Psychopharmacology is a field, which analyses the impact of different drugs on the mental health of patients. It considers how different compounds alter people’s behavior by changing the way that the person thinks or feels. Some of the conditions that these medicines are used to treat include depression, psychosis and anxiety.

What does a psychopharmacologist do?

A psychopharmacologist is an expert advisor on which drug might have the best impact on a patient with a particular mental health condition. They understand how the medicine works and what the expected clinical outcomes are. The medic is also likely to have a grasp of neuroscience as the medicines used have impacts on the functioning of the central nervous system. Moreover, they comprehend the differences between a wide range of mental health conditions.

In order to prescribe drugs, the psychopharmacologist will need to have an in depth understanding of the drug’s pharmacokinetics (i.e. the movement of the drug within the body) and pharmacodynamics (i.e. the effects of the drug and its mechanism of action). This is particularly important should a medicine interact with any reward regions of the body as the psychopharmacologist would not, for example, want a medicine to interact too quickly and cause the patient to become addicted to a possible high that the medicine gives them.

Therefore, the scientist needs to understand how the drug interacts with the body over time at a particular dose, how long it stays in the body and also if it is likely to react with any other medicines that the patient is taking. They should also have some knowledge of the genetics of patients as well as this may have a significant impact as well.

Neurotransmitters for psychopharmacology

The drugs used in psychopharmacology have an impact on the neurotransmitters in the brain.

Developments have focused primarily on agents that affect the neurotransmitters for depression, psychoses and anxiety. However, there have been no further major breakthroughs regarding neurotransmitters in recent years.

The key neurotransmitters affected in psychotropic medicines are:

• Acetylcholine involved in the body’s learning, memory, mood and also Alzheimer’s Disease
• Dopamine involved in motor circuits for Parkinson’s Disease, reward and pleasure centers and Schizophrenia
• Endogenous opioids such as endorphins and enkephalins involved in pain, analgesia and reward
• GABA involved in anxiety, epilepsy, fear, stress and inhibitory neurotransmitter diseases
• Glutamate involved in learning, memory, communication and excitatory neurotransmitter diseases
• Norepinephrine involved in depression and arousal
• Serotonin involved in aggression, depression, desire and schizophrenia

The different types of drugs in mental health management

Scientific awareness of the type of impact that medicines have on the mental health of people progressed considerably in the 1950s. This was when psychotropic drugs, medicines that alter the way a patient behaves, were discovered. Over the years, a wide range of antidepressants, antianxiety, antimanic, antipsychotics and stimulant drugs have been developed.

• selective serotonin reuptake inhibitors (SSRIs) – increase serotonin and are often used as antidepressants
• antimanic drugs (mood stabilizers) – reduce nerve impulses to manage manic episodes
• antianxiety drugs (tranquilizers) – have a calming effect and slow down the central nervous system
• serotonin and noradrenaline reuptake inhibitors – these increase the serotonin and noradrenalin

How drugs affect mental health

Neurons are cells in the nervous system. There are about 100 billion of them. They communicate information in a chemical (neurotransmitter) and electrical way throughout the body. There are different types of neurons. Sensory neurons send information from sensory receptor cells to the brain. Motor neurons are essential in transmitting information from the brain to the muscles. Also interneurons communicate between neurons.

Neurotransmitters bind to proteins on the receiving neuron and then further communication is possible. The medicines that are used in altering the mental health of patients operate by changing the way that these neurons communicate with one another.

Psychotropic drugs also tend to be amphiphilic molecules meaning that they are soluble in both water and lipids. This helps to ease their interactions in the body.

References

• American Society of Clinical Psychopharmacology on psychopharmacology: https://www.ascpp.org/resources/information-for-patients/what-is-psychopharmacology/
• University of Oxford on research into psychopharmacology: http://www.psych.ox.ac.uk/research/psychopharmacology-research-unit
• NHS Choices on SSRIs: http://www.nhs.uk/conditions/SSRIs-(selective-serotonin-reuptake-inhibitors)/Pages/Introduction.aspx
• NHS Choices on treating psychosis: http://www.nhs.uk/conditions/psychosis/Pages/Treatment.aspx
• Encyclopaedia Britannica on antimanic drugs: http://www.britannica.com/topic/antimanic-drug
• NYS Choices on anxiety treatments: http://www.nhs.uk/Conditions/Anxiety/Pages/Treatment.aspx
• http://psych.lf1.cuni.cz/bpen/psychopharmacology.htm
• Noba Project on psychopharmacology: http://nobaproject.com/modules/psychopharmacology
• Psychology Today on where the field is going: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031936/

Further Reading

• All Pharmacology Content
• Pharmacology
• What is Drug Absorption?
• Drug Distribution
• Drug Excretion / Elimination

Written by

Deborah Fields

Deborah holds a B.Sc. degree in Chemistry from the University of Birmingham and a Postgraduate Diploma in Journalism qualification from Cardiff University. She enjoys writing about the latest innovations. Previously she has worked as an editor of scientific patent information, an education journalist and in communications for innovative healthcare, pharmaceutical and technology organisations. She also loves books and has run a book group for several years. Her enjoyment of fiction extends to writing her own stories for pleasure.