Drug Spotlight Program

Abstract

Antianxiety drugs, perhaps the most widely used drugs in all medical practice, may be used better if they are used less. To do this we must recognize the episodic nature of much anxiety, the hypnotic effects of the drugs must be exploited, and the dose must be tailored to the patient. Both these drugs and antidepressive drugs must be used concomitantly with nondrug therapy. The antidepressive drugs are most effective for endogenous depressions, which are probably genetically transmitted and based on a disorder of central neurotransmission. Commoner types of depressions may respond to a wider variety of drugs: stimulants, antianxiety agents, or even small doses of antipsychotic drugs. The latter have revolutionized the practice of psychiatry and have afforded relief for the major psychiatric disorder, schizophrenia. Antipsychotic drugs are often unwisely combined; the nonpsychiatric physician may be able to simplify treatment. Antimanic drugs, especially lithium carbonate, have given a new dimension to our thinking about "functional" psychoses. Both the advent of modern psychotherapeutic drugs and the extensive research on the genetic-biochemical bases of emotional disorders are forcing psychiatry back to its origins in biomedical science.