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Saturday, June 25, 2011

Psychiatric Medications - Do You Really Need Them?

So you want a medication for your mood? You think a pill will make everything better right? Of course we think that...that's what the ads on TV tell us! As a psychiatric nurse practitioner, people come see me for prescriptions. People request pills for all kinds of things like poor sleep, mood swings, depression, racing thoughts, and to focus better.  But sometimes you don't need a pill...actually, most of the time you don't need a pill! Shocking right?  Five psychiatric medications made Forbes top 20 best-selling medications list. Three of those five are antipsychotics!

 Let's take a look at this chart, NIMH (National Institute of Mental Health) shows us the percent of Americans with mental illness.  It helps put things into perspective related to having 5 psychiatric medications on Forbes list of best-selling medications....in other words, I think people who don't necessarily need those medications are being prescribed those medications.
Courtesy of NIMH
Lots of people have difficulty with symptoms that seem to be part of a mental illness. And doctors are right there, ready to give you a prescription for your symptom. But what if your symptom was the result of a vitamin deficiency? What if your depression is the direct result of the loss of your spouse? What if your anxiety is the direct result of an overactive thyroid? Has your doctor ever said, "Gee, I'm sorry you lost your home and you have to care for your kids in a shelter, here's a prescription for zoloft, it will help with your mood."

But maybe all you really needed was help finding resources for homeless families, or a blood test for a B12 deficiency instead of a pill. Or maybe it's something that will take a while to figure out. Doctors don't have the kind of time needed to figure out what's causing your symptom. It's easier for them to give you a pill for the symptom! Really...it's an awful way to treat people. And we all deserve better care.

Some research has shown that antidepressants are no more effective than a placebo. Because maybe all you really need is therapy and learning some new coping skills.  As a prescriber of psychiatric medications for 11 years, I know who needs a medication and who needs to learn good sleep hygiene habits!

And all the psychiatric medications have some significant side effects. Forbes top medication list has those 3 antipsychotics in there! Do you really think you need an antipsychotic?? According to Prescriber's Letter, more money is spent on antipsychotics than any other class of psychiatric medications. There are more than 10 antipsychotics I can pick from to prescribe for you. When we decide to add on an antipsychotic, it should be done with extreme care and a thorough history.  There's cardiac issues, weight and metabolic issues, sedation issues and extrapyramidal issues, not to mention all the drug-drug interactions and cost.

So consider all the options and all the risks before you accept that prescription from your doctor. And, give a Nurse Practitioner a try! We are trained in a holistic manner. We look at the whole you. You deserve a complete work up for what ails you. You deserve a full explanation of each medication considered for you and you deserve to hear possible alternatives.  Please don't settle for a pill.