The CDC estimates 1 in 4 adults in the United States takes a prescription medication for their mental health every month. Though prescription medication use for mental health treatment is common, it is also subject to a wide number of myths and misconceptions — about the medications as well as the people who take them.
Mark Schneiderhan, an associate professor in the University of Minnesota College of Pharmacy on the Duluth campus and psychiatric pharmacist, shares information about what mental health medications are, busts common myths about them and discusses strategies to ensure that every patient is receiving optimized, individualized care for their prescriptions.
Q: What should people know about mental health medications?
Dr. Schneiderhan: There are many misconceptions about mental health medications. When taken as prescribed, most medications:
- Do not negatively change a person’s personality. Ideally, psychiatric medication should help the person feel more like themselves.
- Do not cause substance use disorders. Unless they have specifically labeled warnings, most do not cause dependency and are not habit-forming, such as drugs like nicotine or heroin, and do not get you “high.”
- Do not provide an immediate or magical cure for mental health conditions. Psychiatric medications are meant to treat symptoms of mental illnesses, which is highly beneficial for many patients, but is not the same thing as a cure.
People may also worry that they’ll need to take medication for the rest of their life. If people have untreated symptoms for many years and finally find relief with treatment, they should consider continuing the treatment for at least that length of time. It’s often valuable to take a medication that improves your symptoms for at least a year before decreasing the dosage. Always talk to your pharmacist or physician when you are considering reducing or discontinuing a medication.
Most importantly, seeking treatment is not a sign of weakness. It takes courage to ask for help and accept treatment. Non-medication approaches to improve mental health and well-being — such as psychotherapy, exercise, healthy diet, sleep changes, etc. — should always be encouraged. However, medications can be life-saving and should be considered if other approaches are not working. A combination of medication and non-medication therapies may also be helpful, especially when a single approach is not entirely effective.
Q: What are common medications used in mental health treatment?
Dr. Schneiderhan: Antidepressants are the most commonly prescribed medications for anxiety and depressive disorders, which are the most commonly diagnosed mental health conditions in the U.S. In 2023, sertraline — the generic form of the medication Zoloft — a selective serotonin reuptake inhibitor (SSRI) was listed as number 14 in the top 200 most prescribed medications in the nation.
Stimulants, mood stabilizers and antipsychotics are also commonly used to treat mental health conditions. For example, there are antipsychotics approved by the FDA to treat depression and bipolar disorder symptoms that do not respond to the usual SSRI antidepressants. Sometimes people need combinations of medications to stabilize their symptoms. Doctors are also allowed to prescribe medications for “off-label” use — use that has not yet been FDA-approved — if they believe they will safely reduce symptoms, such as medications for seizure disorders prescribed for mental health purposes.
I am eager to see more research with longer treatment durations and larger sample sizes that demonstrate the safe and effective use of off-label products. I am optimistic we will see more FDA-approved medication therapies in the near future to help people still suffering with symptoms related to mental illness.
Q: What should patients know when starting or adjusting a mental health medication?
Dr. Schneiderhan: There may be a lag time between when you begin the medication and when you start to experience its full benefits — this can be one to two months for antidepressants. It is also critical to not stop taking your medications too soon after you begin feeling better — treatment should continue for at least 12 months after you experience positive results. About half of people who quit taking their antidepressants too soon have a relapse of depression symptoms within the next six months. Suddenly stopping a psychiatric medication that has been taken consistently for 1-2 months can cause side effects like problems sleeping, restlessness, shaking or sweating. Always talk to your doctor or pharmacist before stopping your medications.
There are also many resources for patients and their loved ones. The National Alliance on Mental Illness (NAMI) is a great resource and supportive organization for people who are directly or indirectly affected by mental illness. Psychiatric pharmacists, in particular, provide a wealth of information regarding medication and treatment through NAMI.
Q: How can patients and providers improve care plans?
Dr. Schneiderhan: Comprehensive Medication Management (CMM) is considered a standard of care, but it is first and foremost a partnership between a patient and their health care teams. Using CMM, pharmacists provide personalized, specific care by assessing a patient’s medication usage and health history in collaboration with their other health care providers. Pharmacists use CMM to ensure patients are on the right medication, at the right dosage and for the right reasons or conditions. Pharmacists are highly trained to help patients maximize medication benefits and CMM is shown to reduce unwanted side effects, promote patient confidence in medication therapy and increase patient willingness to continue treatment. Any patient can benefit from CMM, but especially those who take a greater number of medications and/or have a greater number of medical conditions.
Q: What work are you doing at the U of M to advance mental health medication and psychiatric pharmacy?
Dr. Schneiderhan: My primary focus is to improve patient outcomes in clinical practice, including optimizing medication therapy through comprehensive medication management. Some of my major research areas are the measurement of clinical outcomes for pharmacists providing CMM for people with mental illness and related disabilities; the prevention and management of adverse drug reactions to antipsychotic and other psychotropic agents; and the clinical application of pharmacogenetic effects on metabolism and a medication’s effectiveness. As a long-time mentor in the classroom and in my clinical practice, I’ve found great fulfillment in seeing the growing number of pharmacy students pursuing post-doctoral training in mental health and providing care for patients with mental illness. I work with an interprofessional team of clinic providers, nurses and case managers every day to deliver exceptional care for our patients and to educate the next generation of providers.
Mark Schneiderhan is a board-certified psychiatric pharmacist and associate professor in the Department of Pharmacy Practice and Pharmaceutical Sciences at the University of Minnesota. He provides Comprehensive Medication Management at the Human Development Center in Duluth, a community mental health facility serving northeastern Minnesota and northwestern Wisconsin. He has recently published studies on improving medication monitoring, side effects and outcomes for patients taking second-generation antipsychotics and the positive impact of interprofessional care coordination with patients and their families. He was inducted into the Academy of Excellence for Clinical Practice in 2020 and was nominated by his students as preceptor of the year for the 2023-2024 school year.
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Founded in 1892, the University of Minnesota College of Pharmacy is the only pharmacy school in Minnesota, with campuses in the Twin Cities and in Duluth. The College of Pharmacy improves health through innovative education, pioneering research and interdisciplinary practice development that attends to the diverse needs of the people of Minnesota and the world. Learn more at pharmacy.umn.edu.
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