How Mental Health Medications Work: An Overview

Seroquel, Cymbalta and other such medications advertised in the media are supposed to help give people mental balance. These commercials often ask if you have feelings of depression, hopelessness or anxiety and suggest that perhaps their medications can help, even though you can only get them legally through a doctor's prescription. As a psychology grad student, I've had to do research on these medications and others like them to find out how they work since I may one day recommend these prescriptions.

Neurotransmitters. Understanding these medications starts with understanding how your brain's communication system works. Your brain communicates a lot of actions by using neurotransmitters. These are responsible for letting your brain know that your body needs help in certain areas. Neurotransmitters can instruct the brain to adjust your mood. If you need additional alert and awareness, neurotransmitters might ask for additional cortisol or adrenaline. For a calming effect, they could request norepinephrine. To promote a sense of good feeling and balance, neurotransmitters might ask for serotonin or dopamine.

For proper use, the neurotransmitters must be properly produced at adequate levels, and the brain's specific receptors must be ready to take them in. Any damage on either end can result in chemical imbalance. Imagine your brain as a fuel tank with a small hole. Your brain could get all the requested fuel (serotonin) and the tank (receptor) could take it all in well. But if there's a hole in the tank, it will slowly leak and eventually become empty. A damaged tank at the receiving port could prevent fuel from going in; a damaged pump could prevent enough fuel from being produced.

These medications act as quick fixes or long-term repair. However, not everyone's brains are wired the same, and symptoms could be a result of other issues like diseases or substance interaction. There could also be side effects with certain medications that don't interact well with others you may be taking. So although the commercials may advocate relief of certain symptoms, there is no one-size-fits all solution.

Mood Stabilizers. These are used to treat people with mood disorders such as bipolar disorder, where patients can exhibit a high-energy mood known as mania. Mania moods can cause desires to be extremely physically active, no matter the risk. It can also lend to psychotic symptoms such as paranoia and hallucinations, which are also experienced by schizophrenic patients. Using the tank analogy, this would be like putting in 110 octane fuel into a go kart motor rigged up to run a family sedan. Mood stabilizers mostly work by slowing down the speed of those neurotransmitter cells. Many anti-epileptic medications like Depakote are used as mood stabilizers because some seizures are caused by too much electrical charge in brain cells. By reducing the electrical charge, cells flow much slower. Lithium is also a mood stabilizer that works by controlling levels of glutamate, which provide energy to cells. Seroquel is considered an antipsychotic mood stabilizer.

Antidepressants. Antidepressants like Lexapro are considered Selective Serotonin Reuptake Inhibitors, or SSRIs. They help control levels of serotonin by limiting the brain's absorption or re-uptake of them. Going back to the fuel analogy, this would be like repairing a hole in the fuel tank. The more those neurotransmitters are present, the better the mood. Some antidepressants known as MAOIs work by enhancing the brain's neurotransmitter receptor ability. These aren't prescribed as often because they have too many negative interactions with other medications, foods and chemicals. Certain antidepressants can also have negative effects in children and teens, such as increasing suicidal thoughts. Cymbalta is an SSRI variant that also prevents uptake of norepinephrine, a stress neurotransmitter.

Antianxiety. Antianxiety medications will help reduce levels of cortisol or adrenaline in anxiety patients, allowing them to relax better. Anxiolytics like Xanax enhance receptors of GABA, an amino acid that's tasked to regulate neurotransmitter speeds much like mood stabilizers do. Better receptors means more efficient slow-down, which is why Xanax takers may appear to be sleepy. Some medications act as beta blockers, which help regulate blood pressure and heart rate. Those are two symptoms related to certain anxiety disorders and problems like panic attacks. These are prescribed "off-label", which means they aren't designed to treat anxiety but are effective in reducing those symptoms.

Source:
National Institute of Mental Health Medication Descriptions