How Do Other Psychiatry Agents Work?

Other psychiatry agents are psychiatric medications that are not categorized into any of the specific classes of psychiatric drugs. Other psychiatry agents are medications primarily used in the treatment of alcoholism and opioid withdrawal symptoms.

The medications that are grouped under other psychiatry agents include:

• Disulfiram
• Acamprosate
• Lofexidine

Each of the other psychiatry agents works in a unique way. Some modulate the activity of neurotransmitters, chemicals that nerve cells use to communicate and some block enzymes that metabolize alcohol. The other psychiatry agents’ mechanisms of action are as follows:

Disulfiram

Disulfiram produces sensitivity to alcohol by blocking its breakdown by a liver enzyme known as aldehyde dehydrogenase. Disulfiram discourages alcohol intake by causing unpleasant reactions to alcohol which include palpitations, hypotension, chest pain, flushing, nausea and vertigo.

Disulfiram is also being studied for use in treating glioblastoma multiforme, an aggressive brain cancer, because of its ability to cross the blood brain barrier and toxicity to cancer cells. Disulfiram combined with copper gluconate has been found to enhance chemotherapy’s toxicity to cancer cells and reverse cancer cells' resistance to chemotherapy.

Acamprosate

Acamprosate is a synthetic form of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain. Acamprosate blocks the pain signals from alcohol withdrawal by enhancing GABA activity and inhibiting glutamate, an excitatory neurotransmitter. Unlike disulfiram, acamprosate does not cause unpleasant reactions or alcohol aversion.

Acamprosate is also being studied for use in the treatment of fragile X syndrome, an inherited genetic disorder that causes cognitive and learning impairment. Dysfunction in glutamate neurotransmission is believed to be involved in this disorder, and studies suggest that acamprosate significantly improves linguistic communication skills in patients with fragile X syndrome and autism.

Lofexidine

Lofexidine is an alpha-2 agonist that acts on the central nervous system and is used to treat opioid withdrawal. Lofexidine binds to alpha-2 receptors, protein molecules on nerve cell surfaces and blocks the release of norepinephrine, a neurotransmitter that causes withdrawal symptoms.

Other psychiatry agents are oral tablets prescribed in the treatment of the following conditions:

FDA-approved

• Alcoholism: For maintenance of alcohol abstinence in people who are abstinent at the time of initiating treatment.
• Opioid withdrawal: Short-term use for relieving opioid withdrawal symptoms.

Orphan designation

• Glioblastoma multiforme
• Fragile X syndrome

Side effects of other psychiatry agents vary with each type of drug. A few of the most common side effects include:

• Disulfiram:
  • Fatigue
  • Headache
  • Impotence
  • Metallic aftertaste
  • Rash
  • Acneiform eruptions (acne-like skin eruptions)
  • Polyneuritis/peripheral neuropathy (damage to peripheral nerves)
  • Hepatitis
  • Optic neuritis (inflammation of optic nerves)
  • Psychotic disorder
• Acamprosate:
  • Diarrhea
  • Insomnia
  • Anxiety
  • Asthenia (weakness)
  • Depression
  • Pruritus (itching)
  • Nausea
  • Dizziness
  • Anorexia (loss of appetite)
  • Paresthesia (abnormal skin sensation)
• Lofexidine
  • Insomnia
  • Orthostatic hypotension (blood pressure drop when standing up from sitting or lying down)
  • Bradycardia (slow heartbeat)
  • Hypotension (low blood pressure)
  • Dizziness 
  • Somnolence (drowsiness)
  • Sedation
  • Dry mouth
  • Syncope (fainting)
  • Tinnitus (ringing in the ears)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of some of the other psychiatry agents include:

• acamprosate
• Antabuse
• disulfiram
• xlofexidine
• Lucemyra