Comparing Similar Drugs
When you're living with an illness, a medication could mean the difference between feeling great and suffering. But you often have choices in the pills you take.
If you rely on a prescription medication, you’re not alone. Research from Consumer Reports suggests that about half of us take at least one doctor-ordered drug every day.
Frequently, your doctor will suggest a specific type of pill, and you’ll try it to see if it works. If you don’t get relief, you try something new. You may repeat this several times until you find the perfect solution.
But walking into your doctor’s office with research can help you steer the conversation. You might suggest a drug first that your doctor wanted to hold back. In doing so, you just might take a less harmful version and avoid medication-delivered problems.
In this article, we’ll help you understand your medication options if you’re living with:
- Bipolar disorder
- Chronic pain
We’ll also dig into solutions to try that don’t require a medicine cabinet. And we’ll help you understand why talking to your doctor about anything you try is so important.
People with depression aren’t just sad. They have a chemical imbalance deep within the brain that prevents them from experiencing joy. Addressing that issue with medication can mean bringing light back into a person’s life.
Experts say doctors often reach for these drugs when working with patients who have depression:
- Selective serotonin reuptake inhibitors (SSRIs): These drugs block the reabsorption of serotonin, a common brain chemical. That subtle shift can ease symptoms in some people, and SSRIs come with fewer side effects than other antidepressant drugs.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): These drugs work on two types of brain chemicals: serotonin and norepinephrine. They are often provided when SSRIs aren’t enough to ease depression symptoms.
- Monoamine oxidase inhibitors (MAOIs): These are older medications, and they come with serious side effects that can make day-to-day life difficult. They’re rarely the first choice of therapy for depression, but your doctor might use them if nothing else is working.
- Tricyclic antidepressants: These medications work on multiple brain chemicals to address depression. They can cause severe side effects, so doctors don’t use them unless all other solutions have failed.
Researchers say antidepressant medications come with a low risk of abuse. Most people who have a prescription use the drugs as directed. But some drugs, including MAOIs, can produce effects very similar to stimulants. And others, including tricyclic antidepressants, can cause euphoria when abused.
If you’re given medications for depression and you’re tempted to abuse them, talk with your doctor. A switch to a different solution may be worth discussing.
An anxiety disorder can leave you feeling stressed and worried, even when you’re in a safe place. Overactive electrical signals in the brain are often to blame. Most pharmaceutical therapies aim to slow down your busy cells so you can feel relaxed once more. But there’s one type of medication that’s been linked to abuse and addiction.
The Anxiety and Depression Association of America says there are four main types of anti-anxiety drugs doctors use.
- SSRIs: We’ve talked about how these medications can ease depression. They can also help to soothe some types of depression. When the brain has more serotonin to use, mood tends to improve.
- SNRIs: These antidepressant drugs can also help with anxiety. They’re considered just as helpful as SSRIs, and some doctors use them first to help their patients.
- Benzodiazepines: These drugs are made for short-term treatment of anxiety. Use them for too long, and your brain can become accustomed to them. You may develop seizures when you try to quit. Benzodiazepines have also been associated with drug abuse and addiction.
- Tricyclic antidepressants: These medications can help with some types of anxiety disorders, but they come with significant side effects. Some people experience blood pressure changes, for example, and others develop constipation or urinary retention.
If these solutions don’t work, your doctor might suggest buspirone. This medication alters neuroreceptors in the brain, experts explain, and that can help to ease anxiety symptoms. Researchers say the drug tends to sedate rather than produce euphoria. But some people claim the drug can be abused.
Anxiety disorders are serious, and medications could help you ease symptoms. But it’s not unusual for mental health issues and addictions to form in the same person. If you’re concerned about addiction, discuss this with your doctor.
Your body needs rest to repair muscles, set down memories, and grow. When sleep won’t come, or you can’t stay asleep, your body can’t tackle this critical work. Medication could help to reset your internal clock, so you can get spend your nights asleep. But some insomnia solutions come with risks.
Mayo Clinic says most sleep medications can lead to dependence, including:
Develop drug dependence, and you’ll need medications to feel normal. Without them, you might feel sick. In some cases, you could develop seizures when you try to quit sleeping pills.
Insomnia solutions in the benzodiazepine class, including estazolam and Restoril, have also been associated with addiction. These drugs can boost chemicals in the brain associated with pleasure, and when that happens, a pill sparks euphoria.
No matter what sleeping pill you use, work with your doctor. If you’re tempted to take too many doses or swallow more pills each time, your doctor will want to know. This could indicate that substance abuse is an issue, and your doctor may have suggestions that can help.
Treating Bipolar Disorder
Life with bipolar disorder isn’t easy. Your mood seems to swing from one fixed point to the next, or you’re stuck in a deep depression with no way out. Medications may ease chemical imbalances that lead to bipolar disorder flareups.
But your doctor might need to do a few experiments to find the one that works for you. Experts say most people with bipolar disorder try several different drugs until they find one that works.
Your doctor might suggest these medications:
- Mood stabilizers: Drugs like Lithium have been used to treat bipolar disorder for decades. When it enters the body, Lithium alters several neurotransmitters and receptors. Levels of chemicals like serotonin rise, while others like norepinephrine decrease. Mood stabilizers come with several uncomfortable side effects, and that often keeps people from abusing these drugs.
- Antipsychotic medications: If you experience psychosis during your mood swings, these medications may help you. They reduce electrical activity within the brain, and they can dampen chemical signaling too.
- Antidepressants: All of the medications we mentioned when discussing depression could be suggested by your doctor as a solution for bipolar disorder. That’s especially true if your disease manifests as a persistent blue mood.
Open communication with your doctor is critical, as you might need to tinker with your drugs quite a bit before you find relief. And if you find you’re tempted to abuse your medications, your doctor may have suggestions that can help.
Treating Chronic Pain
Everyone has discomfort from time to time. But when it won’t leave your side, it can keep you from doing what you love. In severe cases, pain can lead to depression and anxiety. Doctors have many medication solutions available, but they tend to fall into two classifications.
Your doctor might choose opioids to help. They include:
These drugs don’t address what causes your pain. They can’t reduce inflammation or cut a fever. But they can make discomfort easier to ignore, as your brain is awash in pleasure chemicals.
Many people who take opioids abuse them. The National Institute on Drug Abuse says up to 29 percent of people with an opioid prescription for chronic pain abuse their drugs.
Opioids aren’t your only option. Mayo Clinic says non-opioid solutions include the following:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like Advil and Aleve can reduce pain and inflammation. But take too much too often, and you can develop kidney problems, high blood pressure, and more.
- Acetaminophen: Drugs like Tylenol can ease pain, although doctors aren’t quite sure why. Take too much or too often, and these drugs can cause liver failure or kidney damage.
- COX-2 inhibitors: These newer medications are designed to provide pain relief similar to NSAIDs without the risk of stomach damage. But if you take too many, they can cause kidney problems.
Managing discomfort can be a balancing act, as you may have good days followed by bad ones. Your doctor might suggest a pain journal, so you can look back and determine how well your medications are working.
What Else Can You Try?
Every medication we’ve listed here comes with the potential for side effects, and some of those complications are life-threatening. Your doctor might suggest other solutions in addition to — or instead of — your medications to ease your symptoms. But you shouldn’t try anything without talking to your doctor first.
- Insomnia: Exercise and relaxation therapy are considered effective and safe solutions for people with chronic sleep troubles, researchers say. Exercise may wear out muscles and increase relaxation brain chemicals, so you fall asleep faster and stay asleep for longer.Relaxation therapy may help you learn how to shut down at the end of the day rather than dwelling on what happened and what’s to come.
- Anxiety, depression, and bipolar disorder: Therapy may help you learn how to control your triggers and reduce outbreaks. You may use therapy in conjunction with medication, or your doctor may find that you’re better with just therapy. You’ll need to work with a professional to get the most benefit.
- Pain: Your doctor may suggest acupuncture, massage, or biofeedback to ease discomfort. None of these solutions involve medication, and they all could help you reduce pain signals.
Managing a chronic condition can be tiring, and it’s not unusual for people to look for DIY solutions. But it’s critical to stay in contact with your doctor. Trying something new, like switching one medication for another, could mean dealing with a relapse of your symptoms.
Most lifestyle changes, such as sleeping more and exercising with intention, seem safe. But there are times when even those shifts require a talk with a doctor. Some drugs shift your blood pressure, for example, so lifting weights might not be safe. Talking with your doctor could help you prevent those problems.