 5, 6
- Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) for comorbid depression and anxiety 7
- Benzodiazepines for acute treatment of anxiety symptoms and buspirone for chronic generalized anxiety 7
- Nefazodone and venlafaxine for comorbid depression and anxiety 7
Specific Conditions and Medications
- Depression: SSRIs, TCAs, MAOIs, nefazodone, and venlafaxine 4, 5, 6, 7
- Anxiety disorders: SSRIs, benzodiazepines, and buspirone 4, 5, 6, 7, 8
- Eating disorders: SSRIs 4, 6
- Premenstrual dysphoric disorder (PMDD): SSRIs 4, 6
- Obsessive-compulsive disorder: SSRIs 6
- Panic disorder: SSRIs 6
- Social phobia: SSRIs 6
- Substance abuse treatment: SSRIs (possibly) 4
Characteristics of Medications
- SSRIs: improved patient tolerability, low risk of lethality in overdose, and no dependence potential 4, 6
- SSRIs: low potential for pharmacokinetic drug interactions 4
- Sertraline: similar efficacy to other SSRIs, favourable side effect profile, and no potent inhibition of cytochrome P450 isoenzyme systems 4