Usually about 20-50 percent of my patients are taking psychiatric medication. Psychiatric medication can be extremely useful, even crucial; however, it is often misprescribed.
About one out of every five times I see a new patient who is already on psychiatric medication, the person has been prescribed the wrong medication. Someone might ask how I know, as I am not a medical doctor. First of all, if a medication isn't working, then someone should not be taking it. Secondly, my consulting work in psychiatric facilities involves reading the entire medical records of patients. I've read the records of severely ill patients who are taking three, four, or even five medications. I spend time discussing clinical care with the prescribers in the hospitals (along with a multidisciplinary team including our team psychiatrist). What this means is that I've become extremely familiar with both the intended effects, side effects and possible adverse reactions of most psychiatric medications.
Some common errors I have seen are: Prescribing dangerous anti-psychotic medications instead of anti-depressants to depressed patients, failing to properly diagnose conditions such as Attention Deficit Hyperactivity Disorder in adults, failing to prescribe mood stabilizers when warranted, prescribing anti-anxiety medications for what is actually depression, failing to consider the consequences of prescribing addictive medications to persons who already have addictions, and more.
Several years ago I had two patients who were being prescribed Zyprexa, an anti-psychotic with potentially serious side effects. I knew this was not the right medication for these two depressed patients. In one case, I called the patient's psychiatrist and suggested changing the medication to something else. The doctor decided to try something different and the patient improved markedly. In the second case, the doctor (a different doctor) ignored my suggestion and the patient tried to kill herself. Fortunately, she did not die, and I made sure she was admitted to a hospital where her medication regimen was changed.
In other cases I have just spoken directly with the patient and suggested they talk to their prescriber about their medication. Sometimes this is effective. In one case, the patient had been taking a medication for panic disorder even though she did not have panic disorder. She had been dutifully taking this medication every day (a highly addictive medication) and had begun to wonder if it was making her sleepy. Her doctor agreed she could reduce the medication and she quickly became less sleepy without developing any more anxiety.
I have often thought in recent years that the practice of medicine in this country leaves much to be desired. The explanation of one of my colleagues is "today doctors treat symptoms instead of illnesses." He's probably right. Without figuring out what the underlying illness is, the medication can be wrong and even dangerously wrong.
If you need psychiatric medication, or a new prescriber, I can refer you to someone whom I believe to be competent.
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