You may not have heard about this from your psychiatrist, but the debate on whether or not psychiatric medications help mental illness is still quietly raging.
I’ve seen stunning improvements of symptoms in people with mental illness who take their prescribed medication; I also have seen medications improperly prescribed and over or under-prescribed. In some cases even highly-effective medications cause severe side-effects, have no effect at all or even worsen symptoms in some patients.
Obviously this debate is not over yet.
As in most treatments for mental illness, a well-trained, compassionate treatment-planner (therapist, usually, but not always, especially if you are in a clinical program) who follows up regularly, monitors closely, and encourages you to participate fully in your treatment, will work to ensure that medications, if prescribed, are working. The treatment planner can help you (and your family or supportive friends) decide if the relief from symptoms is worth any side-effects that might occur. They can also recommend other supportive therapies.
In some cases, medication to help alleviate symptoms (such as the uncomfortable symptoms of extreme anxiety), can help you find relief. They give you the the “space” to enter into effective talk-therapy. In other cases, long-term medications, such as those that reduce schizophrenic hallucinations, may dramatically improve quality of life for a lifetime.
But the truth is, not all medications work, and not all medications work for everyone or in every case. And of course, medications are not the entire treatment picture. Traditional talk therapy, spiritual counseling, diet and nutrition, behavioral approaches, and numerous other treatment may be used in combination (or alone) to support or even in cases, replace, medication.
Without questioning the motives of those who advocate for or against medication, it is safe to say that there is significant evidence that many medications do work as well as they are supposed to, and that many medications simply do not.
When a patient who may be best served by taking medication seeks a prescription, I often recommend that they meet with a psychopharmacologist who agrees to work very, very closely (this is KEY) with their therapist. A psychopharmacologist can evaluate and monitor you to prevent medication mishaps (though they still can occur). They have the knowledge and experience to do a good job fine-tuning medications and dosages and when more than one is needed, to make sure that safe combinations are taken. (See informational patient links at the American Society Of Clinical Psychopharmacology.)
As for those who argue against medications, certainly, irresponsible pill-popping seems to have reached an all-time high. This *New York Magazine article exposes what might be an all-too-common way to abuse psychiatric medication rather than seek other (perhaps more challenging) ways to address serious issues that are simply a part of one’s chosen path in life.
For example, people are popping Klonopin to help them relax before a business presentation. Yes, this and other abuses of psychiatric meds happens here in NYC and perhaps other places, too. I see it and hear about it all too often.
Meanwhile, if you want to read opinions (and some evidence) in support of both sides of the medication debate, this recent Op-Ed in Pharmalot and especially the comments-section below the article, are worthwhile exploring.
And if you’re taking medication for mental illness, don’t be shy about advocating for yourself. If you notice that your medication doesn’t seem to be working as well as you had hoped, or has stopped working, if you are experiencing side-effects that are unexpected and/or very uncomfortable, or if you haven’t had a thorough medical check-up or haven’t had your medication prescriptions evaluated recently, go ahead and ask your therapist and/or prescribing physician to order blood work. Have them do a complete medication evaluation.
But, don’t stop taking any prescription without the support and supervision of your doctor and/or therapist. Stopping your medication can cause serious problems and is dangerous if it isn’t done correctly.
*Correction: The original link said New Yorker. It is NY Magazine.
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Last reviewed: 17 Oct 2012