Mental Health Medications Guide

Written by Lori M. King, PhD
Medically Reviewed by Zilpah Sheikh, MD on February 03, 2025
11 min read

There are several types of drugs available to treat mental illnesses. Some of the most commonly used are antidepressants, anti-anxiety drugs, antipsychotics, mood-stabilizers, and stimulants.

 

What types of drugs are used for mental illness?

Most of the medicines used to treat mental illnesses affect your neurotransmitters, which are chemicals that carry messages in your nervous system. Examples of neurotransmitters include serotonin, dopamine, and norepinephrine.

What are the most common mental health medications?

The most commonly used mental health medications include antidepressants, anti-anxiety medications, stimulants, antipsychotics, and mood stabilizers.

If you have a depressive disorder, your doctor may suggest an antidepressant medicine to help ease your symptoms. Depressive disorders include:

  • Major depressive disorder (MDD), which may also be called unipolar depression or clinical depression
  • Persistent depressive disorder, or dysthymia
  • Premenstrual dysphoric disorder
  • Depressive disorder due to another medical condition

Your doctor may also suggest you try certain antidepressants if you have other conditions, such as:

  • Obsessive-compulsive disorder
  • Social phobia
  • Panic disorder
  • Generalized anxiety disorder (GAD)
  • Posttraumatic stress disorder (PTSD)

There are several types of antidepressants on the market. They all work slightly differently by targeting certain chemicals in your brain called neurotransmitters. The currently available antidepressants mostly work on two neurotransmitters: serotonin and norepinephrine. 

These neurotransmitters help control your mood and behavior. Researchers think that antidepressants stop your nerve cells from reabsorbing the neurotransmitters after they've been used. This helps maintain higher levels of serotonin and norepinephrine in your nerve synapses, allowing their mood- and behavior-altering effects to last longer.

Also, experts think that increasing the amount of neurotransmitters in your synapses boosts levels of proteins that help protect certain cells in your brain. One of these proteins is called brain-derived neurotrophic factor (BDNF). People with depression seem to have naturally low levels of BDNF in their brains. Some experts think that increasing BDNF levels in your brain is what ultimately brings your depressive condition into remission.

For most types, you need to take the medicine daily for several weeks to months before symptoms improve. If one type doesn't help you, you can try other types. But don't just stop taking your medicine once you've started. You'll need to decrease your dose gradually over four weeks or you risk getting antidepressant discontinuation syndrome. This can cause symptoms such as fatigue, headache, muscle aches, sweating, anxiety, insomnia, nausea, dizziness, tingling, or shock-like sensations. Ask your doctor before you stop. They can help you come up with a schedule to help you wean yourself off the drug with minimum symptoms.

Regardless of the type of antidepressant you take, the most common side effects include:

  • Sexual dysfunction, such as erectile dysfunction or inability to have an orgasm
  • Drowsiness
  • Weight gain
  • Insomnia
  • Anxiety
  • Dizziness
  • Headache
  • Dry mouth
  • Blurred vision
  • Nausea
  • Rash
  • Tremors

Antidepressants are classified based on which neurotransmitter they most affect. The most widely used types include:

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs work by blocking your nerve synapses from taking up serotonin. These are generally the first antidepressant type your doctor may prescribe.

Examples of SSRIs include:

The most common side effects people report with SSRIs include sexual dysfunction, headache, and QTc prolongation (a delay in the heart's electrical recovery between beats).

Selective serotonin & norepinephrine inhibitors (SNRIs)

SNRIs block your nerve synapses from taking up both serotonin and norepinephrine. Different SNRIs vary in how well they block each of these neurotransmitters. For instance, some work more on serotonin than on norepinephrine, and others work more on norepinephrine.

Examples of SNRIs and the neurotransmitters they target more include:

  • Desvenlafaxine (Khedezla) — works more on serotonin than on norepinephrine
  • Duloxetine (Cymbalta) — works more on serotonin than on norepinephrine
  • Levomilnacipran (Fetzima) — works more on norepinephrine than on serotonin
  • Milnacipran (Savella) — works more on norepinephrine than on serotonin
  • Venlafaxine (Effexor) — works more on serotonin than on norepinephrine

The most common side effects of SNRIs include high blood pressure, headache, excessive sweating, and bone resorption or loss. 

Novel serotonergic drugs (serotonin modulators)

Like SSRIs, these antidepressants block your nerve synapses from taking up serotonin. But they do this by binding to different proteins on your cells than SSRIs do. Each of these serotonin modulators works on slightly different proteins or sets of proteins on the cells of your nerve synapses. So, each has a slightly different way of working and a slightly different set of side effects.

Examples of serotonin modulators include:

The most common side effects reported for each are as follows:

  • Nefazodone: Liver toxicity, including the risk for acute hepatitis and liver failure
  • Trazodone: Drowsiness and a prolonged erection lasting more than four hours
  • Vilazodone (Viibryd): Diarrhea
  • Vortioxetine (Trentellix): Nausea

Tricyclic antidepressants

Like SNRIs, tricyclic antidepressants block both serotonin and norepinephrine, but at a different point in the process. Tricyclic antidepressants may also block histamine and muscarine receptors on your nerve cells. Muscarine and histamine trigger your nerve cells to release acetylcholine, a neurotransmitter that helps control muscle contracting and plays a role in memory, thinking, and learning.

Examples of tricyclic antidepressants include:

  • Amitriptyline (Elavil)
  • Amoxapine
  • Clomipramine
  • Desipramine
  • Doxepin (Sinequan)
  • Imipramine (Tofranil)
  • Maprotiline
  • Nortriptyline (Pamelor)
  • Protriptyline
  • Trimipramine

The most common side effects for tricyclic antidepressants include:

  • Drowsiness
  • Confusion
  • Blurred vision and dilated pupils
  • Dry mouth, eyes, and skin
  • Fast heart rate
  • Vomiting
  • Muscle weakness

Monoamine oxidase inhibitors (MAOIs)

The first antidepressants discovered, MAOIs block an enzyme called monoamine oxidase, which helps serotonin, norepinephrine, and dopamine neurotransmitters work. Doctors don't prescribe them as much anymore because there's a risk for interactions with your other medicines, and the side effects tend to be more challenging than those of other antidepressants. 

Examples of MAOIs include:

The most common side effects of MAOIs include sexual dysfunction and serotonin syndrome. Serotonin syndrome is when you have too much serotonin in your nerve cells. Symptoms of too much serotonin include:

  • Nervousness or anxiety
  • Nausea and vomiting 
  • Diarrhea
  • Dilated pupils
  • Muscle twitching, involuntary contractions, spasms, and rigidity
  • Sweating and shivering
  • Side-to-side eye movements
  • In serious cases, confusion, delirium, fast heart rate, high blood pressure, fever, seizures, and loss of consciousness

Atypical antidepressants and N-methyl-D-aspartate (NMDA) antagonists

These two types of antidepressants work slightly differently from the ones above, and also from each other. 

Examples of atypical antidepressants include:

  • Agomelatine, which increases levels of melatonin, dopamine, and norepinephrine
  • Bupropion (Wellbutrin), which increases levels of norepinephrine and dopamine
  • Mirtazapine (Remeron), which increases levels of norepinephrine and dopamine

NMDA antagonists keep two neurotransmitters called glutamate and gamma-aminobutyric acid (GABA) from binding to NMDA — a protein on your nerve cells. This calms your nervous system and may help ease your symptoms. You generally need to take these along with another medicine. NMDA antagonists include:

  • Esketamine-intranasal spray
  • Dextromethorphan

Atypical antidepressants can have different side effects. The most common ones include:

  • Agomelatine: Liver toxicity
  • Bupropion: Seizures
  • Mirtazapine: Drowsiness and weight gain

Drug combinations for depression

For people with treatment-resistant depression, your doctor may suggest esketamine-intranasal spray along with an oral antidepressant to help ease symptoms. If you have major depressive disorder, your doctor may suggest you try bupropion and dextromethorphan together. This drug combination can help relieve symptoms within about a week, faster than other antidepressants.

If you have an anxiety disorder, there are several options you can try, including antidepressants, benzodiazepines, and beta-blockers.

Anxiety disorders include:

  • Separation anxiety disorder
  • Selective mutism
  • Specific phobia
  • Social anxiety disorder
  • Panic disorder
  • Agoraphobia
  • Generalized anxiety disorder
  • Substance- or medication-induced anxiety disorder
  • Anxiety disorder due to medical conditions

Antidepressants for anxiety disorders

Several antidepressants also work for anxiety disorders, including:

  • SSRIs, such as citalopram escitalopram, fluoxetine, paroxetine, and sertraline
  • SNRIs, such as duloxetine and venlafaxine
  • Tricyclic antidepressants, such as amitriptyline, imipramine, and nortriptyline

Benzodiazepines

Benzodiazepines are medicines that calm your nervous system. They work by triggering your brain to release a neurotransmitter called gamma-aminobutyric acid (GABA), which makes your nervous system less active. Benzodiazepines are used mostly for anxiety and seizure disorders, alcohol withdrawal, and insomnia.

They tend to work fast, usually within an hour, so they're particularly helpful for panic attacks or episodes of overwhelm. But, they're mostly used for the short-term management of anxiety. That's because they can be habit-forming and you may develop tolerance (which means you will need higher doses over time to get the same result). They may also have challenging side effects, such as blocking your ability to form new memories (anterograde amnesia), drowsiness, poor concentration, and irritability.

Examples include:

Buspirone (BuSpar) 

Buspirone is a mild tranquilizer that works by balancing dopamine and serotonin levels in your brain. You generally need to take it for about two weeks before you notice improvements. But it's non-habit-forming and generally doesn't cause withdrawal symptoms when you stop taking it. It's often used to treat GAD.

Beta-blockers

These block proteins on your heart, kidneys, and muscles from responding to adrenaline. They're mainly used to treat heart conditions, such as high blood pressure. But they can help control some of the symptoms of anxiety, such as fast heart rate, sweating, trembling, and dizziness. They aren't FDA-approved for anxiety disorders, but your doctor can prescribe them off-label if they think it may help you ease your symptoms.

Examples include:

  • Atenolol
  • Propranolol

Side effects may include:

  • Slow heart rate
  • Low blood pressure
  • Irregular heartbeat
  • Fatigue
  • Dizziness
  • Nausea
  • Insomnia
  • Dry mouth and eyes
  • Erectile dysfunction (this is rare)

Psychotic disorders are mental health conditions that include signs of psychosis. Psychosis is a cluster of symptoms that indicate you have disruptions in your thoughts and how you interpret them, making it hard for you to identify what's real and what isn't. You may have delusions, hallucinations, disorganized thought, behavior, and speech patterns, and a reduced ability to function.

Antipsychotic medications are classified into two different types:

  • First-generation (or typical antipsychotics) —these generally work by blocking your nerves from taking up dopamine.
  • Second-generation (or atypical antipsychotics) — they work on serotonin and dopamine.

Antipsychotics are used for conditions, such as:

  • Schizophrenia and schizoaffective disorders, including childhood schizophrenia
  • Acute mania
  • Major depressive disorder with psychotic features
  • Delusional disorder
  • Severe agitation
  • Tourette's syndrome
  • Borderline personality disorder
  • Dementia and delirium
  • Substance-induced psychotic disorder

Examples of first-generation antipsychotics include:

  • Chlorpromazine
  • Fluphenazine
  • Haloperidol (Haldol)
  • Loxapine (Adusuve)
  • Molidone
  • Perphenazine
  • Pimozide (Orap)
  • Prochlorperazine (Compro)
  • Thiothixene
  • Thioridazine
  • Trifluoperazine

Examples of second-generation antipsychotics include:

Different antipsychotics vary in their side effects, and some people may experience certain side effects more severely than others. You'll need to work with your doctor to find the right drug for you. Your doctor can change medications or dosages to help minimize any side effects you have.

Many side effects of antipsychotic drugs are mild, and many go away after the first few weeks of treatment. Common side effects may include:

  • Drowsiness
  • Rapid or irregular heartbeat
  • Dizziness when changing positions
  • Decrease in sexual interest or ability
  • Problems with menstrual periods
  • Skin rashes or sensitivity to the sun
  • Weight gain
  • Muscle spasms
  • Restlessness and pacing
  • Slowing down of movement and speech
  • Shuffling walk
  • Menstrual irregularities in women

A few serious side effects are possible, especially with long-term use of antipsychotic medications. They include:

Tardive dyskinesia

This is a movement disorder that results in unusual and uncontrollable movements, usually of your tongue and face (such as sticking out your tongue and smacking your lips), and sometimes jerking and twisting movements of other parts of your body. Your doctor can help manage these symptoms with deutetrabenazine (Austedo) or valbenazine (Ingrezza).

Neuroleptic malignant syndrome

This is a potentially fatal disorder marked by severe muscle rigidity (stiffening), fever, sweating, high blood pressure, delirium, and sometimes coma.

Agranulocytosis

This is a condition marked by a sharp decrease in the number of infection-fighting white blood cells in your body. It can leave you prone to infection and at greater risk of death. Agranulocytosis has been particularly linked with Clozaril, affecting about 1 in 100 patients. If you take Clozaril, you need regular blood tests to closely track your white blood cell count. However, all antipsychotics carry an FDA warning, noting that they can lower white blood cell count as a class.

Changes in blood sugar and cholesterol

Some atypical antipsychotics can increase blood sugar, which could eventually lead to diabetes. They could also increase blood lipids (fats) such as cholesterol and triglycerides. You'll need regular blood tests to monitor these factors if you take these drugs.

Your doctor can change medications or dosages, or sometimes add additional medicines, to counteract troublesome side effects like weight gain or high blood lipids. The newer atypical antipsychotic medications appear to be much better tolerated, with fewer side effects such as movement disorders or drowsiness. But they do require monitoring for weight and metabolic risks, which appear to be higher than those of older-generation antipsychotics.

Your doctor has several options for attention deficit hyperactivity disorder (ADHD) treatment, including:

Stimulants

These are the most common type of medicine used to treat ADHD. They work by increasing the levels of dopamine and norepinephrine in your brain. These are neurotransmitters that help you pay attention, think, and stay motivated. 

The most commonly used stimulants include:

Nonstimulants

Your doctor may try these if stimulants don't work. Nonstimulants generally work by increasing your levels of norepinephrine.

Examples include:

  • Selective norepinephrine reuptake inhibitors (similar to the SNRI antidepressants), such as atomoxetine (Strattera) and viloxazine (Qelbree)
  • Alpha-2 adrenergic agonists, such as clonidine (Catapres) and guanfacine (Intuniv)

Antidepressants

Some antidepressants seem to work for ADHD, as well, including:

Side effects of ADHD medicines may include:

  • Reduced appetite
  • Weight loss
  • Trouble sleeping
  • Anxiety
  • Tics
  • Growth delay in kids
  • Nausea and vomiting
  • Changes in your blood pressure and heart rate

The FDA requires all ADHD drugs to include patient medication guides that detail possible serious outcomes, including a slightly higher risk of stroke, heart attack, sudden death, and manic or psychotic episodes.

Many drugs used to treat mental disorders in adults are also used to treat the same illnesses in children. However, doctors often adjust the doses and monitor them more closely.

The FDA says that antidepressant drugs can increase the risk of suicidal thinking and behavior in children and teens with depression and other psychiatric disorders. If you have questions or concerns, discuss them with your health care provider.

Drugs cannot cure mental illnesses. Rather, they work to control many of the most troubling symptoms, often enabling people with mental disorders to return to normal or near-normal functioning. Easing symptoms with medication can also enhance the effectiveness of other treatments, such as psychotherapy (a type of counseling).

Medicines can be an important part of your mental health care plan. You usually use them along with other treatments, such as psychotherapy. Mental health medicines generally affect one or more neurotransmitters, which are chemical signals in your brain. The most commonly used mental health medicines include antidepressants, anti-anxiety, antipsychotic, mood stabilizing, and stimulant medications.

What is the strongest psychiatric medication?

Antipsychotic medicines tend to be used for mental health conditions that have the most serious symptoms. Antipsychotics also have the most challenging side effects.