# Mental Health Medications

## What are mental health medications? 

Medications can play an important role in treating mental disorders and conditions. They are often used in combination with other treatments, such as psychotherapy and brain stimulation therapy. Medications can affect people in different ways, and it may take several tries to find the medication that works best with the fewest side effects. It’s important to work with a health care provider or a mental health professional to develop a treatment plan that meets your individual needs and medical situation.

Information about medications is updated frequently. The U.S. Food and Drug Administration (FDA) has Medication Guides ** with the latest information, warnings, and approved medications. MedlinePlus also provides information on drugs, herbs, and supplements **, including side effects and warnings.

This page provides basic information on mental health medications.**It is not a complete source for all medications available. It should not be used as a guide when making medical decisions.**

## What are antidepressants?

Antidepressants are medications used to treat depression. In some cases, health care providers may prescribe antidepressants to treat other health conditions, such as anxiety, pain **, and insomnia **.

Commonly prescribed types of antidepressants are:
                      - Selective serotonin reuptake inhibitors (SSRIs)
                      - Serotonin-norepinephrine reuptake inhibitors (SNRIs)
                      - Norepinephrine-dopamine reuptake inhibitors (NDRIs)

These medications are commonly prescribed because they improve the symptoms of a broad group of depressive and anxiety disorders. They are also associated with fewer side effects than older antidepressants. Although older antidepressants, such as tricyclics and monoamine oxidase inhibitors (MAOIs), are associated with more side effects, they may be the best option for some people.

Antidepressants take time—usually 4−8 weeks—to work, and problems with sleep, appetite, energy, and concentration often improve before mood lifts. Giving a medication a chance to work is important before deciding whether it is right for you.

Common side effects of SSRIs and other antidepressants include upset stomach, headache, or sexual dysfunction. The side effects are generally mild and tend to go away with time. People who are sensitive to the side effects of these medications sometimes benefit from starting with a low dose, increasing the daily dose very slowly, and changing when or how they take the medication (for example, at bedtime or with food).

Esketamine ** is an FDA-approved medication for treatment-resistant depression, which may be diagnosed when a person’s symptoms do not improve after trying at least two antidepressants. Esketamine is delivered as a nasal spray in a health care provider’s office, a clinic, or a hospital. It often acts rapidly, typically within a couple of hours, to relieve depression symptoms. People usually continue to take an oral antidepressant to maintain the improvement in their symptoms.

Combining antidepressants with other medications or supplements that act on the serotonin system, such as triptans (often used to treat migraine headaches) and St. John’s wort (a dietary supplement), can cause a rare but life-threatening illness called serotonin syndrome **. Symptoms of serotonin syndrome include agitation, muscle twitches, hallucinations (seeing or hearing things others do not see or hear), high temperature, and unusual blood pressure changes. For most people, the risk of such extreme reactions is low. It is important for health care providers to consider all possible interactions and use extra care in prescribing and monitoring medication combinations that have an above-average risk.

**Note**: In****some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting the medication or when the dose is changed. People of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline ** at **988** or chat at 988lifeline.org **. In life-threatening situations, call **911**.

## What are anti-anxiety medications?

Anti-anxiety medications help reduce symptoms of anxiety, such as panic attacks and extreme fear and worry.

Many medications used to treat depression—including SSRIs and SNRIs—may also be used to treat anxiety. In the case of panic disorder or social anxiety disorder, health care providers typically start with SSRIs or other antidepressants as the initial treatment because they have fewer side effects than other medications.

Benzodiazepines are another common type of anti-anxiety medication used to treat some short-term anxiety symptoms. They are sometimes used to treat generalized anxiety disorder.

Health care providers may also prescribe beta-blockers off-label to treat short-term anxiety symptoms, even though the medication is not approved for that specific purpose. For instance, people with a phobia—an overwhelming and unreasonable fear of an object or situation like spiders or public speaking—often experience intense physical symptoms, such as rapid heart rate, sweating, and tremors. Beta-blockers can help manage these symptoms.

Benzodiazepines and beta-blockers are useful as needed to reduce severe anxiety in the short-term. However, taking benzodiazepines over long periods may lead to drug tolerance or even dependence. To avoid these problems, health care providers usually prescribe benzodiazepines for short periods and taper them slowly to reduce the likelihood of withdrawal symptoms or renewed anxiety symptoms. Beta-blockers generally are not recommended for people with asthma or diabetes because they may worsen the symptoms of both conditions.

Buspirone ** is a different type of anti-anxiety medication that can be used to treat anxiety over longer periods. In contrast to benzodiazepines, buspirone must be taken every day for 3−4 weeks to reach its full effect, and it is not effective for treating anxiety on an as-needed basis.

## What are stimulants?

Health care providers may prescribe stimulant medications to treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy **. Stimulants increase alertness, attention, and energy. They can also elevate blood pressure, heart rate, and breathing.

Prescription stimulants improve alertness and focus for most people, regardless of diagnosis. These medications can markedly improve daily functioning for people with significant focus problems, such as people with ADHD. Although motor hyperactivity associated with ADHD in children usually goes away by the time they reach adolescence, people with ADHD may continue to experience inattention and have difficulty focusing into adulthood. As such, stimulant medications can be helpful for adults, as well as for children and adolescents, with ADHD.

Stimulants are safe when taken under a health care provider’s supervision and used as directed. Some children may report feeling slightly different or unlike their usual selves while taking the medication. Most side effects of stimulants are minor and not seen at low doses.

Some parents worry that stimulants may lead to misuse or dependence, but evidence shows this is unlikely when the medications are used as prescribed. Other challenges with stimulant treatment, such as sleep disturbance and slowed growth, can generally be safely managed by a health care provider.

## What are antipsychotics?

Antipsychotic medications are typically used to treat psychosis, a condition that involves some loss of contact with reality. People experiencing a psychotic episode often experience delusions (false beliefs) or hallucinations. Psychosis can be related to drug use or a mental disorder such as schizophrenia, bipolar disorder, or severe depression (also known as psychotic depression).

Health care providers may also prescribe antipsychotics in combination with other medications to relieve symptoms of delirium **, dementia **, or other mental health conditions that are more common in older adults. The FDA requires that all antipsychotics include a black box warning stating that the medications are associated with increased rates of stroke and death in older adults with dementia.

Older, first-generation antipsychotic medications are sometimes called typical antipsychotics (or neuroleptics). Long-term use of typical antipsychotics may lead to a condition involving uncontrollable muscle movements called tardive dyskinesia **, which can range from mild to severe. People who think they might have tardive dyskinesia should check with a health care provider before stopping their medication.

Newer, second-generation medications are sometimes called atypical antipsychotics. Several atypical antipsychotics are available. They are commonly used because they treat a broader range of symptoms compared with older medications. For example, atypical antipsychotics are sometimes used to treat bipolar depression or depression in people that have not responded to antidepressant medication alone. Health care providers may ask people taking atypical antipsychotics to participate in regular monitoring of weight, glucose levels, and lipid levels.

Some symptoms, such as agitation and hallucinations, typically go away within days of starting antipsychotic medication. Other symptoms, such as delusions, usually go away within a few weeks. However, people may not experience the full effects of antipsychotic medication for up to 6 weeks.

If a person’s symptoms do not improve with usual antipsychotic medications, they may be prescribed an atypical antipsychotic called clozapine **. People who take clozapine must have regular blood tests to check for a potentially dangerous side effect that occurs in 1%–2% of people.

## What are mood stabilizers?

Mood stabilizers are typically used to treat bipolar disorder and mood changes associated with other mental disorders. In some cases, health care providers may prescribe mood stabilizers to augment the effect of other medications used to treat depression.

Lithium **, an effective mood stabilizer, is approved for the treatment of mania and bipolar disorder. Some studies indicate that lithium may reduce the risk of suicide among people taking it for long-term symptom maintenance. Health care providers generally ask people who are taking lithium to participate in regular monitoring to check lithium levels and kidney and thyroid function.

Mood stabilizers are sometimes used to treat depression (usually along with an antidepressant), schizoaffective disorder, disorders of impulse control, and certain mental illnesses in children. For people with bipolar depression, health care providers typically prescribe a mood stabilizer and an antidepressant to reduce the risk of switching into mania (known as rapid cycling).

Some anticonvulsant medications may also be used as mood stabilizers, as they work better than lithium for certain people, such as people with “mixed” symptoms of mania and depression or those with rapid-cycling bipolar disorder. Health care providers generally ask people taking anticonvulsants to participate in regular monitoring to check medication levels and assess side effects and potential interactions with other common medications.

## What should certain groups of people consider before taking mental health medications?

All people can take mental health medications, but some groups have special needs and considerations.

### Children and adolescents

Many medications used to treat mental disorders are safe and effective for children and adolescents. However, it is important to know that children may experience different reactions and side effects than adults, and some medications have FDA warnings about potential side effects for younger people.

In some cases, a health care provider may prescribe an FDA-approved medication on an off-label basis to treat a child’s symptoms, even though the medication is not approved for the specific mental disorder or for use by people under a certain age. Although there has been less research on mental disorders in children than adults, there is evidence that medications can be helpful for children. It is important to monitor children and adolescents who take medications on an off-label basis.

A health care provider may suggest trying non-medication treatments first, such as psychotherapy, and add medication later, if necessary. In other cases, a health care provider may suggest non-medication treatment in combination with medication. The National Institute of Mental Health (NIMH) provides more information on common treatment options for children and adolescents.

### Older adults

People over age 65 should take extra care with medications, especially if they are taking multiple medications. Older adults are often more sensitive to medications and can have a higher risk of experiencing drug interactions. Even healthy older adults react to medications differently than younger people because older adults’ bodies often process and eliminate medications more slowly.

Before starting a medication, older adults and their family members should talk to a health care provider about any effects the medication may have on physical and mental functioning. The health care provider can also discuss strategies to make it easier to follow the treatment plan, helping ensure that older adults take the correct dose at the correct time.

The National Institute on Aging has information and practical tips to help older adults take their medications safely **.

### People who are pregnant or may become pregnant

Researchers are continuing to investigate mental health medications during pregnancy. The risks associated with taking medication during pregnancy depend on the type of medication and the stage of pregnancy. While no medication is considered universally safe during pregnancy, untreated mental disorders can also pose risks to the pregnant person and the developing fetus.

Pregnant people should work with a health care provider to develop a personalized treatment plan that considers their individual needs and circumstances. It is important to weigh the benefits and risks of all available treatment options, including psychotherapies, medications, brain stimulation therapies, or a combination of these options. Health care providers may closely monitor a person’s physical and mental health throughout pregnancy and after delivery to look for signs of perinatal or postpartum depression.

Certain medications taken during pregnancy, including some benzodiazepines, mood stabilizers, and antipsychotic medications, have been linked with birth defects, but the risks vary widely and depend on the specific medication.

Antidepressants, especially SSRIs, are generally considered safe for use during pregnancy. Although antidepressants can cross into the placenta and reach the fetus, the risk of birth defects and other problems is very low. Some studies have found an association between third-trimester SSRI exposure and certain symptoms, including breathing problems, in newborns. However, the FDA does not find sufficient evidence for a causal link ** and recommends that health care providers treat depression during pregnancy according to the person’s specific needs.

Visit the FDA website for more information on medications and pregnancy **.

### Postpartum people

Researchers are also investigating medications to help people who experience mental disorders after pregnancy and during the postpartum period. Much of this research has focused on one of the most common postpartum mental disorders—postpartum depression.

The FDA has approved two medications specifically to treat severe postpartum depression. The first is brexanolone **, which is administered through an IV by a health care professional during a brief hospital stay. The other is zuranolone **, which is an oral medication taken in pill form. In clinical trials, both medications reduced postpartum depression symptoms more quickly and effectively than traditional antidepressants.

Postpartum people should work with a health care provider to determine the best treatment plan based on their prenatal health and current symptoms. Like with mental disorders during pregnancy, it is important to weigh the benefits and risks of all treatment options and closely monitor physical and mental health during treatment.

The Office on Women’s Health has more information on treatments for postpartum depression **.

## What should I know about mental health medications?

People respond to medications in different ways, and it may take several tries to find the medication that is most effective with the fewest side effects. In some cases, people find that a medication helps for a while and then their symptoms return. It often takes some time for a medication to work, so it is important to stick with the treatment plan and take medication as prescribed.

People should not stop taking a prescribed medication, even if they are feeling better, without the help of a health care provider. A provider can adjust the treatment plan to slowly and safely decrease the medication dose. It’s important to give the body time to adjust to the change. Stopping a medication too soon may cause unpleasant or harmful side effects.

If you are prescribed a medication:
                      - Tell a health care provider about all other medications, vitamins, and supplements you are already taking.
                      - Remind a health care provider about any allergies. Tell them about any problems you had with medications in the past.
                      - Make sure you understand how to take the medication before you start using it, and take the medication as instructed.
                      - Talk to a health care provider about possible side effects and what to expect when taking a medication.
                      - Do not take medications prescribed for another person. Do not give your prescribed medication to someone else.
                      - Call a health care provider right away if you have problems with your medication or are worried that it might be doing more harm than good. The provider will work with you to address the problems and determine next steps.
                      - Report serious side effects to the  FDA MedWatch Adverse Event Reporting Program ** .

## How do I contact FDA MedWatch?

The FDA is responsible for protecting public health by ensuring the safety, efficacy, and security of medications, biological products, and medical devices. Contact FDA MedWatch ** to voluntarily report a:
                      - Serious adverse effect
                      - Product quality problem
                      - Product use error
                      - Product failure that you suspect is associated with an FDA-regulated drug, biologic, medical device, dietary supplement, or cosmetic

You or a health care provider can make a report online or by calling 1-800-332-1088. You can also report suspected counterfeit medical products to the FDA through MedWatch.

### Subscribe to MedWatch safety alerts

FDA MedWatch also offers several ways to help stay informed about medical products. You can sign up to receive the MedWatch E-list **, which delivers safety information to your email. You can also follow MedWatch on X (formerly Twitter) @FDAMedWatch **.

## Where can I learn more about mental health medications?

### Finding help

NIMH is the lead federal agency for research on mental disorders. NIMH does not provide medical advice, endorse or recommend specific medications, or offer treatment referrals.

NIMH has information on ways to get help and find a health care provider or access treatment. You can also find an NIMH-supported clinical research study.

The Substance Abuse and Mental Health Services Administration has an online tool ** to find mental health services in your area.

### Reports from the Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality (AHRQ) is the lead federal agency charged with improving the safety and quality of America’s health care system. AHRQ develops the knowledge, tools, and data needed to improve the health care system and help the public, health care professionals, and policymakers make informed health decisions.

Examples of AHRQ reports on mental health include:
                      - **Adverse Effects of Pharmacological Treatments of Major Depression in Older Adults** ** : This systematic review assesses adverse events related to antidepressant medications in adults over 64 years.
                      - **Anxiety in Children** ** : This systematic review compares the effectiveness and harms of psychotherapy and medications for treating anxiety disorders in children.
                      - **Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents** ** : This review evaluates strategies for diagnosing, treating, and monitoring children and adolescents with ADHD, including the effectiveness of stimulant medications and non-medication treatments.
                      - **Diagnosis and Management of Obsessive Compulsive Disorders in Children** ** : This systematic review presents findings from studies on tools to identify children and adolescents with obsessive compulsive disorder and psychological and pharmacological treatments for the disorder.
                      - **Evaluation of Mental Health Mobile Applications** ** : This technical brief provides a framework to assess and select mental health mobile applications.
                      - **Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions** ** : This systematic review assesses the benefits and harms of pharmacologic interventions for pregnant and postpartum people with mental disorders.
                      - **Nonpharmacologic Treatment for Maternal Mental Health Conditions** ** : This systematic review assesses the effectiveness and harms of psychological treatments for pregnant and postpartum people with mental disorders and how they compare to pharmacological treatments.
                      - **Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: An Update of the PTSD Repository Evidence Base** ** : This review assesses the effectiveness, benefits, and harms of psychological and pharmacological treatments for adults with post-traumatic stress disorder.
                      - **Psychosocial and Pharmacologic Interventions for Disruptive Behavior in Children and Adolescents** ** : This review evaluates the evidence for psychosocial and pharmacological treatments for children and adolescents with disruptive behavior disorder.
                      - **Treatment for Adults With Schizophrenia** ** : This systematic review evaluates the evidence for schizophrenia treatments, including second-generation antipsychotics, first-generation antipsychotics, and psychosocial interventions.
                      - **Treatment for Bipolar Disorder in Adults: A Systematic Review** ** : This systematic review assesses the effectiveness of treatments for acute mania or depression in adults with bipolar disorder, including lithium and atypical antipsychotics.
                      - **Treatment of Depression in Children and Adolescents** ** : This systematic review evaluates the effectiveness, benefits, and harms of available treatments for children and adolescents with depression.

### Resources from the National Library of Medicine

The National Library of Medicine (NLM) **, part of the National Institutes of Health **, is the world’s largest medical library. NLM produces electronic information resources on a range of topics:
                      - **DailyMed** ** : Contains labeling for prescription and nonprescription drugs for human and animal use and for additional products, such as medical gases, devices, cosmetics, dietary supplements, and medical foods
                      - **MedlinePlus: Antidepressants** ** : Provides information and resources on antidepressant medications
                      - **MedlinePlus: Drugs, Herbs and Supplements** ** : Provides information and resources on drugs, herbs, and supplements

**Last Reviewed:** December 2023

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