The GoodTherapy.org Position on Psychotropic Medication
As the leading advocate for healthy psychotherapy, we are approached daily by consumers who want advice about psychotropic medication. The most common question people have is whether or not GoodTherapy.org recommends medication to deal with mental health concerns such as depression, anxiety, and others. "Should I take medication for..." is one of the most frequent queries we receive. In all instances we inform our site visitors that the best person to discuss medication with is their health care provider. GoodTherapy.org is not authorized to make recommendations about medication or serve as a substitute for professional advice. However, even though GoodTherapy.org is unable to make specific recommendations about medication or advise people on treatment decisions, the GoodTherapy.org Team feels that is in the best interest of consumers to provide resources on medication and to outline the GoodTherapy.org position on the use of medication for mental health purposes.
Medication Can be Useful. For example, for those overwhelmed with paralyzing anxiety, medication can "turn the volume down." For those unable to get out of bed in the morning because depression has stolen all motivation, medication can provide a "kick-start." And for those with a disabling mental illness, such as schizophrenia, medication can be a necessity. Certain people may benefit from taking psychotropic medication, which is determined on a case by case basis.
Medication Can Support the Psychotherapy Process. Similar to Maslow's hierarchy of needs, it's difficult for most people to focus on symptom relief and self-growth when they are in crisis or struggling with strong symptoms of anxiety or depression, for example. In some cases, medication can help to stabilize a person, allowing him or her to progress further in psychotherapy. Of course, a common outcome of successful psychotherapy is the reduction or elimination of the need for psychotropic and other medications.
Medication Can be Harmful. We recognize that medication is an important part of the therapy process for some individuals. However, psychotropic medications (like all drugs), do not come without potential risks or side effects. Physical side effects from medication may include, but are not limited to, dizziness, drowsiness, changes in appetite, sleep disturbance, and/or weight gain. Side effects can also be emotional/psychological in presentation, including mood swings, loss of interest, or emotional numbness. Use of certain psychotropic medication(s) can also cause permanent damage, such as tardive dyskinesia or Parkinsonism, and may even result in death. One should always discuss the risks of medication use with a qualified health professional.
Medication Can Interfere with the Psychotherapy Process. A common side effect of psychotropic medication is difficulty feeling regular amounts of emotion. For example, many people complain of losing the feelings they used to have, such as being able to laugh or cry. Another common side effect is a decrease in libido. For some, medication can impede emotional processing and serve to cover up underlying issues, therefore slowing or blocking the psychotherapy process. A consequence of taking too much medication and becoming numb to feelings is the increased likelihood that a person won't become conscious of the underlying emotional or somatic burdens which often fuel symptoms.
The Gift of Psychotherapy
Our collective experience is that most emotional and mental health problems are not reducible to a biochemical imbalance. Many psychological concerns originate and are influenced by life events, by what happens to us and around us. Because medications do not change how people relate psychologically to their experiences, medication alone cannot "fix" all psychological issues. Treatment with medication alone can be like stitching up a wound without taking the bullet out.
Studies have found that treatment with psychotherapy and medication together is more effective and longer lasting than treatment with medication alone.*
Research has shown that therapy actually stimulates the growth of neurons and synaptic connections between neurons. Medication for depression, anxiety, and other emotional problems does not do this. This is why therapy can heal core problems and create long-term changes, and why medication cannot.**
For more in depth comparison of medication and psychotherapy, please read "Doctor, do you think I need medication?"
* The Effectiveness of Psychotherapy: The Consumer Reports Study
** A Neurobiologically Informed Perspective on Psychotherapy
If you want more information or resources related to psychotropic medication, please visit our Psychotropic Drug Resources and Links page, below.
Overview of Psychotropic Drugs and Mental Illness
Psychotropic drugs are prescribed to treat a variety of mental health problems when these problems cause significant impairment to healthy functioning. Psychotropic drugs typically work by changing the amounts of important chemicals in the brain called neurotransmitters. Some mental health issues show improvement when neurotransmitters in the brain are increased or decreased. Psychotropic drugs are usually prescribed by a psychiatrist, a psychiatric nurse practitioner (PMHNP), or a primary care physician, though or in some areas a clinical psychologists with prescriptive privileges may prescribe them to clients.
Many people will experience a mental health problem at some point in their lives. Depression and anxiety are among the most common issues, and these issues affect people regardless of age, gender, ethnicity, or background. Researchers still cannot say with certainty what causes most instances of mental illness. Environmental factors and genetics often combine to predispose someone to a particular problem. In other cases, traumatic events or serious injuries result in psychological symptoms that persist for years.
Psychotropic drugs are often not enough by themselves to help someone overcome a mental health issue. Social support from family and friends, structured therapy, lifestyle changes, and other treatment protocols can all be highly important. Severe mental health issues may require rehabilitation before the person can return to everyday life.
Psychotropic Drug Category Descriptions
The following is a list of the major categories of psychotropic drugs:
15 Most Frequently Prescribed Psychotropic Drugs
Based on 2011 data, here is the list of the 15 most prescribed psychotropic drugs in the United States. The number following each drug name indicates how many millions of prescriptions were written during the year 2011.
- Xanax (alprazolam), 47 .7
- Celexa (citalopram), 37.7
- Zoloft (sertraline), 37.2
- Ativan (lorazepam), 27.1
- Prozac (fluoxetine), 24.5
- Lexapro (escitalopram), 23.7
- Desyrel (trazodone HCL), 22.5
- Cymbalta (duloxetine), 17.7
- Valium (diazepam), 14.6
- Seroquel (quetiapine), 14.2
- Paxil (paroxetine), 13.9
- Effexor XR (venlafaxine HCL ER), 12.4
- Wellbutrin XL (bupropion HCL XL), 12.1
- Risperdal (risperidone), 12
- Adderall (amphetamine salts), 9.6