Psychopharmacotherapy: Side Effects

Psychopharmacology studies drug-induced alterations in the cognitive function and behavior of humans and aims to develop treatment strategies for neurological and psychiatric disorders. Like all drugs, psychoactive drugs are associated with side effects (adverse effects) which may be generated both centrally and peripherally. The spectrum of drug effects originate largely from their effects on multiple neurotransmitter systems, and the interactions of these systems with each other and other sites of action in the central nervous system. One of the strongest predictors of treatment noncompliance is early onset and persistence of side effects. The strongest determinant of the interindividual variation in the experience of side effects is believed to be in the genetic make up. The study of pharmacogenetics targets drug development that will be both efficacious and well tolerated for each individual. Management of side effects includes a baseline assessment, careful choice of medication, patient and family education, minimization of the number of drugs (to decrease potential side effects and to avoid drug interactions), single bedtime dosing, the availability of clinicians, adjustment in dosage, counteractive drug treatment, and continuous assessment. In this article, major behavioral side effects of psychoactive drugs such as sedative, cognitive, and motor effects are examined. These factors play a critical role in the quality of life of patients.