Mental Health Medicines

When medication may be considered

Medication may be considered when:

• symptoms are moderate to severe
• symptoms persist despite self-help or psychological therapy
• risk of deterioration is high
• previous episodes responded well to medication

Medication is usually part of a broader care plan rather than a standalone solution.

Main Classes of Mental Health Medicines

Antidepressants (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for depression and anxiety disorders.

Common examples include:

• sertraline
• citalopram
• fluoxetine
• escitalopram

They work by increasing serotonin activity in the brain, which can help regulate mood and anxiety.

Important points:

• They usually take several weeks to show full benefit
• Temporary side effects may occur early in treatment
• They are not addictive

Regular review is important during the first few weeks of treatment.

Other Antidepressants

Other antidepressants may be used depending on symptoms and previous response.

Examples include:

• mirtazapine
• venlafaxine
• duloxetine

These medicines work through different mechanisms and may be considered if SSRIs are not suitable or effective.

Monitoring may include:

• blood pressure (for some medicines)
• side effect review
• symptom tracking

Medicines for Anxiety and Short-Term Distress

Short-term medications may occasionally be used for acute anxiety symptoms. These are prescribed cautiously and usually for limited duration.

Beta blockers for physical symptoms

Beta blockers such as propranolol may be prescribed to reduce the physical symptoms of anxiety, including:

• palpitations
• tremor
• sweating
• shaking

They do not directly treat anxious thoughts, but can reduce the body’s adrenaline response in situations such as public speaking or performance anxiety.

They are generally used on an as-needed basis rather than as long-term treatment for generalised anxiety disorder.

Because beta blockers also affect heart rate and blood pressure, suitability is assessed individually.

Short-term sedative medicines

Certain sedative medicines may be used for short periods in specific circumstances. These carry a risk of dependence and are not typically recommended for long-term anxiety management in primary care.

Treatment decisions are made cautiously and usually alongside non-medication strategies.

Mood Stabilising Medicines

Mood stabilising medicines are commonly used in bipolar disorder and certain complex mood conditions. These are usually initiated or guided by specialist services.

Examples include lithium and other specialist treatments.

Primary care may be involved in blood test monitoring and shared care arrangements.

Antipsychotic Medicines

Antipsychotic medicines are used for conditions such as psychosis, bipolar disorder, and sometimes as part of treatment for severe depression.

Common examples include:

• olanzapine
• quetiapine
• aripiprazole

These medicines require structured monitoring due to potential metabolic and neurological side effects.

Specialist involvement is common.