MEDICATION IN PSYCHIATRY

MEDICATION PART TWO: Services

INTRODUCTION OF MEDICATION

Medication for the treatment of psychiatric disorders were identified through experimentation, observation and research.
One of the first psychiatric medications discovered was Chlorpromazine which was used for the treatment of Schizophrenia.
In addition to Blocking the activity of Dopamine (the primary treatment of Psychosis/Schizophrenia) it also had an effect on a multitude of other receptors.
It was observed that this Chemical Substance also had an effect on Depression in particular.
This led to the Monoamine Hypothesis which helped to identify specific Neurochemicals i.e.(Noradrenaline and Dopamine).
In the process another Neurochemical (Serotonin) was also identified.
We then had a better understanding of how Neurochemicals played a role in Psychiatric Disorders.
Chlorpromazine was the Precursor Molecule or Template from which many other Medications were derived.
Tricyclic Antidepressants (TCA), then Serotonin Reuptake Inhibitors (SSRI), Noradrenaline-Dopamine Reuptake Inhibitors (NDRI) and combination Serotonin-Noradrenaline Reuptake inhibitors (SNRI).
Even Antipsychotics were refined over time from First Generation Antipsychotics or Typical Antipsychotics that specifically targeted Dopamine (such as Haloperidol), to Second Generation of Atypical Antipsychotics that targeted both Dopamine and Serotonin, to Partial Dopamine Agonists.

Lithium Salt was actually the first psychiatric medication to be used.
We are still to this day not entirely sure how it works.
It remains one of the most effective Mood Stabilizers. Other mood stabilizers were later identified i.e. Sodium Valproate/ Valproic Acid and Lamotrigine. Antipsychotics also have mood stabilizing properties and often a combination of a Mood Stabilizer and Antipsychotic are used to prevent Bipolar Relapse.

The term "chemical imbalance" is often used to help patients understand that neurotransmitters or "chemicals" are not in "balance" or dysregulated. Psychiatric medications aim to rectify the "chemical imbalance".
Serotonin and Norepinephrine (also known as Noradrenaline): Regulation of either one or both can improve depression and anxiety.
Dopamine: Regulation of Dopamine can improve psychotic symptoms.

Your psychiatrist will help you to determine which is the most appropriate mediation for you based on you diagnosis.
Some medications will have an immediate effect and some require at least 4-6 weeks to take effect.
There is no one size fits all and often treatment involves a trial and error approach.
The duration of time one has to be on medication will depend on the condition, the number or relapses and other factors.