Psychotropic Medications 101
Before you start taking any medication for a mental illness (I am going to use “psychotropic” as a catch-all term), there are some basic points you need to know.
1. The treatment of mental illness begins with working with a competent therapist. Although medication can be helpful to help address undesirable symptoms, medication alone is rarely successful. You are not depressed because you have a Prozac deficiency. Often people living with depression are struggling with past or current stressors while people struggling with anxiety are often worried about the future. A competent therapist can help you examine your thoughts and behaviors that may be contributing to your depression and/or anxiety while simultaneously teaching you coping skills or different ways of thinking to help decrease your symptoms.
2. Medication can be useful because it helps you work with your therapist. Sometimes your mental illness can get in the way of you working with your therapist. For instance, you may be too anxious/depressed/unfocused to engage in therapy. Medication can reduce those symptoms, allowing you and your therapist to do the real work, changing your unwanted thoughts and/or behaviors.
3. Antidepressants are not going to make you happy, just less miserable. If your prescriber decides that an antidepressant would be helpful, be prepared to take it for at least 6 months. This will give you time to work with your therapist on decreasing your mental health symptoms using a variety of techniques such as Cognitive- Behavioral Therapy, Eye Movement Desensitization Reprocessing, Cognitive Processing Therapy, Art-Resolution Therapy, or other evidence-based techniques.
4. Every medication has side effects. The art of medicine is finding a drug whose beneficial effects outweigh its adverse side effects. All medications have adverse side effects. Your medication prescriber will ask you a series of questions including asking about any known allergies and past medication use to determine what medication may or may not work best for you.
5. A drug’s adverse side effects almost always appear before its positive side effects. This is one of the main reasons people stop taking antidepressants. It generally takes 6-8 weeks at full dose before symptoms of depression start to lift. The good news is, if you start taking a medication at low doses, its adverse side effects usually can be minimized.
6. First-line medication for anxiety is an antidepressant. Unlike depression, feelings of anxiety start to improve after 3-4 weeks of use of an antidepressant.
7. Sleep medications do not provide natural sleep. Almost all medications prescribed for insomnia (hypnotics, anxiolytics, antidepressants, antipsychotics) simulate sleep by sedation. Sedation is not synonymous with sleep. You may be prescribed one of these medications to assist with your symptoms of anxiety, mood instability, or depression, and that is legitimate. Just do not expect to get “a good night sleep” and be aware that you may have residual daytime grogginess.
8. Genetic testing can help in selecting the proper medication for you — sort of. Any substance that you allow to enter your body, whether it be a nutrient, a poison, or a drug, can have adverse side effects based on your genetic background and eventually needs to be metabolized and excreted. Metabolism is covered by your genes, which are simply proteins. Some genes metabolize psychotropic medications better than others, and some not at all. Knowing your genetic background can help you avoid medications that are either going to have a higher likelihood of adverse side effects or not going to work particularly well. This knowledge can accelerate the process of finding the right drug for you.
9. Other medications you are taking, including over-the-counter drugs and herbal products, can interact with your psychotropic medications. It is extremely important that your prescriber knows all the substances you are taking. This includes “natural” products, such as marijuana and kratom, and various illegal substances, such as methamphetamine and cocaine.
10. Your therapist and your prescriber are a team, and your therapist is the captain of that team. There are no quick fixes, just consistent commitment to the therapyprocess and open and honest communication with your therapist and your medical provider.
This article was written by Medical Doctor, Dr. Allan Wilke. To read more about Dr. Wilke or to schedule an appointment with him, click the link here Dr. Allan Wilke, MD
