Medication Risks vs Benefits
Deciding if medication is right for you is a decision that involves a discussion of risk and benefits. This is a difficult and loaded topic for most people. It brings up imagery from stories or films of people “drugged” and controlled by psychiatric medications. Further, people have fears about what the long term effects of medications are.
I frequently hear statements such as:
“I don’t want to be drugged”. “It will make me a zombie”
“I want to be able to deal with my problems on my own”
“I’m scared of being dependent on medications”
Despite being a medical doctor, I am the first to dissuade my patients from taking medication that isn’t appropriate for them. It is not unusual for me to see a patient on three or more medications for unclear reasons. Re-evaluating those medications and frequently reducing the number is often the first intervention we make.
That being said, I believe strongly in the effectiveness and utility of medication for psychiatric issues. However, it needs to make sense. Let's look at some questions that will help elucidate that but before we do, I’d like to clear up some common myths about psychiatric medications.
Myth Number 1:
They are just making me pretend I am happy.
There are no psychiatric medications that make you happy. In fact, it would be nice if we had pills that were that effective, as there are patients with treatment resistant depression that might benefit from it! In actuality, our medications help level out moods. They reduce levels of anxiety and/or help prevent significant extremes in mood.
Myth Number 2:
They cause people to kill themselves.
It would be illogical to give someone a medication for depression that would make them kill themselves. The origin of this comes from some small studies that showed an increase in suicidal thoughts on one specific SSRI. The FDA (whose main goal is monitor drug safety) put a label on ALL antidepressants saying they could cause suicidal ideations. Interestingly, there is data that suicide increased after that label was added.
Many studies have been done on a large scale to examine this important issue. There is an increase of 1% to 2% in thoughts of suicide for people on those mediations versus those who were taking a placebo. There is no evidence people actually kill themselves. To address this, we monitor closely when people are starting these medications.
Myth Number 3:
If I need medications, I am weak and I can’t fix my problems on my own.
I see this myth as an extension of the “pull yourself up by your bootstraps” idea. This is an old-fashioned thought process, often ingrained in one’s mind from movies one might’ve watched in the past. In today’s world, there is support and strength that can be found in seeking mental health treatment.
Myth Number 4:
I am just being drugged or it will make me a zombie.
I believe this myth has a historical explanation. Barbiturates were a class of medications that was developed and used widely in the early 1950s. Frequently called “mother’s little helper.” These medications are highly sedating and addictive. When taken, particularly in excess of what is prescribed, they are likely to produce a “drugged” mental status. This class of medications is almost never used for psychiatric reasons anymore. However, the myth of this has lingered in popular culture.
Questions to ask yourself when considering medication:
1. Do I have a disorder or symptoms that are treatable with medication?
2. What is this medication targeting and how will it help me?
3. What is the likelihood this medication will help me?
4. Could I treat my symptoms without medication?
If you decide that you want to look further into a medication then consider:
Are there any risks associated with the medication? How likely are they to occur?
What are potential side effects? How likely are they to occur? How unpleasant are they?
Reach out to my Practice if you have any questions about medication and/or psychotherapy and how it can help you. Our Integrative Psych treatment model combines psychological, biological and social disciplines to promote complete-wellness.