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Antidepressants and Antipsychotics - Similarities and Differences

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Antipsychotics and antidepressants are used for treating mental disorders. To know more about these medicines, read the article below.

Medically reviewed by

Dr. Vishal Anilkumar Gandhi

Published At November 7, 2022
Reviewed AtDecember 8, 2022

Introduction:

The secret to good health is mental fitness. Several mental disorders affect an individual's life and decrease quality. Psychosis and depression are the most common mental disorders. These disorders are treated by antipsychotic and antidepressant medications, respectively.

Before knowing the similarities and differences between antipsychotics and antidepressant medicines, one should thoroughly know what they actually are. This article will provide insight into the details of the same.

What Is Psychosis and Antipsychotic Drugs?

Antipsychotic drugs are medicines that are used to treat a mental condition called psychosis. Psychosis is an altered mental state in which a person sees or hears imaginary things that actually do not exist in reality. This symptom is called hallucination.

Apart from hallucinations, people with psychosis also experience delusions. Delusion is a condition in which a person has false beliefs which show that his or her thoughts are not normal. In addition, the person with a delusion will be strongly convinced that their belief is true even if the evidence contradicts their belief. For example, a delusional person will have false beliefs that someone will hurt or be jealous of them, their spouse is not faithful, etc.

Psychosis can occur in conjunction with other mental illnesses, which are listed below:

  • Schizophrenia (a severe mental illness in which patients have an aberrant interpretation of reality).

  • Schizoaffective disorder (a long-term mental illness characterized by schizophrenia-like symptoms and mood-related symptoms, such as mania and sadness).

  • Some personality disorders (these are groups of mental disorders characterized by rigid and unusual thought, feeling, and behavior patterns).

  • Bipolar disorder (long-term mood disorder that results in abrupt changes in mood, energy, and behavior).

Apart from these mental illnesses, psychosis can also be drug-induced and occur as a side effect of long-term intake of corticosteroids, which is usually given to treat autoimmune diseases like idiopathic thrombocytopenic purpura (ITP), systemic Lupus erythematosus (SLE), etc.

How Do Antipsychotic Medications Work?

It is believed that dopamine contributes to the development of psychosis. Among the many chemicals present in the brain, dopamine plays a major role in communicating messages between different parts of the brain. When the brain releases an excessive amount of dopamine, it results in psychosis.

Hence, to control psychosis symptoms, the overproduction of dopamine has to be controlled, which is done by these antipsychotic medications. These medicines basically block dopamine receptors present in the brain and bring back the right ratio of dopamine to other brain chemicals. This balancing helps in improving the symptoms.

Antipsychotic medications also affect other chemicals of the brain (neurotransmitters serotonin, noradrenaline, and glutamate), which regulate mood.

It is particularly critical to monitor antipsychotics closely if the patient also suffers from epilepsy, a disorder characterized by seizures and fits.

What Are the Types of Antipsychotic Medicines?

Antipsychotic medicines are of two types:

  1. Typical or First generation (older) Antipsychotics: These medicines are the older ones that can cause significant neuromuscular side effects. In addition, they can result in drowsiness or movement disorders. Examples are Haloperidol, Chlorpromazine, Flupentixol, Levomepromazine, and Promazine.

  2. Atypical or Second Generation (newer) Antipsychotics: These medicines are newer, have fewer side effects than typical antipsychotics, and provide a better mood, thoughts, and motivation. However, they may result in weight gain and alteration in blood sugar levels. Examples are Amisulpride, Clozapine, Aripiprazole, Lurasidone, Olanzapine, Quetiapine, and Paliperidone.

What Is Depression and What Are Antidepressant Drugs?

Antidepressants are medicines used to treat clinical depression, the most common and well-known mental illness. In depression, a person constantly feels sad and loses interest in daily activities. Apart from depression, these medicines can be used in the treatment of the following conditions:

  • Obsessive-compulsive disorder (OCD).

  • Anxiety disorder.

  • Panic disorder.

  • Phobia.

  • Post-traumatic stress disorder (PTSD).

  • Bulimia (eating disorder).

  • Neuropathic pain (nerve pain).

What Are the Different Types of Antidepressants?

The different types of antidepressants are listed below:

  1. Selective Serotonin Reuptake Inhibitors (SSRIs): These medications are the most common type of antidepressant and have fewer side effects. Examples are Fluoxetine, Citalopram, and Sertraline.

  2. Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs): These antidepressants are quite similar to SSRIs and are considered more effective than the latter. Examples are Duloxetine and Venlafaxine.

  3. Noradrenaline and Specific Serotonergic Antidepressants (NASSAs): This type of antidepressant is suitable for individuals who cannot tolerate SSRI group medications. For example, Mirtazapine.

  4. Tricyclic Antidepressants (TCAs): These medications are not prescribed regularly because they cause toxicity if taken in overdose. Additionally, they have more side effects than other antidepressants. However, TCAs are prescribed if a person’s symptoms do not improve with other antidepressants. Examples are Amitriptyline, Nortriptyline, Lofepramine, Dosulepin, Clomipramine, and Imipramine.

  5. Serotonin Antagonists and Reuptake Inhibitors (SARIs): These medications are also not regularly prescribed but are given only when other types of antidepressants either show side effects or are not shown to be effective. An example of this group is Trazodone.

  6. Monoamine Oxidase Inhibitors (MAOIs): They can result in severe side effects; therefore, they are rarely used. Examples are Phenelzine, Isocarboxazid, and Tranylcypromine.

How Do Antidepressant Medications Work?

Neurotransmitters are the brain chemicals that control how the brain functions. Some neurotransmitters like serotonin and noradrenaline are associated with emotions and mood. Antidepressants increase the neurotransmitter levels in the brain and improve depression symptoms. Additionally, some antidepressants may be able to reduce chronic pain because neurotransmitters may also have an impact on the nerves' ability to send pain signals.

Are Antipsychotics the Same as Antidepressants?

No, many people think that antidepressants and antipsychotics are the same medicines. However, this is not true. They both work differently and are used to treat different symptoms.

Key Features of Antipsychotics:

  • Antipsychotic medicines control psychosis symptoms but do not treat depression.

  • They work by modifying brain chemistry to help lessen psychotic symptoms and prevent them from coming back. However, these medicines cannot completely cure psychosis.

  • Rather than eliminating antipsychotic symptoms completely, antipsychotic medications may reduce their intensity so that the person feels better and is able to function more easily and productively. Therefore, they are considered mood relaxants.

  • There are alternatives for antipsychotic drugs: cognitive behavioral therapy (CBT), family therapy, self-help groups, and rehabilitation.

  • Side effects of antipsychotics include tremors (involuntary shaking of limbs), muscle spasms, irregular periods in women, fluid retention, and restlessness.

  • The consumption of these medicines with alcohol is prohibited.

  • Antipsychotics can be given to pregnant women.

Key Features of Antidepressants:

  • Antidepressants improve depression symptoms. They are considered mood uplifters. They relax the person, bring calmness, and bring a good mood by elevating serotonin levels. Apart from this, these medications also help the person to have better sleep and improve their focus and thinking.

  • Usually, they are required to treat moderate and severe depression. A milder form of depression can be treated by lifestyle modifications and other psychological therapies like CBT, interpersonal therapy (IPT), counseling, exercise, yoga, and meditation.

  • Antidepressants do not cause addictions. However, they have some side effects, including weight gain, abdominal discomfort like diarrhea or constipation, dizziness, blurred vision, loss of appetite, abdominal discomforts, and sweating.

  • Antidepressants and alcohol do not go well together as they can be dangerous. Pregnant women are not advised to take antidepressants. In children and teenagers also use of antidepressants is not recommended.

Conclusion:

To conclude, both antipsychotic and antidepressant drugs are used to treat mental illnesses. However, both are specific in treating a disorder. Antipsychotic treats psychosis, whereas antidepressant treats depression. Both cannot be taken with alcohol and have some common side effects like weight gain, dizziness, headaches, dry mouth, and sexual problems. On the contrary, both have different mechanisms of action. Therefore, a psychiatrist can best advise an individual on which drug can improve their symptoms.

Frequently Asked Questions

1.

Are Antipsychotics the Same as Depressants?

No, antipsychotics are not depressants. Antipsychotic drugs are used for the treatment of psychosis, while depressant drugs lower arousal and stimulation by affecting the central nervous system. They slow down communication between the brain and body, leading to reduced concentration, coordination, and responsiveness to unexpected situations. In small amounts, they induce relaxation and lower inhibition. Larger amounts can result in drowsiness, vomiting, unconsciousness, and even death. Depressants are used to treat conditions such as anxiety disorders, insomnia, and certain types of seizures.

2.

Do Psychotic and Antipsychotic Differ?

Psychosis is an altered state of consciousness in which people perceive or hear things that do not truly exist. Hallucination is the term for this symptom. Delusions are another symptom of psychosis, in addition to hallucinations. A person with delusions has erroneous views that demonstrate that their thinking is not normal. On the other hand, antipsychotic terms are used for those medications prescribed to treat the mental illness known as psychosis.

3.

Do Antidepressants and Antipsychotics Work Together?

Yes, a number of more recent or "second generation" antipsychotics have been demonstrated to be beneficial in enhancing or "boosting" the efficacy of antidepressants, despite the fact that they often do not have strong antidepressant effects on their own.

4.

Are Antipsychotic Drugs Worse Than Antidepressants?

It is not accurate to say that antipsychotic drugs are worse than antidepressants because both are different drugs used for different purposes and have different mechanisms of action. Antipsychotics are used to treat psychosis, whereas antidepressants are used to treat depression. Both medications cannot be taken with alcohol and have common adverse effects such as weight gain, dizziness, headaches, dry mouth, and sexual dysfunction. In contrast, their mechanisms of action are distinct.

5.

How Do Antipsychotic Drugs Feel?

Antipsychotics can make some people feel "wired" and unable to stop moving. This effect could be confused with an illness getting worse instead of a side effect of the medicine. On the other hand, these same drugs can also make people feel tired.

6.

Why Do Antipsychotics Improve the Symptoms of Depression?

The antidepressant effect of standard antipsychotics is thought to be due to the blockage of D2/D3 receptors on the dopamine (DA) pathway in the prefrontal cortex, which raises DA levels in the prefrontal cortex. Most antipsychotic medications are known to inhibit some dopamine receptors in the brain. This lowers the flow of these messages, which may aid in the reduction of one's psychotic symptoms.

7.

Is Antipsychotic Medicine Used to Treat Anxiety?

Atypical antipsychotics such as Quetiapine, Aripiprazole, Olanzapine, and Risperidone have been shown to be effective in treating anxiety and depressive symptoms in people with schizophrenia and schizoaffective disorders and have since been used to treat a variety of mood and anxiety disorders.

8.

What Is the Mechanism of Action of Antipsychotics?

Excessive dopamine is linked to psychosis development. Antipsychotics control this by blocking dopamine receptors, restoring balance among brain chemicals. These meds also impact serotonin, noradrenaline, and glutamate, which influence mood. Close monitoring is crucial when using antipsychotics for epilepsy patients due to seizure risks.

9.

Are Emotions Suppressed by Antipsychotics?

Antipsychotic drugs affect emotion perception in a negligible, non-statistically significant manner. Antipsychotics are widely utilized for a variety of conditions, from treating schizophrenia to managing sleep disturbances. A common negative side effect of its use is emotional flatness. This may have an impact on how some patients communicate with others, diminish their sense of self, and cause overt emotions of melancholy. According to one study, emotional flattening and cognitive impairment are common symptoms in how patients describe their experiences on the internet.

10.

What Happens When a Regular Person Takes Antipsychotics?

Antipsychotic medications should only be used when absolutely necessary. They may make daily tasks more challenging for a person with dementia. Additionally, they have harmful side effects such as increased anxiety, agitation, loss of appetite or thirst, excessive sleeping, and even death. According to the NIMH (National Institute of Mental Health), adverse effects from both typical and atypical antipsychotics include sleepiness, dizziness, blurred vision, constipation, nausea, and vomiting. These usually disappear. The medications, however, can also have negative long-term side effects.
According to the NIMH, typical antipsychotics frequently result in greater neurological adverse effects that impair physical mobility, such as muscle rigidity, spasms, tremors, tics, and restlessness.

11.

What Antipsychotic Drug Is the Strongest?

The most effective antipsychotic drug is Clozapine. It is saved for patients who do not react to previous therapies because it has a variety of side effects and requires frequent blood testing.

12.

What Antipsychotic Drug Is the Weakest?

Risperidone is the weakest atypical antipsychotic. However, the efficacy of antipsychotic drugs is based on the individual's specific disease, symptoms, and response to treatment.

13.

Are Antipsychotics Prescribed for Life?

Antipsychotics are frequently prescribed for patients with schizophrenia or other serious mental diseases throughout the rest of their lives because they are effective at controlling psychotic symptoms in the near term and may lower the likelihood of relapse. These medications are also increasingly being administered 'off-label' for problems such as insomnia and anxiety. Long-term antipsychotic medication is a very common outcome for patients with schizophrenia, but it is not an assurance.

14.

Can One Lead a Normal Life While Taking Antipsychotic Medications?

Yes, many people who use antipsychotic drugs can live normal and regular lives. In order to enhance general functionality and quality of life, antipsychotics are often used to help control the symptoms of illnesses, including schizophrenia, bipolar disorder, and other psychotic diseases.
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Dr. Vishal Anilkumar Gandhi
Dr. Vishal Anilkumar Gandhi

Psychiatry

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