From the Guidelines
Psychiatric conditions, such as anxiety disorders, depression, bipolar disorder, and schizophrenia, are mental health disorders that affect a person's thinking, mood, behavior, and overall functioning, and the most effective treatment approach typically involves a combination of psychotherapy and medication, with cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) being highly effective for anxiety disorders, as supported by the most recent and highest quality study 1.
Key Considerations
- Psychiatric conditions can have a significant impact on a person's quality of life, and early intervention is crucial to improve outcomes.
- A comprehensive treatment plan should include a combination of psychotherapy and medication, with the specific approach depending on the condition being treated.
- Cognitive-behavioral therapy (CBT) is a highly effective therapy approach for anxiety disorders, and can be delivered in weekly sessions for 12-20 weeks.
- Selective serotonin reuptake inhibitors (SSRIs) are a commonly used medication for depression and anxiety, with fluoxetine (20-80mg daily) and sertraline (50-200mg daily) being examples of effective SSRIs.
- Mood stabilizers, such as lithium (600-1200mg daily), are effective for bipolar disorder, while antipsychotics, such as risperidone (2-6mg daily) or olanzapine (5-20mg daily), are effective for schizophrenia.
Treatment Approaches
- Psychotherapy: CBT, interpersonal therapy, and psychodynamic therapy are examples of effective therapy approaches for psychiatric conditions.
- Medication: SSRIs, mood stabilizers, and antipsychotics are examples of effective medications for psychiatric conditions.
- Combination therapy: combining psychotherapy and medication can be an effective approach for treating psychiatric conditions.
Important Factors to Consider
- Genetic predisposition: a family history of psychiatric conditions can increase the risk of developing a condition.
- Brain chemistry imbalances: imbalances in neurotransmitters, such as serotonin and dopamine, can contribute to psychiatric conditions.
- Environmental stressors: stress, trauma, and social isolation can contribute to the development of psychiatric conditions.
- Psychological factors: cognitive distortions, negative thinking patterns, and coping mechanisms can contribute to psychiatric conditions.
From the FDA Drug Label
*Parkinsonism includes extrapyramidal disorder, musculoskeletal stiffness, parkinsonism, cogwheel rigidity, akinesia, bradykinesia, hypokinesia, masked facies, muscle rigidity, and Parkinson’s disease Akathisia includes akathisia and restlessness. Dystonia includes dystonia, muscle spasms, muscle contractions involuntary, muscle contracture, oculogyration, tongue paralysis. Tremor includes tremor and parkinsonian rest tremor Psychiatric Disorders Insomnia Anxiety
The psychiatric conditions associated with risperidone include:
- Insomnia
- Anxiety
- Parkinsonism
- Akathisia
- Dystonia
- Tremor 2
From the Research
Psychiatric Conditions
- Psychiatric disorders, such as depression, are prevalent worldwide, affecting 4.4% of the global population 3
- Selective serotonin reuptake inhibitors (SSRIs) are a common treatment for various psychiatric disorders, including depression, and work by inhibiting presynaptic reuptake of serotonin at the serotonin transporter 3
Treatment Options
- Olanzapine/fluoxetine is a fixed-dose combination of an atypical antipsychotic and an SSRI, used to treat depressive episodes associated with bipolar I disorder and treatment-resistant major depressive disorder 4, 5
- This combination has been shown to be effective in treating patients with acute bipolar depression, with an efficacy greater than that of olanzapine alone or lamotrigine 5
- Olanzapine + fluoxetine is also ranked highest for effect size and response in the treatment of bipolar depression, and is recommended as a first-line treatment 6
SSRI Efficacy
- A review of systematic reviews found that escitalopram was the most effective SSRI in terms of response rate, remission rate, and withdrawal rate in the treatment of major depressive disorder 7
- The same review found that SSRIs are a commonly prescribed and effective treatment for major depressive disorder, with escitalopram being a better choice than other SSRIs in terms of remission rate and withdrawal rate 7
Adverse Effects
- SSRIs can have adverse effects, including an increased risk of suicidality in children and young adults aged 18-24, although this risk is not seen in adults without certain risk factors 3
- Olanzapine/fluoxetine can also have adverse effects, including weight gain and potential elevations in glucose, lipid, and prolactin levels, although it does not increase the risk of treatment-emergent mania 5