Psychotropic drugs can be used by themselves or in conjunction with psychotherapy. Frequently, drugs are used to help reduce the severity of symptoms in patients so that they may benefit from psychotherapy. Effective psychotherapy requires you to be comparatively calm, rational, and able to make well-thought-out decisions. These things are not possible if you are terribly agitated, are despondent and crying much of the time, or {228} may, for example, have disturbing hallucinations and are no longer in touch with reality. The aim of drug therapy is, eventually, to eliminate the need for medication. In this respect, psychopharmacology is similar to psychotherapy: both would like to help the patient so that he or she no longer needs either one. It is not always possible to do this, however. Some disorders are, at present anyway, chronic conditions. People with parkinsonism or epilepsy may have to take medication indefinitely. But the general trend is to use psychotropic drugs as temporary measures to bring symptoms quickly under control so that psychotherapy can be started. The only professionals who are legally authorized to prescribe psychotropic drugs are physicians and, in particular, psychiatrists. However, psychotherapists are now being trained to be sensitive to conditions that may have an organic basis. Certainly, it is wise to have a thorough physical exam to rule out organic problems that can cause emotional or mental upset (see Chapter 8). Numerous studies have shown that up to half of the individuals who are referred to a psychotherapist have undiagnosed organic problems.[1] This is an important caution to bear in mind. [1] See, for example, L. Small, _Neuropsychodiagnosis in Psychotherapy_ (New York: Brunner/Mazel, 1980). TYPES OF PSYCHOTROPIC DRUGS There are nine main classes of psychotropic drugs: _Antianxiety, or Anxiolytic, Drugs_ These are the so-called _minor tranquilizers_. They are sedatives for the waking hours that are prescribed for people who have excessive tension and anxiety. _Neuroleptics, or Antipsychotics_ Psychosis is a disorder that impairs a person's abilities to think, remember, communicate, respond with appropriate emotions, and interpret reality without great distortion. People who have these difficulties can often be treated effectively with neuroleptic or antipsychotic drugs, also known as the _major tranquilizers_, which have specific effects on the brain's activity. {229} _Sedative-Hypnotic Drugs_ These drugs act as sedatives at low doses and produce a "hypnotic" action at higher doses. (The word _hypnotic_ as used by pharmacologists does not refer to a hypnotic trance but means simply that a drug causes drowsiness and reduces motor activity.) In even larger doses, these drugs act as anesthetics. Antianxiety drugs, the minor tranquilizers, can be grouped with these drugs because of their sedative effect. _Antidepressants_