What Medication Offers
The medications your doctor can offer you to treat psychiatric symptoms do just that- They target specific symptoms and help decrease their intensity, frequency and/or duration.
What does that mean?
It means that no drug we use cures anything. Only psychotherapy can offer that. However, for most people, getting rid of the symptoms is more than enough. It's really no different than cold medicine. There is no cure for the common cold, but if the symptoms are controlled, you feel better.
How do I know if medication is right for me?
The only way to figure that out is to talk with your doctor or a psychiatrist, and make sure that they spend the time explaining how the medication will work for your specific symptoms as well as potential side effects.
What about alternative medicine?
Alternative medicine has yet to really prove itself clinically. This doesn't mean it doesn't work, but only that the jury is out. Another thing to keep in mind is that many herbs interact with psychiatric medications. It's a bad idea to mix them. I do not recommend combining Chinese Medinicine with Western Medicine. I have seen castastrophic results.
If you are taking three or more medications and don't feel better,
chances are the medications may be making you worse. A lot of times doctors start a new medication before stopping the old one. I don't recommend this. Even though you are feeling terrible, it gets harder and harder to figure out if the medication is working for you or against you.
What are the best medications?
The single greatest acheivement in psychiatric medication in the past three decades was the development of medications that target the serotonin system in the brain. These medications are typically called antidepressants, though not all antidepressants work on serotonin. They are widely used to treat anxiety, depression, borderline personality disorder, bipolar disorder, and obsessive compulsive disorder. They are very safe medications, and most importantly, they are not addictive.
What medications should I avoid?
Long term use and abuse of sedatives (benzodiazepines and sleeping pills) is a big problem in mental health. If you have an anxiety disorder, or suffer from insomnia, your doctor may have recommended these drugs. Most sedatives work in the same manner as alcohol, and can be nearly as problematic and sometimes even more addictive.
Sedatives can cause problems with balance, coordination, and memory. Many times, long term use can actually make you more depressed and anxious than you were when you started them! Research has also demonstrated that they are not good for sleep. Several of the newest medications have actually been linked to cancer in human and animal studies.
Getting off these medications can be very challenging, and most patients don't complain about them, so doctors just keep on prescribing them.
Medications by Disorder
Depression - I recommend Lexapro first. After that I recommend Celexa, which is basically the same molecule...then Wellbutrin and Cymbalta... click here to learn more...
Anxiety - I still recommend the antidepressant Lexapro- it safe and non-addictive. Almost all people with anxiety disorders should be treated with psychotherapy.
Insomnia - There are no proven, safe, long-term medication regimens for insomnia. Treating the underlying condition is essential. click here to learn more.
Obsessive Complusive Disorder - Lexapro in high doses is my treatment of choice. Anyone who suffers from OCD needs cognitive behavioral therapy!
Opiate Addiction - Suboxone and Subutex are very effective. Sometimes Naltrexone can be very effective at "resetting" the opiate pathways.
Bipolar Disorder - Very complicated- treatment first depends on determining what type of bipolar disorder you have and what symptoms you are experiencing. Then it's a process of trial and error. A mood stabilizer is essential for control of severe bipolar disorder.
Attention Defecit Disorder (ADD / ADHD) Some people do well on Provigil, but most will need an amphetamine derivitive such as Concerta, Adderall, or Ritalin. Some clients are having success with the patch.
Smoking Cessation - Nicotine replacement is very important. For some people, starting with gum and then switching to the patch works well. Wellbutrin, also known as Zyban, is great for diminishing craving. All the research shows that therapy, whether a group such as Smokenders or individual psychotherapy, is essential.
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