Questions & Answers on Psychiatric Medications
Tadao Ogura, M.D.
How Do Psychiatric Medications Actually Work?
When a person suffers from a psychiatric condition, there is usually some abnormality in the way the brain is working. Sometimes, the abnormality is mild, and the brain activity may just be at only a little lower than the optimum level. In other cases, there may be a severe dysfunction or disorder.
Since the brain is a living organ, it is possible for it to recover, or "heal." For example, if the dysfunction is a result of alcohol intoxication (i.e. a hangover), the brain may recover on its own (i.e. you "sleep it off"). However, when you suffer from a severe depression, "sleeping it off" just does not work, nor will it be a wise action to pursue, although too many people "escape" into sleep.
As noted above, psychiatric medications act on the brain. Some medications actually facilitate recovery and cure certain brain disorders, while others merely compensate for brain dysfunctions to allow the brain (or mind) to function close to its optimum level.
For example, many popular antidepressants such as Prozac, Zoloft and Paxil are classified as Selective Serotonin Reuptake Inhibitors (SSRI) because they block the reuptake of serotonin at the synaptic junctions in the brain and prevent the level of Serotonin from diminishing to too low a level. Other antidepressants like Wellbutrin work as Noradrenergic agents while many "Major Tranquilizers" like Risperdal and Zyprexa work as Dopaminergic agents.
All these medications are believed to affect the balances among the "biological amins" such as Serotonin, Noradrenalin, and Dopamine in the brain. If there are some chemical imbalances, these medications are designed to restore the balances in the brain and normalize the associated "mental functions."
Some other psychiatric medications work differently. For example, most Benzodiazepines such as Klonopin (Clonazepam) and Ativan (Lorazepam) seem to elevate the threshold of the nerve cell's sensitivity to incoming stimulation. Therefore, they work as anti-seizure medications as well as tranquilizers. Lithium for "Bipolar Disorders" seems to work by affecting sodium transport in nerve cells and to affect a shift towards intraneuronal metabolism of catecholamines. However, the exact mechanism of how Lithium works is still not fully understood, which may be one of the reasons why there have been so many misconceptions about this medication. I have even heard people describe it as an "antidepressant," which, clinically, it is not.
Like many other medications in General Medicine, psychiatric medications have been tested in laboratories first, then on animals, and then, carefully applied to human volunteers to accumulate data on their functions, benefits, and side-effects. Usually, it takes years to find out how and why a particular medication works. But, what matters most, as we will discuss later, is how the medication works for YOU, and for that, you can rely on your "body's natural wisdom."