# Anti-psychotics and anti-depressants go OTC - what happens?
**URL:** https://boards.straightdope.com/t/anti-psychotics-and-anti-depressants-go-otc-what-happens/644995
**Category:** Great Debates
**Created:** [December 24, 2012, 8:03am UTC](https://boards.straightdope.com/t/anti-psychotics-and-anti-depressants-go-otc-what-happens/644995 "2012-12-24T08:03:03Z")
**Posts on this page:** 6
**Page:** 1
### Author:  [@Bryan\_Ekers](https://boards.straightdope.com/u/Bryan_Ekers)
#### Post date: [December 24, 2012, 8:03am UTC](https://boards.straightdope.com/t/anti-psychotics-and-anti-depressants-go-otc-what-happens/644995/1 "2012-12-24T08:03:03Z")
What would happen if entire families of anti-psychotic and anti-depressive medications became either over-the-counter, or if still by prescription were government-subsidized to the point where the cost to the individual was minor?
Are these drugs addictive? Do they impair driving and motor skills to an extent comparable to, say, alcohol? I see lists of side effects, but are these markedly more common or more severe than drugs that are currently advertised on television?
What does the U.S. currently spend in response to crimes committed by the mentally ill? If clozapine was readily available with minimal hassle (because as yet, getting comprehensive mental-health care in the U.S. is something of a crap-shoot), would someone take it voluntarily if they thought themselves borderline? Would this likely cause a reduction in crime in future years, if borderline patients can self-medicate before their disease progresses?
Are their practical limitations on the production of these drugs, i.e. they are difficult and/or expensive to produce in quantity?
My point being that arguments over guns is likely useless - the U.S. is not going to get rid of its vast supply of firearms anytime soon - but would making mental-health medications more available and less expensive address at least some of the problem of the rampage shooter?
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### Author:  [@Grumman](https://boards.straightdope.com/u/Grumman)
#### Post date: [December 24, 2012, 9:38am UTC](https://boards.straightdope.com/t/anti-psychotics-and-anti-depressants-go-otc-what-happens/644995/2 "2012-12-24T09:38:11Z")
This seems like an inherently bad idea: if your judgement is impaired by psychosis or depression, you probably aren’t in great shape to self-medicate with mind altering substances. Considering that they can have side effects and withdrawal symptoms like _causing_ psychosis or depression, making them available OTC might make the problem even worse.
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### Author:  [@Blackberry](https://boards.straightdope.com/u/Blackberry)
#### Post date: [December 24, 2012, 10:08am UTC](https://boards.straightdope.com/t/anti-psychotics-and-anti-depressants-go-otc-what-happens/644995/3 "2012-12-24T10:08:06Z")
> [@Bryan\_Ekers](#):
>
> What would happen if entire families of anti-psychotic and anti-depressive medications became either over-the-counter, or if still by prescription were government-subsidized to the point where the cost to the individual was minor?
Well, the second one wouldn’t be hard to figure out. Just look at all the people who are already in that situation. Or, reading ahead to your question about mentally-ill people like the CT shooter: they had an income of at least $24k/month, so money was definitely not a barrier for them.
> [@](#):
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> Are these drugs addictive?
No.
> [@](#):
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> Do they impair driving and motor skills to an extent comparable to, say, alcohol?
Generally antidepressants don’t, or at least not more than very common OTC meds like Benadryl. Antipsychotics, especially at high doses, could.
> [@](#):
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> If clozapine was readily available with minimal hassle (because as yet, getting comprehensive mental-health care in the U.S. is something of a crap-shoot), would someone take it voluntarily if they thought themselves borderline?
Probably not. Generally, antipsychotics have very undesirable side-effects, and people who really need them don’t recognize that they do need them.
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### Author:  [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)
#### Post date: [December 24, 2012, 10:51am UTC](https://boards.straightdope.com/t/anti-psychotics-and-anti-depressants-go-otc-what-happens/644995/4 "2012-12-24T10:51:41Z")
I can’t figure out if this is a gun control debate or a prescription medication debate…
Making anti psychotics and anti depressants available OTC would not keep people from dying from weapons.
Of the 12,000 or so gun-related homicides, most are inner city, low income area impulse crimes, often related to drugs. Voluntary access to free medication won’t help this group.
Of the 17,000 or so gun-related suicides, I see no argument that self-medication would help this group significantly, or that the cost of anti-depressants is a significant barrier. It’s not a trivial point, but medication of the psychotic and the depressed is a fairly tricky issue, and I seriously doubt self-medication would be productive.
For the “rampage” shooter, you’d be talking about a teeny tiny percentage of all gun-related deaths, and only a small chance you happen to get the right med to the right guy, so even though that category gets all the headlines, it wouldn’t make much of a dent, in my opinion, to get free treatment drugs out to everyone. As a rule of thumb this sort of really crazy individual is almost impossible to medicate properly, and the barrier is not typically either the cost of medication or the fact that it is prescription-only. They are not going to self-medicate, even if the drugs are free.
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### Author:  [@Bryan\_Ekers](https://boards.straightdope.com/u/Bryan_Ekers)
#### Post date: [December 24, 2012, 4:32pm UTC](https://boards.straightdope.com/t/anti-psychotics-and-anti-depressants-go-otc-what-happens/644995/5 "2012-12-24T16:32:03Z")
It’s not a gun control debate, or at least that absolutely was not my intent. It was, however, _prompted_ by a post in a gun control thread, namely:
> [@Having laid low, the N.R.A. is fully prepped and rehearsed to control legislation. As usual.](https://boards.straightdope.com/t/having-laid-low-the-n-r-a-is-fully-prepped-and-rehearsed-to-control-legislation-as-usual/644605/287):
>
> If everyone has their own shrink, meds will be handed out like M&Ms.
…and it occurred to me, what if they _were_ handed out like M&Ms? What if anyone who thought they might need them or had a sufficiently concerned and persuasive family member could easily get them. One common argument against all-out drug legalization is an increase in the number of addicts and damage to the moral fabric of society or something. Is that a concern for these classes of drugs? Are there anti-depressants that give a Ritalin-like boost, to be abused by study-minded high school and college students?
If not the drug legalization issue, suppose there was a dramatic effort to increase the number of American mental health care professionals, as the launch of _Sputnik_ increased the call for more scientists and engineers. Would that help destigmatize mental health issues to the point where going to see a psychiatrist is like going to see a dentist?
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### Author:  [@Mdcastle](https://boards.straightdope.com/u/Mdcastle)
#### Post date: [December 24, 2012, 4:56pm UTC](https://boards.straightdope.com/t/anti-psychotics-and-anti-depressants-go-otc-what-happens/644995/6 "2012-12-24T16:56:54Z")
> [@Bryan\_Ekers](#):
>
> What would happen if entire families of anti-psychotic and anti-depressive medications became either over-the-counter, or if still by prescription were government-subsidized to the point where the cost to the individual was minor?
>
> Are their practical limitations on the production of these drugs, i.e. they are difficult and/or expensive to produce in quantity?
I don’t think much would happen. The consequences of inappropriate use are minor compared to say anti-anxiety or narcotic agents. I am told some common anti-depressents are available OTC in some Latin American countries. You’d probably see a lot of inappropriate use “I’m sad, these will make me happy”, as well as more appropriate use by people who won’t see a MH professional for one reason or another. The new antidepressants (SSRIs, SNRIs, tetracylics) much safer in overdoses than common drugs like tylenol.
Both classes are affordable now, most people can afford $10.00 for a 3 month supply of generics at the local big box stores. Walmart at least imports huge amounts of the base drug from low cost, high volume places in India.
> [@](#):
>
> Are these drugs addictive? Do they impair driving and motor skills to an extent comparable to, say, alcohol? I see lists of side effects, but are these markedly more common or more severe than drugs that are currently advertised on television?
Neither are additive. Antipsychotics can zonk you out when you first start them, and to a lesser extent ongoing. This can be desirable in that they are sometimes prescribed off-label for sleep. Antipsychotics can cause Parkinsons like symptoms that may be permanent, more so with high doses/long term/older medication use.
> [@](#):
>
> What does the U.S. currently spend in response to crimes committed by the mentally ill? If clozapine was readily available with minimal hassle (because as yet, getting comprehensive mental-health care in the U.S. is something of a crap-shoot), would someone take it voluntarily if they thought themselves borderline? Would this likely cause a reduction in crime in future years, if borderline patients can self-medicate before their disease progresses?
Antipsychotics can be helpful for Borderline Personality Disorder but Clozapine isn’t a “magic pill”, I’m not sure it’s better than any other AP for that purpose and that drug in particular is less likely to go OTC than the others since the US and the manufactueres havce decided that blood monitoring is required.