What Is Psychopharmacology?

Psychopharmacology is the study of drugs used for mental health purposes. Along with therapy, medication can play a significant role in a person’s treatment plan for certain mental illnesses. A psychopharmacologist is a medical prescriber who studies the use of medications in treating mental disorders, such as psychiatrists, medical doctors, and psychiatric nurse practitioners.

According to the American Society of Clinical Psychopharmacology, psychopharmacologists must understand both what the body does to a drug (pharmacokinetics) as well as what a drug does to the body (pharmacodynamics). This includes an understanding of:

• Interactions between multiple drugs
• The relationship between genetics and medication
• How long a drug can last in a person’s system
• Drug efficacy and protein binding

Along with the intended effects of medication, psychopharmacologists also study alternative uses for medications intended for other conditions. For example, certain anticonvulsant drugs used to prevent seizures have also been shown to produce a mood-stabilizing effect, making them useful for people suffering from bipolar disorder or extreme mood swings.

Psychopharmacologists are not only interested in drugs that can improve a person’s mental health, but also in substances that can alter a person’s mental processes. Ongoing research focuses on both legal and illegal substances, such as:

• Alcohol
• Caffeine
• Cannabis
• Cocaine
• Heroin
• LSD
• Meth
• Nicotine

Basic Principles of Psychopharmacology

Biochemistry and Brain Health

One of the major tenets of psychopharmacology is the idea that your brain chemistry can have an effect on your mental health. Your brain requires certain levels of nutrients and neurotransmitters to function properly. Chemical imbalances in the brain can cause an overproduction or underproduction of these necessary nutrients and neurotransmitters, resulting in mental health problems.

Genetics and Mental Illness

Biochemistry is the study of how chemical imbalances affect our mental health. But why do chemical imbalances occur in the first place?

Genes play a major role in shaping both our physical and mental health. Your DNA can provide greater resistance to certain illnesses as well as greater vulnerability to others. Trauma experienced by your parents or grandparents can shape the way certain genes are expressed, creating an increased risk for mental illness.

It’s important to note that genetics aren’t destiny. Although your genes may predispose you to certain mental illnesses or tendencies, it’s rare that they cause a specific mental health disorder on their own. Rather, genes pass on greater or lesser risk for mental illnesses. Your mental health is influenced not only by your genes but also by external factors, such as your family, environment, culture, nutrition, and physical health.

How Drugs Affect the Brain

The ways in which drugs affect the brain are incredibly complex. However, there are four terms that outline the basics of how drugs affect the mind and body:

• Psychoactive drug: Interacts with the brain in any capacity by crossing the blood-brain barrier
• Psychotropic drug: Interacts with the brain in a way that affects your mental state, perception, behavior, and/or cognitive functioning
• Agonist drug: Increases activity at the synapse (space between two neurons), increasing or enhancing the production or release of certain chemicals in the brain
• Antagonist drug: Decreases activity at the synapse, blocking receptors from receiving certain chemicals in the brain

It’s important to note that many of these terms overlap. “Psychoactive” is an umbrella term that covers all other terms regarding drugs that affect the brain in some capacity. Examples of psychoactive drugs include alcohol, nicotine, caffeine, and many prescription and over-the-counter medications. Psychoactive drugs can be classified as depressants, stimulants, opioids, or hallucinogens. However, not all psychoactive drugs are psychotropic, and psychotropic drugs may be agonist, antagonist, or both, depending on the synapses affected by the drug.

For example, CBD, which is derived from cannabis (marijuana), is a psychoactive drug because it interacts with your brain. However, CBD is not a psychotropic drug because it does not affect your mental state or perception of reality—in short, CBD won’t get you high. It is typically classified as an antagonist because it blocks certain receptors.

On the other hand, THC, which is also derived from cannabis, is both psychoactive and psychotropic. It interacts with the brain in a way that affects your mental state and cognitive abilities—in this case, causing a high. THC is typically classified as an agonist because it increases activity for certain synapses.

Common Drugs Used to Treat Mental Health Disorders

Most psychotropic drugs can be classified in one of the following categories:

• Anti-anxiety medications
• Antidepressants
• Antipsychotics
• Mood stabilizers
• Stimulants

Anti-Anxiety Medications

Anti-anxiety medications can help people overcome the effects of generalized anxiety disorder (GAD) as well as other forms of anxiety, such as social anxiety, panic disorder, or specific phobias. Most anti-anxiety medications are benzodiazepines (“benzos”), which should only be prescribed for short-term use due to their risk for dependency and addiction. Common anti-anxiety medications include:

• Xanax (alprazolam)
• Valium (diazepam)
• Klonopin (clonazepam)
• Ativan (lorazepam)

Antidepressants

Depression exists in a variety of forms. There are multiple types of depression, including major depressive disorder (MDD), persistent depressive disorder (PDD), psychotic depression, postpartum depression (PPD), and seasonal affective disorder (SAD). Depression can also vary in terms of severity, ranging from mild to moderate to severe (also known as major).

Depending on the type and severity of depression you may be experiencing, your doctor may prescribe from a wide variety of antidepressants, including:

• Selective serotonin reuptake inhibitors (SSRIs): Lexapro (escitalopram), Zoloft (sertraline), Paxil (paroxetine)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): Cymbalta (duloxetine), Effexor (venlafaxine)
• Norepinephrine-dopamine reuptake inhibitors (NDRIs): Wellbutrin (bupropion)
• Monoamine oxidase inhibitors (MAOIs): Nardil (phenelzine), Marplan (isocarboxazid)
• Tricyclic antidepressants: Norpramin (desipramine), Tofranil (imipramine)

Antipsychotics

Antipsychotics can help treat schizophrenia as well as other forms of psychosis or mental illness. Common antipsychotics include:

• Thorazine (chlorpromazine)
• Haldol (haloperidol)
• Abilify (aripiprazole)
• Risperdal (risperidone)
• Zyprexa (olanzapine)
• Seroquel (quetiapine)

Mood Stabilizers

Mood stabilizers can help treat mood disorders, such as depression, bipolar disorder, disruptive mood dysregulation disorder (DMDD), premenstrual dysphoric disorder (PMDD), and mood disorders caused by substances or other medications. They can also be used to treat the symptoms of impulsivity and emotion dysregulation associated with several personality disorders. Common mood stabilizers include:

• Lithium (sold under multiple brand names)
• Carbamazepine (sold under multiple brand names)
• Anticonvulsants (anti-seizure medications), such as Depakote (valproate), Tegretol (carbamazepine), and Lamictal (lamotrigine)

Stimulants

Stimulants are mainly used to treat attention-deficit/hyperactivity disorder (ADHD), although they can also be prescribed for narcolepsy. Common prescription stimulants include:

• Adderall (amphetamine)
• Ritalin (methylphenidate)

Most prescription stimulants are only prescribed for short-term use due to their potential for dependency. Keep in mind that non-prescription stimulants, such as caffeine and nicotine, can also cause dependency and may lead to addiction. Illegal stimulants, including methamphetamine and cocaine, are also highly addictive.

Benefits of Psychopharmacology

Can Medication Help with Mental Illness?

Yes! Medication is often part of many mental health treatment plans. Just like with any physical illness or injury, mental health medication can play an important role in your healing process. Although most mental health disorders cannot be cured, medication can help alleviate and even eliminate some symptoms of certain mental illnesses.

Fight the Stigma

It’s important to note that medication is a valid, healthy way of addressing the effects of mental illness. Taking medication doesn’t make you weak or less “yourself.” It helps your brain and body heal, just like medication for any other injury or illness.

Keep in mind that success may look like taking medication every day for a few weeks, months, years, or even a lifetime. There is no shame in how much medication you need or how often you need to take it. Some people wear glasses, walk with a cane, or use prescription-strength hand lotion every day to address their body’s needs. Medication is just another tool that can help you go about your life.

Your brain is another part of your body that medication can help. If your doctor prescribes you medication for your mental illness, you should take it as instructed.

What Are the Limits of Medication?

Although medication can improve mental health, it is not a cure-all, and its benefits should not be overstated. It’s important to consider:

• Individuality: Some drugs affect individuals in different ways. For example, two people who both suffer from major depression may require different types of medication in order to see results.
• Dosage: It’s important to find the right dosage for your body and your condition. Even the medication that works best for you may cause more problems than it solves if the dosage is too low or too high.
• Side effects: Certain mental health medications carry more serious side effects than others. Ask your doctor about the side effects of your prescription, and make sure to follow any and all instructions to minimize your risk for potential problems.
• Addiction risk: Some medications carry a greater risk for addiction than others. Additionally, some people have a family history that makes them more vulnerable to addiction. Ask your doctor if you have questions or concerns about developing an addiction or relapsing.
• Other treatments: Mental health medications are often best at alleviating or eliminating symptoms that interfere with a person’s ability to live their life. However, they may not address the root cause of a person’s mental health problems. Other treatment is often necessary to bring about more holistic healing, such as therapy.

Psychopharmacology Treatment

If you’re interested in learning more about the benefits of psychopharmacology, ask your physician or psychiatrist if medication is right for you. Keep mind that you may need to also start or continue with therapy during the course of your medication treatment. To get started, click here to find a therapist near you.