Are you frustrated by your psychiatric medications? Do you find that you continue to take your medications for day, months, or even weeks, and still haven't found relief from your symptoms? Do you often find yourself wondering if you're even on the right medications, or wondering if your doctor has misdiagnosed you?
Before you give up, it's worth keeping in mind that psychiatric medications don't work for everyone. For example, many studies report that only about 60-70% of patients will respond to antidepressant therapy.
However, this doesn't mean you should give up hope if your medications aren't working as expected. Consider the following common medication errors:
1) Changing the time you take the medication each day.
As harmless as it may seem, taking your medications at different times of the day can have a tremendous impact on outcome. Some medications, for example, should only be taken in the morning as they are more likely to cause insomnia if taken closer to bedtime. Other variables, such as whether or not medication is taken with meals, can also impact absorption rates and, ultimately, outcomes. To avoid this error, be sure to take your medication at the same time every day, and ask your doctor if food impacts the absorption of your medication.
2) Taking your medication only when needed.
Some medications have a fast onset of action and are intended to be taken only as needed when symptoms arise. But the majority of medications prescribed for anxiety and depression have a delayed onset of action. Many patients assume that if they are feeling better there is no need to take medications consistently. Be sure you understand which medications should be taken as needed and which should be taken on a regular schedule.
3) Combining medications with over-the-counter medications to "boost" the effect.
Patients sometimes assume that combining prescription medication with over the counter supplements such as St. John's Wort or SAM-e is a harmless practice. It's not. Cases of serotonin syndrome, a serious and potentially life threatening drug reaction, have been reported in patients who combined their antidepressants such as Prozac (fluoxetine) with St. John's Wort. Don't assume that because a medication or supplement is available without a prescription, it's safe to take with your prescription medication. Ask your doctor.
4) Continuing to use alcohol, even in moderation.
Let's not forget that alcohol is a central nervous system depressant. If your taking an antidepressant and continuing to drink, even in moderation, you may be setting yourself up for failure. Alcohol, moreover, is known to intensify the side effects of many antidepressant and anti-anxiety medications. If your medication seems to have stalled and you're still drinking, consider abstaining until you're back on track.
5) Not defining specific target symptoms or treatment goals.
Perhaps the single most important reason why medications don't work is the failure to identify treatment goals. It's simply not enough identify "depression" or "anxiety" as target symptoms. Major depressive disorder and generalized anxiety disorder are conditions characterized by a constellation of symptoms, including: fatigue, difficulty concentrating, sleep disturbances, and restlessness. I ask patients to identify at least three target symptoms. Together, we track the outcome of these symptoms with each follow-up visit. Doing so gives us a better idea of treatment outcomes instead of relying on subjective reports of a single symptom.
While medications for treating depression and anxiety are far from perfect, you improve your chances of having a favorable outcome by avoiding the pitfalls listed above.
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