Hello from Dr. Arif.
I as a medical doctor working in the field of community Psychiatry. I travel a lot. Since 8 years I have been hearing dangerous myths regarding psychiatric medicine. I used the word dangerous because psychiatric or psychotropic medicine save lives, along with counseling can save patient from committing suicide or changing life of a patient from dysfunctional, miserable, dependent life to a functional, happy and independent life. Before going any further let me tell one more thing “All medicines having positive effects will have few side effects but side effects of taking medicines is nothing as compared to life threatening effects of not taking medicines”. Due to these myths regarding all medicines and in particular psychiatric medicine many patients are deprived of seeking help from doctors. Many patients who have hypothyroidism stop taking medicine as after taking it for few months their thyroid profile shows normal levels, they fail to understand their tests are normal because of taking medicine.
Golden rule is ” Never start a medicine on your own, nor stop it on your own”.
There are following groups of medicines commonly used in treating disorders of central nervous system.
1. Tricylic and related antidepressants: Mostly commonly used by qualified psychiatrists, currently 40 preparations are used ,they not sleeping pills , but used to counter depression, anxiety, obsessive compulsive disorder etc. They form 85 % of psychiatric prescriptions of qualified psychiatrists.
2. Sedatives and Tranquilizers: used with patients having extreme sleeplessness, intolerable levels of irritability, their dose generally tapered after patient gets relief and a counselor starts CBT [ Cognitive behavioral therapy]
3. Antimaniac drugs: used in schizophrenia, bipolar disorder etc.
4. Anticonvulsants: used generally in epilepsy.
5. Drugs Controlling Rigidity and Tremors: Used in Parkinsonism.
6. Cerebral activators: Used in mental retardation, cerebral insufficiencies, memory problems, hyperactivity disorder.
7. Drugs used in treating migraine.
8. Drugs used in neuropathy.
So it’s evident that only one type of medicine comprising of about 8 medicines[sedatives and tranquilizers] if used by a non psychiatrist and without counseling can cause addiction.
Now the question that how does psychiatric medicine work?
• Psychiatric medicine work by increasing, changing or blocking activities of neurotransmitters. Nerves carry information from the body to the brain and vice versa. The brain is composed of roughly 86 Billion neurons. Chemical messengers called neurotransmitters carry messages between neurons to help the brain receive the information, decide what it means and execute a reaction. Neurotransmitters are responsible for emotional regulation, pain perception, motivation, concentration, memory energy, mood, sleep patterns, libido. Any imbalance can result in Depression , Nightmares, Mental Fatigue, Anxiety, Impaired cognition, attention, and arousal, Apathy, Lack of motivation, Poor attention, and Fatigue. In Psychiatry there is a simple qualification of psychiatric ailments, which classifies diseases into neurotic [when touch with reality is not lost, like in anxiety, depression] and psychotic[ when touch with reality is loss like in schizophrenia or madness]. Most of the time a qualified psychiatrist uses anti depressants which do not cause sleep, in first few months of treatment depending upon the psychiatric ailment anxiolytics, also known as ‘tranquilizers’ or are used. Again depending upon the type of ailment mostly psychiatrist begins to taper the dose after 6 months. Antipsychotics are used for longer periods specially as in case of Schizophrenia[ known as insanity or madness], where a patient suffers from hallucinations[ inside voices or scenes perceived by patients ,like hearing or seeing commands from holy men to walk on river, [which results in drowning] , commands asking patients to do acts of self harm etc. There is an ailment called Bipolar disorder, in its maniac phase patient not only tends to spend lakhs of rupees in few days but also indulge in unsafe sex which can lead to patient getting sexually transmitted diseases and HIV/AIDS. Even if drug abuse if left untreated, the drug addict can get Hepatitis, HIV/AIDS through sharing of needles among drug addicts. In treating drug addiction help of Psychiatrist is again must.
• Yes, along with taking medicine counseling is must, counseling leads to self empowerment; it helps you to identify triggers of anxiety, frustration, anger etc. and how to deal with them.
• My article no way supports irrational use of even antidepressants, but its aim is to clear myths about medicine, here I also stress the need of never taking psychiatric medicine alone, but importantly taking help of any mental health counselor near you.