Psychopharmacology 101

Many clients, whether they be electricians, administrative assistants, 
professors, janitors, salespeople, lawyers… have misconceptions about medications.  
This sometimes gets in the way of proper treatment.  

Here is some information about commonly prescribed “anti-depressants”.

After 4 – 6 weeks, these medications help improve mood as well as physical symptoms associated with depression such as insomnia, poor appetite / concentration / motivation.  Most also alleviate anxiety.
It is important that a physician monitor medication and prescribe increased doses each 4 weeks,
until symptoms are significantly better or maximum dose is reached.

Serotonin Reuptake Inhibitors 

Celexa, Cipralex, Prozac, Zoloft, Luvox, Paxil

SRI’s inhibit the recycling of the neurotransmitter serotonin back into neurons.
Hence there is more serotonin available.

Serotonin and Norepinephrine Reuptake Inhibitors

Effexor XR,  Cymbalta, Pristiq

SNRI’s inhibit the recycling of the neurotransmitters serotonin and norepinephrine back into neurons. 
Hence there is more serotonin and norepinephrine available.  

Norepinephrine and Dopamine Inhibitors

Wellbutrin  XL and SR
SNRI’s inhibit the recycling of the neurotransmitters  norepinephrine and dopamine back into neurons. 
Hence there is more seritonin and norepinephrine available.  
Because dopamine is stimulating, Wellbutrin can be particularly helpful to boost energy, concentration and motivation.  However, is can worsen anxiety and insomnia.  
It can also be added to a SRI or SNRI to boost its anti-depressant and anti-anxiety effects, 
particularly if the maximum dose is reached, providing only partial relief of symptoms or to alleviate
sexual side effects.
Wellbutrin is not associated with weight gain or sexual side effects.  Hence, some clients prefer to 
avoid the possibility of these side effects of SRI’s and SNRI’s.  
Wellbutrin can be prescribed to treat Attention Deficit Hyperactivity Disorder or 
help people to quite smoking.  

Clients often tell me they have tried several medications in the past they “didn’t work”.  Sometimes this is accurate, or the medications were discontinued due to intolerable side effects, but often they say they tried it for a few days or a week.

They often stop because they were ambivalent about taking medications, told by family or friends they shouldn’t take medications, or did not  fill the prescription once they ran out of samples.

An adequate trial of a medication is at least  6 weeks at a therapeutic dose.

Once adequate treatment is obtained, it is important to continue medication for at least a year.  People sometimes discontinue their medications after few months of feeling better, and often have a relapse of  symptoms.

Discuss any possible changes in medications with a physician.  Some of the medications have uncomfortable withdrawl symptoms, when they are discontinued too abruptly.

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