The Drugs Don’t Work (or do they?)


Medication is not my forte’, but working as I do, in a multi-disciplinary team where there are doctors and nurses present, I have a great opportunity to check any information I’m need clarification about.

I make liberal use of the BNF (British National Formulary) website which lists comprehensively all the medications that are used, I also found particularly useful a book called ‘The Approved Social Worker’s Guide to Psychiatry and Medication’ which I’d recommend highly as a non-medic’s text to, well, psychiatry and medication which assumes some background knowledge of mental health (although it has a clarity which makes it useful across the board to non-experts).

Anyway, with that proviso, I came across a couple of articles at the weekend relating specifically to medication.

Firstly an article at Psychminded which challenges the assumption that schizophrenia needs to be necessarily treated with medication. Medication has it’s place but it not exclusively.

image rselph at flickr

Then an article I have to say I found a little sobering from a magazine called ‘Woman’s Day’ which publishes ‘Six tips towards Choosing an Antidepressant’. As we know, information is empowering but I just found it a little incongruent that drugs should be compared like candy. The article itself is useful in that it points towards possible factors that should be discussed in order to best choose but honestly, I’d hope any prescribing doctors would (and do)  take these factors into account anyway.

I wonder how much there is a culture of leaning on medication as the ‘easiest’ option through a period of difficulty. I am by no means anti-medication. I have seen some almost miraculously positive results and pharmacology is a vital part in most treatment plans but something about the normalisation of antidepressant medication seems to sit uncomfortably.

10 thoughts on “The Drugs Don’t Work (or do they?)

  1. The article regarding the non meds way of treating Schizophrenia was quite an eye opener. It makes me wonder how the ‘support’ can contribute to a sufferer’s wellness. I find it hard to accept that not fiddling around with Dopamine levels (and other chemical imbalances requiring treatment ) can actually have an impact on a prognosis. In all the years my husband has lived with his diagnosis he has never been offered any CBT (or any other therapy) to manage his symptoms. It always revolved around medication levels. He does know that stress particularly at work can trigger an episode of psychosis, so I guess that piece of insight is an advantage for him in managing his condition. Apparently he is not on a CPA because his CPN once said something along the lines that there’s nothing available within services to help him (not entirely sure the correct wording !) .

    As for the ‘Six tips towards choosing an antidepressant’ I was quite relieved to see Sertraline mentioned with such a positive response . It has been the only one out of three meds to have had any effect on me.

    Regards
    Sis x

    • It’s funny, isn’t it? I thought that article was really interesting and particularly useful to note that the NICE guidelines specify more talking therapies for schizophrenia.
      I don’t think we can discount meds but I don’t see why other methods can’t be at least, tried – or at least I do, it’s probably money.

  2. I find psych meds fascinating, and I’m glad I don’t have to prescribe them! No way I would be a good psychiatrist. I do however like to stay informed, especially when I know I have clients who may be seeing multiple doctors for multiple meds, it’s nice to know when something looks fishy…

  3. Woman’s Day is a pretty big magazine here in the US. I actually found the steps pretty generic and really just pointers for discussing with your doctor. Yes, there is a worry that as a culture we are dependent on meds as the first and sometimes only option. I think most doctors take the philosophy that they’ll prescribe something to get people started and then as they start to feel a bit better then get them into therapy if the patient is willing. Unfortunately there are quite a few doctors who keep prescribing the same meds year after year without trying to get the patient to work on some of the issues that might be contributing to the depression.

    As someone who’s had this discussion with her doctor — it often seems like they are pulling a drug name out of the air and saying “we’ll try this” . Patients shouldn’t be afraid to ask their doctor, why are you selecting this particular drug for me? Should the drug not work well or the side effects be too much, the patient needs to be able to go back to their doctor and say “what are our other options”. It should be a dialogue.

    As social workers I think we should talk with our clients about how they are working with their doctor and how their medication is working for them. Help them see they have options and encourage them to take control of the discussion of their healthcare. (easier said than done!)

    • Thanks for the comment, Amy. I guess I’d never heard of it (Woman’s Day, that is) so I didn’t know how big an operation it was! Honestly, some of the advice is useful in that, as you say, it is important to talk through types of medications with doctors – but doctors have a place in our culture and society which sometimes makes their authority difficult to challenge! I know that’s one of the things I’ve been getting my head round in the team I work in!

  4. It’s really interesting to look back at drug use…the Reunion on Radio 4 was talking about Thalidomide on Sunday. In passing, Sue Mcgregor mentioned how tranquillisers were routinely prescribed after the second world war…so much so that by the sixties there was an epidemic of women addicted to them. Thalidomide was a drug that even though the side effects were documented from the beginning of its use and even though Distillers (the drink manufacturer who heavily invested in this wonder drug) had to pay massive compensation, it was never taken off the market completely and is in use now as an anti malarial drug, though there are still issues with its effects on the nervous system.

    When you think back to the 60s and the normal prescription of sedatives to help women ‘cope’, women in Northern Ireland, for example, during the troubles, women here, too who were married to men who could never talk about their experiences in the war, in a way you can see the ground being prepared for an increasing blurring of the lines between illegal and legal drugs as a chemical ‘shut up’ to more natural and democratic ways of dealing with normal and abnormal distress due to war and social and economic upheaval.

    Susan Greenfield has recently written a book: The Quest for Identity in 21st Century Society and although, superficially, the book appears to be about the major issues facing ‘us’ as we become more immersed in technology and the human genome, what struck me is that she seemed really to be warning us that the old liberal language and its expectations had been firmly jettisoned by the underlying power and force of science. The problem is that through technology dividing society neatly into the haves and have nots, young people are being socialised into thinking that they should really die before they get old or poor or ill or weak.

    So the discussion that should happen between all groups in society is not given the time and space to evolve. Protest is controlled (think of the Plane Stupid protestor) as ‘ideology’ (there’s a local authority training guide on how to identify troublemakers in your organisation and what to do about such ‘difficult people’ for example) so, increasingly, we can’t discuss our moral, emotional and physical aches and pains without appearing to be loony or demented.

    Thus, the issues around pharmacy and illness are not accountable in terms our language and culture can recognise. And we take a real life and career risk in blowing the whistle on how our quality of life is diminishing.

    Because we think we understand that science and technology is working for us, we willingly give ourselves up to be guinea pigs to things we know are wrong but have become culturally acceptable.

    I suppose we have to think and work with the notion that we need to think of ways to resourcefully change things, set a standard of diversity, difference and questions to be the norm rather than increasing homgeneity and superficial consensus about capacity and potential over the next hundred years rather than just the next few hours or days!

    • Thanks for that, Soapsoane – lots of interesting stuff there. There are many way to approach the work beyond medication although not necessarily exclusively without it.

  5. Interesting reading, though I admit to not yet reading the articles mentioned in the post.

    The medication issue might [should?] have been challenging for me – a natural medicine practitioner and someone with a clinically depressed relative whom I love dearly.

    Yet it’s not; the person I love spent a year at least, undiagnosed and struggling, drinking hard; dark, humourless, and misanthropic.

    A correct diagnosis, supportive therapies and the ‘right’ medication have enabled my loved one to become himself again, to be functional, more joyous, loving, and lovable.

    Without these combined therapies, and the awareness and support of family and friends, his thoughts of suicide, may well have become actions.

    There is rarely one ‘right’ way, or single therapeutic modality to address a disorder. The journey into depression is often multi-factorial, and the way home to equanimity and quiet joy, will always require more than just medication.

    Margi

    • I completely agree about it being all these things in conjunction. Not just medication, not just therapy but also the balance between the different elements varies from person to person and situation to situation – that’s why it’s important to have a variety of possibilities and not just the ‘prescribe’ option

Comments are closed.