Psychology2016

Psychological Therapies 617

especially in schizophrenia that starts in adolescence or young adulthood, the medication
must be taken for the rest of the person’s life. Long-term use of antipsychotics, particu-
larly the older typical drugs, has been associated with a decrease in cognitive functioning
such as impaired memory and sedation, possibly due to the chemical actions of the drugs
themselves. The hope for newer atypical antipsychotics is that they will not only produce
fewer negative side effects but also have less impact on the cognitive processes of those
persons taking these drugs (Julien et al., 2011; Stahl, 2013).

ANTIANXIETY DRUGS The traditional antianxiety drugs are the minor tranquilizers
or benzodiazepines such as Xanax, Ativan, and Valium. All of these drugs have a seda-
tive effect and, in the right dose, can start to relieve symptoms of anxiety within 20 to
30 minutes of taking the drug by mouth (Preston et al., 2008). Although many side
effects are possible, the main concern in using these drugs is their potential for addic-
tion as well as abuse in the form of taking larger doses to “escape” (National Institute
on Drug Abuse [NIDA], 2002).

MOOD-STABILIZING DRUGS For many years, the treatment of choice for bipolar disor-
der and episodes of mania has been lithium, a metallic chemical element that in its salt
form (lithium carbonate) evens out both the highs and the lows of bipolar disorder. It is
generally recommended that treatment with lithium continue at maintenance levels in
people with recurring bipolar disorder. Lithium affects the way sodium ions in neuron
and muscle cells are transported, although it is not clear exactly how this affects mood.
Side effects typically disappear quickly, although the use of lithium has been associated
with weight gain. Diet needs to be controlled when taking lithium because lowered
levels of sodium in the diet can cause lithium to build up to toxic levels, as can any sub-
stance that removes water from the body such as the caffeine in sodas, tea, and coffee.
Anticonvulsant drugs, normally used to treat seizure disorders, have also been
used to treat mania. Examples are carbamazepine, valproic acid (Depakote), and lam-
otrigine. These drugs can be as effective in controlling mood swings as lithium and can
also be used in combination with lithium treatments (Bowden et al., 2000; Thase & Sachs,
2000). Some atypical antipsychotics work as mood stabilizers and may be used alone or
in conjunction with anticonvulsant medications (Julien et al., 2011; Preston et al., 2008;
Stahl, 2013).

ANTIDEPRESSANT DRUGS As is so often the case in scientific discoveries, the first
types of drugs used in the treatment of depression were originally developed to treat
other disorders. Iproniazid, for example, was used to treat tuberculosis symptoms in
the early 1950s and was found to have a positive effect on mood, becoming the first
modern antidepressant (López-Muñoz & Alamo, 2009). This drug became the first
of the monoamine oxidase inhibitors (MAOIs), a class of antidepressants that blocks the
activity of an enzyme called monoamine oxidase. Monoamine oxidase is the brain’s
“cleanup worker” because its primary function is to break down the neurotransmitters
norepinephrine, serotonin, and dopamine—the three neurotransmitters most involved
in control of mood. Under normal circumstances, the excess neurotransmitters are bro-
ken down after they have done their “job” in mood control. In depression, these neu-
rotransmitters need more time to do their job, and the MAOIs allow them that time by
inhibiting the enzyme’s action.
Some common MAOIs in use today are isocarboxazid (Marplan), phenelzine sul-
fate (Nardil), and tranylcypromine sulfate (Parnate). These drugs can produce some
unwanted side effects, although in most cases the side effects decrease or disappear with
continued treatment: weight gain, constipation, dry mouth, dizziness, headache, drows-
iness or insomnia, and sexual arousal disorders are possible. People taking MAOIs in
general should also be careful about eating certain smoked, fermented, or pickled foods,
drinking certain beverages, or taking some other medications due to a risk of severe high
blood pressure in combination with consumption of these items, although there are a

antianxiety drugs

drugs used to treat and calm anx-

iety reactions, typically minor

tranquilizers.

antidepressant

drugs used to treat depression and

anxiety.