If Medication Doesn’t Work, Then Why I Prescribe it Anyway?

It is indeed a long debate and in fact, still going on among psychiatric medicine fraternity – do medications for mental health disorder really work? Before you jump to any sort of conclusion, let me admit that I am neither against pharmaceutical industry nor an anti-medication psychiatric professional. Also at this juncture, I should also stress upon the stunning results attained for several chronic patients when treated with antidepressants, mood stabilizers, or antipsychotic medicines. Being a practising psychiatrist in Pune for more than 20 years, I firmly believe and to stress upon is that medications alone can never cure a patient.

What exactly is the problem?

The complete medical fraternity is trying to make their patients devoid of illness and get better by adopting all possible measures, tools, and techniques. We, psychiatrists, are no an exception to these efforts, but people’s mind is much more complicated than any other machine invented so far and definitely, it can’t be read by few diagnostic tests for chemical imbalances. It is true that when medications work for many patients, numerous success stories and theories can be floated. But what about the rest for whom they simply don’t respond? Remember, no two people can benefit from the same way of treatment and the going gets tough when medications don’t work. Again, changing the dosage or composition of the medicines immediately is a futile exercise and may not yield the desired results.

What next?

When medications don’t work, the first and foremost action that needs to be taken is to switch the direction of treatment. It may be a case of ‘something else’ that needs treatment and not the one that was envisaged earlier. The situation may be back to square one, but it would be a prudent decision to have more sessions with the patient. By all probability, these additional sessions may lead to extraction of details that have not surfaced before such as usage of abused substance, a severe history of trauma, an ongoing conflict at work or domestic front, continuous anxiety, stress, or even a chronic physiological medical illness.

How to begin?

Psychiatrists around the world would readily accept that continuous medication is not a solution for treating mental disorders. Unlike physiological disorders where diagnostic tools can clearly pinpoint the treatment line, psychological treatments are not so easy. Medications and treatments in the field of psychiatry are entirely dependent on the symptoms, interviews with the patients and the results of the counselling sessions. Based on the initial diagnosis, it would be definitely advantageous to explore the possibility of treatment with medications, but that should not be construed as the end; in fact, it is the beginning.

What’s the solution?

The only way out is to spend more time with the patients to understand them better and reach the root of the problem. This enables psychiatrists like us to offer an integrated psychotherapeutic approach that combines

  • Cognitive Behavior Theory (CBT)
  • Rational Emotive Behavior therapy (REBT)
  • Mindfulness-Based Cognitive Behavior therapy (MBCT)
  • Psychoanalytical and Psychodynamic Therapies
  • Supportive Psychotherapy
  • Clinical Hypno Psychotherapy and many more

 

In fact, most of the mental health disorders such as behavioural, perceptual, affective, and cognitive abnormalities can be effectively treated with the right combination of therapies and medications.

In many instances, the problem of overdosage of medications and side effects can be easily solved by educating the patients and their near and dear ones. They should be made to understand the fact that medication alone can manage only to suppress the symptoms of the disease but cannot offer full-fledged cure of the problem. As one of the trusted psychological counsellors in Pune, we do prescribe medications, but they are usually done to keep the symptoms in check and facilitate smooth conducting of ongoing therapeutic treatments. As a good psychiatric care provider, we don’t rely only on the outcome of diagnostic results, but we listen to your concerns and offer a collaborative treatment process to make you surpass difficulties.

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