the least intrusive therapy is always best, miles. issues arise when the patient's symptoms are so difficult or distracting to the patient that "talk" therapy simply doesn't work. then a decision must be made. often the most effective therapy is a combination of medication and conversation (in the professional sense).
john's point about carefully monitoring patients taking drugs is essential, particularly in the initial stages. when a drug is properly titrated and is working effectively, close monitoring is not necessary. but the patient must always give the therapist feedback -- and the therapist must react immediately -- if changes or problems occur. side effects can come up at any stage in treatment for various reasons.
also, the issue of the synergistic effect of drugs must be carefully considered. in other words, if a patient is taking other drugs for other medical problems, the possible interaction of such drugs with psychiatric medication must be evaluated.
certain foods also effect the action of some drugs. for instance, a class of ADs called MAOIs -- monoamine oxidase inhibitors -- or MAOs for short, require extensive dietary restrictions. this tends to make MAOs rather unpopular.
to put it simply, drug treatment is nothing to mess around with. i can't over emphasize that each individual is different. therapy must take this fact in to account, otherwise it's worthless. not everyone needs drug therapy; but if you know someone who does, make sure it's done correctly.
R
At 12:15 AM 7/30/2004, you wrote:
>On Thu, 29 Jul 2004, John Thornton wrote:
>
> > People taking AD's need to have someone monitor their
> > behavior carefully. We still do not know enough about these drugs to treat
> > them as cavalierly as we so often seem to do. It seems sometimes as if the
> > desire not to stigmatize patients on AD's works to suppress awareness
> > and/or discussions of the need to carefully monitor a patients behavior for
> > potentially fatal side effects. Whenever I mention the possible negative
> > side effects I am almost always hit with a reply about how much good they
> > do as if saying anything bad about AD's means I desire to have them banned
> > or believe them to be more harmful than beneficial. That simply isn't true.
>
>I agree that people seem to have a pretty cavalier attitude about these
>powerful drugs. This is one signficant reason why psychotherapy is
>often more effective (and safer!) than drug therapy for the treatment
>of various psychological problems.
>
>Miles