Editing Psychiatric medication (section)

== Adverse and withdrawal effects ==

Psychiatric disorders, including depression, psychosis, and bipolar disorder, are common and gaining more acceptance in the United States. The most commonly used classes of medications for these disorders are antidepressants, antipsychotics, and lithium. Unfortunately, these medications are associated with significant neurotoxicities.

Psychiatric medications carry risk for neurotoxic [[adverse effect]]s. The occurrence of neurotoxic effects can potentially reduce [[Compliance (medicine)|drug compliance]]. Some adverse effects can be [[symptomatic treatment|treated symptomatically]]  by using adjunct medications such as [[anticholinergic]]s (antimuscarinics). Some [[rebound effect|rebound]] or [[Drug withdrawal|withdrawal]] adverse effects, such as the possibility of a sudden or severe emergence or re-emergence of [[psychosis]] in antipsychotic withdrawal, may appear when the drugs are discontinued, or discontinued too rapidly.<ref name="Moncrieff">{{cite journal|last=Moncrieff|first=Joanna|date=23 March 2006|title=Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse|journal=Acta Psychiatrica Scandinavica|volume=114|issue=1|pages=3–13|issn=1600-0447|url=http://www3.interscience.wiley.com/journal/118626311/abstract|archive-url=https://archive.today/20130105081330/http://www3.interscience.wiley.com/journal/118626311/abstract|url-status=dead|archive-date=5 January 2013|access-date=3 May 2009|doi=10.1111/j.1600-0447.2006.00787.x|pmid=16774655|s2cid=6267180}}</ref>

===Medicine combinations with clinically untried risks===
While [[clinical trial]]s of psychiatric medications, like other medications, typically test medicines separately, there is a practice in psychiatry (more so than in somatic medicine) to use [[polypharmacy]] in combinations of medicines that have never been tested together in clinical trials (though all medicines involved have passed clinical trials separately). It is argued that this presents a risk of adverse effects, especially [[brain damage]], in real-life mixed medication psychiatry that are not visible in the clinical trials of one medicine at a time (similar to mixed drug abuse causing significantly more damage than the additive effects of brain damages caused by using only one illegal drug). Outside clinical trials, there is evidence for an increase in mortality when psychiatric patients are transferred to polypharmacy with an increased number of medications being mixed.<ref>Michael S Ritsner (2013) "Polypharmacy in Psychiatry Practice, Volume I: Multiple Medication Use Strategies"</ref><ref>Michael S Ritsner (2013) "Polypharmacy in Psychiatry Practice, Volume II: Use of Polypharmacy in the "Real World""</ref><ref>Otto Benkert, Wolfgang Maier, Karl Rickels (2012) "Methodology of the Evaluation of Psychotropic Drugs"</ref>