Is there a cure for mental illness
Mental illness - Diagnosis and treatment
To determine a diagnosis and check for related complications, you may have:
- A physical exam. Your doctor will try to rule out physical problems that could cause your symptoms.
- Lab tests. These may include, for example, a check of your thyroid function or a screening for alcohol and drugs.
- A psychological evaluation. A doctor or mental health professional talks to you about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.
Determining which mental illness you have
Sometimes it's difficult to find out which mental illness may be causing your symptoms. But taking the time and effort to get an accurate diagnosis will help determine the appropriate treatment. The more information you have, the more you will be prepared to work with your mental health professional in understanding what your symptoms may represent.
The defining symptoms for each mental illness are detailed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. This manual is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.
Classes of mental illness
The main classes of mental illness are:
- Neurodevelopmental disorders. This class covers a wide range of problems that usually begin in infancy or childhood, often before the child begins grade school. Examples include autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD) and learning disorders.
- Schizophrenia spectrum and other psychotic disorders. Psychotic disorders cause detachment from reality — such as delusions, hallucinations, and disorganized thinking and speech. The most notable example is schizophrenia, although other classes of disorders can be associated with detachment from reality at times.
- Bipolar and related disorders. This class includes disorders with alternating episodes of mania — periods of excessive activity, energy and excitement — and depression.
- Depressive disorders. These include disorders that affect how you feel emotionally, such as the level of sadness and happiness, and they can disrupt your ability to function. Examples include major depressive disorder and premenstrual dysphoric disorder.
- Anxiety disorders. Anxiety is an emotion characterized by the anticipation of future danger or misfortune, along with excessive worrying. It can include behavior aimed at avoiding situations that cause anxiety. This class includes generalized anxiety disorder, panic disorder and phobias.
- Obsessive-compulsive and related disorders. These disorders involve preoccupations or obsessions and repetitive thoughts and actions. Examples include obsessive-compulsive disorder, hoarding disorder and hair-pulling disorder (trichotillomania).
- Trauma- and stressor-related disorders. These are adjustment disorders in which a person has trouble coping during or after a stressful life event. Examples include post-traumatic stress disorder (PTSD) and acute stress disorder.
- Dissociative disorders. These are disorders in which your sense of self is disrupted, such as with dissociative identity disorder and dissociative amnesia.
- Somatic symptom and related disorders. A person with one of these disorders may have physical symptoms that cause major emotional distress and problems functioning. There may or may not be another diagnosed medical condition associated with these symptoms, but the reaction to the symptoms is not normal. The disorders include somatic symptom disorder, illness anxiety disorder and factitious disorder.
- Feeding and eating disorders. These disorders include disturbances related to eating that impact nutrition and health, such as anorexia nervosa and binge-eating disorder.
- Elimination disorders. These disorders relate to the inappropriate elimination of urine or stool by accident or on purpose. Bed-wetting (enuresis) is an example.
- Sleep-wake disorders. These are disorders of sleep severe enough to require clinical attention, such as insomnia, sleep apnea and restless legs syndrome.
- Sexual dysfunctions. These include disorders of sexual response, such as premature ejaculation and female orgasmic disorder.
- Gender dysphoria. This refers to the distress that accompanies a person's stated desire to be another gender.
- Disruptive, impulse-control and conduct disorders. These disorders include problems with emotional and behavioral self-control, such as kleptomania or intermittent explosive disorder.
- Substance-related and addictive disorders. These include problems associated with the excessive use of alcohol, caffeine, tobacco and drugs. This class also includes gambling disorder.
- Neurocognitive disorders. Neurocognitive disorders affect your ability to think and reason. These acquired (rather than developmental) cognitive problems include delirium, as well as neurocognitive disorders due to conditions or diseases such as traumatic brain injury or Alzheimer's disease.
- Personality disorders. A personality disorder involves a lasting pattern of emotional instability and unhealthy behavior that causes problems in your life and relationships. Examples include borderline, antisocial and narcissistic personality disorders.
- Paraphilic disorders. These disorders include sexual interest that causes personal distress or impairment or causes potential or actual harm to another person. Examples are sexual sadism disorder, voyeuristic disorder and pedophilic disorder.
- Other mental disorders. This class includes mental disorders that are due to other medical conditions or that don't meet the full criteria for one of the above disorders.
Your treatment depends on the type of mental illness you have, its severity and what works best for you. In many cases, a combination of treatments works best.
If you have a mild mental illness with well-controlled symptoms, treatment from your primary care provider may be sufficient. However, often a team approach is appropriate to make sure all your psychiatric, medical and social needs are met. This is especially important for severe mental illnesses, such as schizophrenia.
Your treatment team
Your treatment team may include your:
- Family or primary care doctor
- Nurse practitioner
- Physician assistant
- Psychiatrist, a medical doctor who diagnoses and treats mental illnesses
- Psychotherapist, such as a psychologist or a licensed counselor
- Social worker
- Family members
Although psychiatric medications don't cure mental illness, they can often significantly improve symptoms. Psychiatric medications can also help make other treatments, such as psychotherapy, more effective. The best medications for you will depend on your particular situation and how your body responds to the medication.
Some of the most commonly used classes of prescription psychiatric medications include:
- Antidepressants. Antidepressants are used to treat depression, anxiety and sometimes other conditions. They can help improve symptoms such as sadness, hopelessness, lack of energy, difficulty concentrating and lack of interest in activities. Antidepressants are not addictive and do not cause dependency.
- Anti-anxiety medications. These drugs are used to treat anxiety disorders, such as generalized anxiety disorder or panic disorder. They may also help reduce agitation and insomnia. Long-term anti-anxiety drugs typically are antidepressants that also work for anxiety. Fast-acting anti-anxiety drugs help with short-term relief, but they also have the potential to cause dependency, so ideally they'd be used short term.
- Mood-stabilizing medications. Mood stabilizers are most commonly used to treat bipolar disorders, which involves alternating episodes of mania and depression. Sometimes mood stabilizers are used with antidepressants to treat depression.
- Antipsychotic medications. Antipsychotic drugs are typically used to treat psychotic disorders, such as schizophrenia. Antipsychotic medications may also be used to treat bipolar disorders or used with antidepressants to treat depression.
Psychotherapy, also called talk therapy, involves talking about your condition and related issues with a mental health professional. During psychotherapy, you learn about your condition and your moods, feelings, thoughts and behavior. With the insights and knowledge you gain, you can learn coping and stress management skills.
There are many types of psychotherapy, each with its own approach to improving your mental well-being. Psychotherapy often can be successfully completed in a few months, but in some cases, long-term treatment may be needed. It can take place one-on-one, in a group or with family members.
When choosing a therapist, you should feel comfortable and be confident that he or she is capable of listening and hearing what you have to say. Also, it's important that your therapist understands the life journey that has helped shape who you are and how you live in the world.
Brain-stimulation treatments are sometimes used for depression and other mental health disorders. They're generally reserved for situations in which medications and psychotherapy haven't worked. They include electroconvulsive therapy, repetitive transcranial magnetic stimulation, deep brain stimulation and vagus nerve stimulation.
Make sure you understand all the risks and benefits of any recommended treatment.
Hospital and residential treatment programs
Sometimes mental illness becomes so severe that you need care in a psychiatric hospital. This is generally recommended when you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else.
Options include 24-hour inpatient care, partial or day hospitalization, or residential treatment, which offers a temporary supportive place to live. Another option may be intensive outpatient treatment.
Substance misuse treatment
Problems with substance use commonly occur along with mental illness. Often it interferes with treatment and worsens mental illness. If you can't stop using drugs or alcohol on your own, you need treatment. Talk to your doctor about treatment options.
Participating in your own care
Working together, you and your primary care provider or mental health professional can decide which treatment may be best, depending on your symptoms and their severity, your personal preferences, medication side effects, and other factors. In some cases, a mental illness may be so severe that a doctor or loved one may need to guide your care until you're well enough to participate in decision-making.
- Mental health providers: Tips on finding one
- Deep brain stimulation
- Electroconvulsive therapy (ECT)
- Transcranial magnetic stimulation
- Vagus nerve stimulation
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Lifestyle and home remedies
In most cases, a mental illness won't get better if you try to treat it on your own without professional care. But you can do some things for yourself that will build on your treatment plan:
- Stick to your treatment plan. Don't skip therapy sessions. Even if you're feeling better, don't skip your medications. If you stop, symptoms may come back. And you could have withdrawal-like symptoms if you stop a medication too suddenly. If you have bothersome drug side effects or other problems with treatment, talk to your doctor before making changes.
- Avoid alcohol and drug use. Using alcohol or recreational drugs can make it difficult to treat a mental illness. If you're addicted, quitting can be a real challenge. If you can't quit on your own, see your doctor or find a support group to help you.
- Stay active. Exercise can help you manage symptoms of depression, stress and anxiety. Physical activity can also counteract the effects of some psychiatric medications that may cause weight gain. Consider walking, swimming, gardening or any form of physical activity that you enjoy. Even light physical activity can make a difference.
- Make healthy choices. Maintaining a regular schedule that includes sufficient sleep, healthy eating and regular physical activity are important to your mental health.
- Don't make important decisions when your symptoms are severe. Avoid decision-making when you're in the depth of mental illness symptoms, since you may not be thinking clearly.
- Determine priorities. You may reduce the impact of your mental illness by managing time and energy. Cut back on obligations when necessary and set reasonable goals. Give yourself permission to do less when symptoms are worse. You may find it helpful to make a list of daily tasks or use a planner to structure your time and stay organized.
- Learn to adopt a positive attitude. Focusing on the positive things in your life can make your life better and may even improve your health. Try to accept changes when they occur, and keep problems in perspective. Stress management techniques, including relaxation methods, may help.
Coping and support
Coping with a mental illness is challenging. Talk to your doctor or therapist about improving your coping skills, and consider these tips:
- Learn about your mental illness. Your doctor or therapist can provide you with information or may recommend classes, books or websites. Include your family, too — this can help the people who care about you understand what you're going through and learn how they can help.
- Join a support group. Connecting with others facing similar challenges may help you cope. Support groups for mental illness are available in many communities and online. One good place to start is the National Alliance on Mental Illness.
- Stay connected with friends and family. Try to participate in social activities, and get together with family or friends regularly. Ask for help when you need it, and be upfront with your loved ones about how you're doing.
- Keep a journal. Or jot down brief thoughts or record symptoms on a smartphone app. Keeping track of your personal life and sharing information with your therapist can help you identify what triggers or improves your symptoms. It's also a healthy way to explore and express pain, anger, fear and other emotions.
Preparing for your appointment
Whether you schedule an appointment with your primary care provider to talk about mental health concerns or you're referred to a mental health professional, such as a psychiatrist or psychologist, take steps to prepare for your appointment.
If possible, take a family member or friend along. Someone who has known you for a long time may be able to share important information, with your permission.
What you can do
Before your appointment, make a list of:
- Any symptoms you or people close to you have noticed, and for how long
- Key personal information, including traumatic events in your past and any current, major stressors
- Your medical information, including other physical or mental health conditions
- Any medications, vitamins, herbal products or other supplements you take, and their dosages
- Questions to ask your doctor or mental health professional
Questions to ask may include:
- What type of mental illness might I have?
- Why can't I get over mental illness on my own?
- How do you treat my type of mental illness?
- Will talk therapy help?
- Are there medications that might help?
- How long will treatment take?
- What can I do to help myself?
- Do you have any brochures or other printed material that I can have?
- What websites do you recommend?
Don't hesitate to ask any other questions during your appointment.
What to expect from your doctor
During your appointment, your doctor or mental health professional is likely to ask you questions about your mood, thoughts and behavior, such as:
- When did you first notice symptoms?
- How is your daily life affected by your symptoms?
- What treatment, if any, have you had for mental illness?
- What have you tried on your own to feel better or control your symptoms?
- What things make you feel worse?
- Have family members or friends commented on your mood or behavior?
- Do you have blood relatives with a mental illness?
- What do you hope to gain from treatment?
- What medications or over-the-counter herbs and supplements do you take?
- Do you drink alcohol or use recreational drugs?
Your doctor or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your time with the doctor.
By Mayo Clinic Staff
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Can Mental Illness Be Cured or Treated?
According to the National Alliance on Mental Illness (NAMI), about 1 in every 5 adults, and 1 in 6 youth, experience a mental health disorder each year in the United States. A mental health disorder, more commonly known as a mental illness, is a medical condition that disrupts a person’s thoughts, feelings, mood, and ability to relate to others or carry out daily tasks.
Examples of common mental illnesses include depression, anxiety, bipolar disorder, post traumatic stress disorder, and ADHD, or attention deficit hyperactivity disorder.
While mental illness is not always visible, it is a very real medical condition, much like heart disease or diabetes. As a result, mental illness is also very treatable. Treatments have been identified to ease the symptoms and help people manage mental illness successfully.
If you or a loved one is struggling with mental illness, rest assured that there is help available.
Diagnosing Mental Illness
Although mental illness is a medical health condition, it is not always easy to spot or diagnose. This is because it differs from the physical ailments we typically know and see affect someone’s health. For example, when a person struggles with heart disease, they show physical symptoms like chest pain and shortness of breath. They are diagnosed with a series of blood tests and electrocardiograms.
Mental illnesses are disorders of the mind. Therefore, they must be diagnosed through a psychological evaluation, in which a clinician assesses each patient’s symptoms, thoughts, feelings, and behavioral patterns. A physical exam may also be conducted to ensure there are no underlying medical issues causing mental symptoms. This is a critical step.
Getting a diagnosis is a turning point for many people with mental illness. It can feel like an incredible relief to finally have a name for the things that are causing them pain and distress. It can also pave the way for treatment. Getting a mental health diagnosis means that treatment is possible.
Doctors and therapists use diagnoses to determine a person’s treatment options. Every mental health disorder requires different treatment methods. For clinicians, having a formal diagnosis can help them understand which next steps to take, whether that be therapy, medication, or a combined approach.
For you, getting a diagnoses means that mental health treatment is possible. Recovery is around the corner. Steps can be taken to improve your quality of life.
Mental Illness is Treatable
For those asking, “Is mental illness treatable?” The answer is yes.
Most people diagnosed with a mental illness can experience relief, manage their symptoms effectively, and lead a fulfilling, productive life with active and ongoing treatment. Mental health treatment must be personalized to fit each person’s needs and specific disorder.
A mental health treatment plan, for example, may involve medication, psychotherapy, support groups, or a combination of modalities. It can also involve holistic, therapeutic activities like exercise, yoga, art and music. It should also entail good nutrition, consistent sleeping patterns, as well as social activities and opportunities. Again, each mental illness requires its own approach and care. It is important to get a formal assessment from a professional, in order to understand what combination – and which specific therapy methods – will work best for you.
Can Mental Illness Be Cured?
Mental illness can be treated, but it cannot be cured.
When a person is cured from an illness, it means that the illness is gone forever. However, some conditions simply cannot be cured. One example is diabetes. Diabetes is a chronic, lifelong condition that stays with a person after diagnosis. However, diabetes can be treated and managed successfully. Those with diabetes can take medications, make lifestyle changes, and go on to lead long, fulfilling lives.
Mental illness is very similar. Currently, there is no cure for mental illness. As a chronic disorder of the brain, mental illness affects a person for life. However, mental illness can be treated and managed effectively. People with mental health conditions – such as depression, anxiety, schizophrenia, and PTSD – can recover and live long, healthy, and happy lives.
For chronic conditions like mental illness, diabetes, arthritis, and hypertension, treatment must be ongoing. There must be an active and continued commitment to therapy, medication, and any lifestyle changes made. By being actively engaged in your treatment, and prioritizing your mental health, you will have the best chance at recovery.
As stated by the NAMI, “For many people, recovery — including meaningful roles in social life, school and work — is possible, especially when you start treatment early and play a strong role in your own recovery process.”
Treatments for Mental Illness
Mental illnesses should be treated professionally. A doctor or mental health professional can assess the severity of your symptoms, how much they are affecting your daily life, as well as the risks and benefits of different treatment methods. From there, they can develop an individualized treatment plan, which might involve a combination of the following methods:
- Medication: Different medications can help to improve symptoms of mental illness. This varies by disorder. For example, those struggling with depression may be prescribed an antidepressant like Prozac or Zoloft, to help balance the chemicals within the brain.
- Therapy: Therapy is also recommended to help manage symptoms, regulate emotions, overcome triggers, and develop healthy coping skills. For example, individuals with anxiety can learn how to better manage stress and nervousness through therapy sessions. Therapy may be one-on-one with a counselor, or involve a group facing similar diagnoses. There are different types of mental health therapies out there, including Cognitive Behavioral Therapy, Motivational Interviewing, interpersonal therapy, family therapy, and more.
- Support groups: Support groups offer an opportunity for individuals with similar conditions to get together, to share their experiences, and to provide support for one another. Support groups allow those struggling to better understand their condition and possible coping methods. These groups also provide them with friendship, mentorship, tools, and support when in need.
The goal of mental illness treatment is to alleviate difficult symptoms and allow a person to live a healthy, purposeful, and satisfying life. Mental illness often gets in the way of people living their life to the fullest. It can make it difficult to get out of bed, meet new people, or maintain a career. Treatment is designed to decrease these disruptions and make it possible to live healthily and fully again.
Getting Proper Mental Health Treatment
Anyone, of any background, can develop a mental illness. It may be a result of genetics, environment, lifestyle, and behavioral issues. Not one single event causes a mental illness. Similarly, it is not a personal fault that leads to mental illness. It does not come from weakness or doing something “wrong.” Rather, mental illness may be triggered by a combination of factors, like chemical imbalances, brain injury, family histories, past traumas, stressful environments, substance abuse, and social isolation.
Therefore, mental illnesses can be complicated. They cannot be overcome alone.
As stated by the NAMI of California, “Mental health conditions cannot be overcome through will power and are not related to a person’s character or intelligence, but they are treatable.”
Getting the right treatment starts with getting a diagnosis. If you suspect that you, or someone you love, is facing symptoms of a mental illness, call a doctor or mental health professional today. A medical assessment is needed to determine a course of treatment.
If you do not know where to start, you can always contact Turnbridge for support. Turnbridge is a mental health treatment center for young adults and adolescents. Call 877-581-1793 today.
Medicines for mental illness
The effectiveness of drug therapy with psychotropic drugs is determined by the compliance of the choice of the drug with the clinical picture of the disease, the correctness of its dosing regimen, the method of administration and the duration of the therapeutic course. As in any field of medicine, in psychiatry it is necessary to take into account the entire complex of drugs that the patient takes, since their mutual action can lead not only to a change in the nature of the effects of each of them, but also to the occurrence of undesirable consequences. nine0003
There are several approaches to the classification of psychotropic drugs. Table 1 shows the classification proposed by the WHO in 1990, adapted to include some domestic medicines.
Table 1. Classification of psychopharmacological drugs.
|Generic and common trade names
Chlorpromazine (chlorpromazine), promazine, thioproperazine (majeptil), trifluperazine (stelazine, triftazine), periciazine (neuleptil), alimemazine (teralen)
|nine0002 Xanthenes and thioxanthenes
Chlorprothixene, Clopenthixol (Clopexol), Flupentixol (Fluanxol)
Haloperidol, trifluperidol (trisedil, triperidol), droperidol
Fluspirilene (imap), pimozide (orap), penfluridol (semap)
Risperidone (rispolept), ritanserin, clozapine (leponex, azaleptin)
Indole and naphthol derivatives
Sulpiride (eglonil), metoclopramide, racloprid, amisulpiride, sultopride, tiapride (tiapridal)
Derivatives of other substances
Diazepam (Valium, Seduxen, Relanium), Chlordiazepoxide (Librium, Elenium), Nitrazempam (Radedorm, Eunoctin)
Alprazolam (Xanax), Triazolam (Chalcion), Madizopam (Dormicum)
Benactizine (staurodorm), hydroxyzine (atarax)
Busperone (buspar), zopiclone (imovan), clometizol, gemineurin, zolpidem (ivadal)
Amitriptyline (Triptisol, Elivel), Imipramine (Melipramine), Clomipramine (Anafranil), Tianeptine (Coaxil)
Mianserin (Lerivon), Maprotiline (Ludiomil), Pyrlindol (Pyrazidol),
Citalopram (Seroprax), Sertraline (Zoloft), Paroxetine (Paxil), Viloxazine (Vivalan), Fluoxetine (Prozac), Fluvoxamine (Fevarin),nine0016
Noradrenergic and specific serotonergic antidepressants (NaSSA)
Mirtazapine (remeron), milnacipran (ixel)
MAO inhibitors (reversible)
Nootropics (as well as substances with a nootropic component of action)
Cyclic derivatives, GABA
Vincamine, Vinpocetine (Cavinton)
Vasopressin, oxytocin, thyroliberin, cholecystokinin
Ionol, mexidol, tocopherol
Amphetamine, salbutamol, methamphetamine (Pervitine)
Lithium salts (lithium carbonate, lithium hydroxybutyrate, lithonite, micalite), rubidium chloride, cesium chloride
Carbamazepine (Finlepsin, Tegretol), Valpromide (Depamide), Sodium Valproate (Depakine, Convulex)
|nine0002 Amino acids (glycine), opium receptor antagonists (naloxone, naltrexone), neuropeptides (bromocriptine, thyroliberin)
The main clinical characteristics and side effects of the listed classes of pharmacological drugs are given below.
Clinical characteristics. This class of drugs is central to the treatment of psychoses. However, the scope of their application is not limited to this, since in small doses in combination with other psychotropic drugs they can be used in the treatment of affective disorders, anxiety-phobic, obsessive-compulsive and somatoform disorders, with decompensation of personality disorders. nine0003
Regardless of the characteristics of the chemical structure and mechanism of action, all drugs of this group have similar clinical properties: they have a pronounced antipsychotic effect, reduce psychomotor activity and reduce mental arousal, neurotropic effect, manifested in the development of extrapyramidal and vegetovascular disorders, many of they also have antiemetic properties .
Side effects. The main side effects in the treatment of neuroleptics form the neuroleptic syndrome. The leading clinical manifestations of this syndrome are extrapyramidal disorders with a predominance of either hypo- or hyperkinetic disorders. Hypokinetic disorders include drug-induced parkinsonism, manifested by increased muscle tone, lockjaw, rigidity, stiffness, and slowness of movement and speech. Hyperkinetic disturbances include tremor and hyperkinesis. Usually in the clinical picture in various combinations there are both hypo- and hyperkinetic disorders. The phenomena of dyskinesia can be paroxysmal in nature, localized in the mouth area and manifested by spasmodic contractions of the muscles of the pharynx, tongue, lips, jaws. Often there are phenomena of akathisia - feelings of restlessness, "restlessness in the legs", combined with tasikinesia (the need to move, change position). A special group of dyskinesias includes tardive dyskinesia, which occurs after 2-3 years of taking antipsychotics and is expressed in involuntary movements of the lips, tongue, face. nine0003
Among the disorders of the autonomic nervous system, orthostatic hypotension, sweating, weight gain, changes in appetite, constipation, diarrhea are most often observed. Sometimes there are anticholinergic effects - visual disturbances, dysuric phenomena. Possible functional disorders of the cardiovascular system with changes in the ECG in the form of an increase in the Q-T interval, a decrease in the T wave or its inversion, tachycardia or bradycardia. Sometimes there are side effects in the form of photosensitivity, dermatitis, skin pigmentation; skin allergic reactions are possible. nine0003
Antipsychotics of new generations, compared with traditional derivatives of phenothiazines and butyrophenones, cause significantly fewer side effects and complications.
Clinical characteristics. This group includes psychopharmacological agents that relieve anxiety, emotional tension, fear of non-psychotic origin, and facilitate the process of adaptation to stressful factors. Many of them have anticonvulsant and muscle relaxant properties. Their use in therapeutic doses does not cause significant changes in cognitive activity and perception. Many of the drugs in this group have a pronounced hypnotic effect and are used primarily as hypnotics. Unlike neuroleptics, tranquilizers do not have a pronounced antipsychotic activity and are used as an additional tool in the treatment of psychosis - to stop psychomotor agitation and correct the side effects of neuroleptics. nine0003
Side effects of during treatment with tranquilizers are most often manifested by daytime drowsiness, lethargy, muscle weakness, impaired concentration, short-term memory, as well as a slowdown in the speed of mental reactions. In some cases, paradoxical reactions develop in the form of anxiety, insomnia, psychomotor agitation, hallucinations. Among the dysfunctions of the autonomic nervous system and other organs and systems, hypotension, constipation, nausea, urinary retention or incontinence, decreased libido are noted. Long-term use of tranquilizers is dangerous due to the possibility of developing addiction to them, i.e. physical and mental dependence. nine0003
Clinical characteristics. This class of drugs includes drugs that increase the pathological hypothymic effect, as well as reduce depression-related somatovegetative disorders. A growing body of scientific evidence now suggests that antidepressants are effective for phobic anxiety and obsessive-compulsive disorders. It is assumed that in these cases, not the actual antidepressant, but the anti-obsessional and antiphobic effects are realized. There is data confirming the ability of many antidepressants to increase the threshold of pain sensitivity, to have a preventive effect in migraine and vegetative crises. nine0003
Side effects. Side effects related to the central nervous system and the autonomic nervous system are expressed as dizziness, tremor, dysarthria, impaired consciousness in the form of delirium, epileptiform seizures. Possible exacerbation of anxious disorders, activation of suicidal tendencies, inversion of affect, drowsiness or, conversely, insomnia. Side effects may be manifested by hypotension, sinus tachycardia, arrhythmia, impaired atrioventricular conduction. nine0003
When taking tricyclic antidepressants, various anticholinergic effects are often observed, as well as an increase in appetite. With the simultaneous use of MAO inhibitors with food products containing tyramine or its precursor - tyrosine (cheeses, etc.), a "cheese effect" occurs, manifested by hypertension, hyperthermia, convulsions and sometimes leading to death.
When prescribing serotonin reuptake inhibitors (SSRIs) and reversible MAO-A inhibitors, there may be disturbances in the activity of the gastrointestinal tract, headaches, insomnia, anxiety, and impotence may develop against the background of SSRIs. In the case of a combination of SSRIs with drugs of the tricyclic group, the formation of the so-called serotonin syndrome, which is manifested by an increase in body temperature and signs of intoxication, is possible. nine0003
Clinical characteristics. Normotimics include drugs that regulate affective manifestations and have a preventive effect in phasic affective psychoses. Some of these drugs are anticonvulsants.
Side effects of when using lithium salts are most often tremor. Often there are violations of the function of the gastrointestinal tract - nausea, vomiting, loss of appetite, diarrhea. Often there is an increase in body weight, polydipsia, polyuria, hypothyroidism. Acne, maculo-papular rash, alopecia, as well as worsening of psoriasis are possible. nine0003
Signs of severe toxic conditions and overdose of the drug are a metallic taste in the mouth, thirst, severe tremor, dysarthria, ataxia; in these cases, the drug should be stopped immediately.
It should also be noted that side effects may be associated with non-compliance with the diet - a large intake of liquid, salt, smoked meats, cheeses.
Side effects of anticonvulsants are most often associated with functional disorders of the central nervous system and manifest as lethargy, drowsiness, ataxia. Hyperreflexia, myoclonus, tremor can be observed much less frequently. The severity of these phenomena is significantly reduced with a smooth increase in doses. nine0003
With a pronounced cardiotoxic effect, atrioventricular block may develop.
Clinical characteristics. Nootropics include drugs that can positively affect cognitive functions, stimulate learning, enhance memory processes, increase brain resistance to various adverse factors (in particular, to hypoxia) and extreme stress. However, they do not have a direct stimulating effect on mental activity, although in some cases they can cause anxiety and sleep disturbance. nine0003
Side effects - rare. Sometimes there are nervousness, irritability, elements of psychomotor agitation and disinhibition of drives, as well as anxiety and insomnia. Dizziness, headache, nausea and abdominal pain may occur.
Clinical characteristics. As the name of the class implies, it includes psychotropic drugs that increase the level of wakefulness, have a stimulating effect on mental and physical activity, temporarily increase mental and physical performance and endurance, reduce the feeling of fatigue and drowsiness. nine0003
Side effects of are mainly related to effects on the central nervous system (tremor, euphoria, insomnia, irritability, headaches, signs of psychomotor agitation) and the autonomic nervous system (sweating, dry mucous membranes, anorexia). In addition, there may be disorders of cardiovascular activity (arrhythmia, tachycardia, increased blood pressure), as well as a change in the body's sensitivity to insulin in patients with diabetes mellitus. Long-term and frequent use of stimulants can lead to the development of mental and physical dependence. nine0003
How do I find the right medication for a mental disorder?
Almost every second course of drug treatment in psychiatry fails or causes serious side effects in patients. The process of selecting a suitable drug is influenced by many factors: the professionalism of doctors, the collection of anamnesis and the characteristics of the patient's body. One of the key goals of modern psychiatry is to learn how to select effective and at the same time safe medicines for each patient. In recent years, science has achieved outstanding results in this direction. Already, thanks to genetic research, there is a way to select drugs four times more effective than before. nine0003
History taking and prescription by a psychiatrist
When a psychiatrist prescribes a drug to a patient, he is guided not only by his own experience and professionalism, but also by information about the disease and symptoms that the patient or his relatives broadcast. In order to select the most appropriate remedy, the psychiatrist examines the symptoms, collects and analyzes information about previous treatment and its effectiveness. He determines which of the previously prescribed drugs had side effects and which did not. The specialist needs to study a huge amount of information. Unfortunately, this information is not always correct and truthful. The patient may not remember something or misinterpret his own state. Also, the person may have experience of being treated with suitable medications that have been dosed incorrectly. Therefore, the picture of previous treatment that a psychiatrist receives is most often extremely subjective. nine0003
Usually, the conclusion about how this or that drug will affect the patient's body is made by a specialist on the basis of a blood test, and not neuroimaging methods of verification.
When choosing a drug treatment, the specialist pursues two main goals - to reduce the symptoms of the disease and at the same time not harm the patient's body. It is often difficult for a psychiatrist to predict how the patient's body will react to a particular drug. As a rule, medicines aimed at treating psychiatric disorders, such as schizophrenia or depression, have many serious side effects. They can lead to metabolic and neurological disorders, as well as have a negative impact on the human endocrine system. nine0003
Usually, the conclusion about how this or that drug will affect the patient's body is made by a specialist on the basis of a blood test, and not neuroimaging methods of verification. You cannot do a functional MRI or an EEG and immediately find out how the patient's brain works and what his problem is. When prescribing treatment, the psychiatrist proceeds from his own knowledge, experience, recommendations from the Ministry of Health and other sources that may influence the final decision.nine0501 See also
Myths about diagnosing mental illness
Drug action and side effects
In order to receive a suitable drug treatment, the patient must go through some inconvenience before the drug has the desired effect. Even the highest quality drug of the latest generation, which has passed clinical trials and is recommended for the treatment of a particular mental disorder, may suit one patient the first time, and not suit another at all. In the second case, the selection process of the drug begins anew. Sometimes, in order to understand whether the medicine is suitable for a particular patient, a lot of time must pass. There is a cumulative effect in which the drug begins to have a full effect only after a few weeks of its use. nine0003
Many patients with psychiatric disorders, such as depression or bipolar disorder, refuse to take drugs because they cannot tolerate the side effects. The drug can be extremely effective in reducing symptoms, but at the same time have a devastating effect on the body. Sometimes side effects can be noticed almost immediately - 3-5 days after the start of the drug. Only a highly qualified specialist can determine whether it is worth “tolerating” the side effects, or whether the medicine is not suitable for the patient and needs to be replaced with another one. nine0003
The same medicine may cause side effects in some people but be safe and effective in others.
In addition, it happens that the drug is easily tolerated by the patient and does not have side effects, but the symptoms of mental illness remain. In the absence of side effects, the drug may begin to act in full force only 3-5 weeks after the appointment. In addition, after this period, the patient may stop some symptoms and appear others, hidden under the first. In this case, it is necessary to add other drugs to the treatment or change the dosage of drugs. nine0003
Selection of drugs using genetic analysis
The medicine will help or harm, determine the mechanisms in the cells of the human body. These mechanisms are controlled by genes - sections of the DNA molecule. Genes can differ from person to person, which is why every patient metabolizes drugs differently. The same medicine may cause side effects in some people but be safe and effective in others.
The most effective way to select drugs for the treatment of mental disorders that has been created to date is genetic analysis. Such a test is a DNA test that helps to identify the specifics of the body and prescribe medication in accordance with the individual characteristics of the patient. During the test, DNA markers of efficacy, optimal dosage and side effects of drugs are analyzed. nine0003
A special stick and tube for collecting and storing a sample that is sent for genetic analysis.
Mental norm and pathology
The genetic testing method has several distinct advantages. It helps to identify:
Reaction to drugs. nine0015 The test shows the likelihood of a positive or negative reaction of the body to individual drugs, depending on the genetic profile of the patient.
Risk of side effects. Genetic testing shows if a patient has a higher risk of side effects when treated with certain drugs.
Dosage information. nine0015 The test provides information about the genetic factors that control drug activation, distribution and clearance, thus helping to determine the most appropriate dose for the patient.
In order to undergo a genetic test, the patient must pass a saliva sample. The sample is collected with a special stick from the inside of the cheek and placed in a vacuum-packed test tube, after which it is sent for analysis.
Genetic testing is the most accurate method of drug selection in psychiatry.
The company conducting the analysis sends the test result in 2-3 weeks. The result is a very detailed report, written in a language the psychiatrist can understand. You can only check with a referral from a specialist. The analysis process is strictly confidential. None of the authorities involved in testing has the patient's personal information. Each genetic test has a barcode to which the analysis data and final results are linked. nine0003
Example of a table with results from a genetic analysis report.
Risk factors and prospects for genetic testing in psychiatry
Genetic testing is the most accurate method of drug selection in psychiatry. Such a check does not replace the taking of an anamnesis or diagnosis by specialists. However, this tool increases the likelihood of selecting the right drug by four times, which is a significant advantage for patients with mental disorders. nine0003
It is important to note that genetic analysis does not guarantee a 100% effective result for every patient. The results of the test may not be informative enough or not be beneficial to the patient at all. This is due to the fact that at the moment not all groups of genes responsible for the occurrence of mental illness are known to science. The genetic test is most effective in helping patients with depression, bipolar affective disorder, schizophrenia and anxiety disorder choose medication. nine0003
The test is recommended for patients who have already completed at least two unsuccessful courses of drug treatment.
The cost of genetic testing ranges from 1,000 to 2,000 euros, depending on the type of study. The test is absolutely safe and currently has no contraindications. However, due to the high cost of testing, the psychiatrist discusses the need for it with the patient. The test is recommended for patients who have already completed at least two unsuccessful courses of drug treatment. When the patient first visits the clinic, it is recommended to prescribe drugs based on the history that the specialist collects. Unless urgently needed, genetic testing is usually not prescribed during the initial selection of a course of treatment. nine0003
It is likely that in the foreseeable future such genetic testing will be carried out regularly, become widespread and subsequently become more accessible to more patients.