The Promise and Perils of Medication

I don t want to go on medication my patient Sarah said to me, ah most in tears. I ve seen what it s done to my mother. She went on antidepressants ten years ago, and it s always the same—they work great for a few months, then they don t, and then she s worse. Then the doctor puts her on some new medication, and the whole thing starts all over again.  

Sarah was unusual among my patients, many of whom come to me eager for the antidepressants about which they ve heard so much. Both physicians and psychiatrists have come to view such medications as Paxil, Zoloft, and Wellbutrin as true wonder drugs, medicines that have succeeded where traditional talk therapy and other approaches have failed. Even Prozac, despite the rash of bad publicity that it got for a while, continues to enjoy a reputation as a cure-all for anxiety and depression. 

But Sarah s mother s predicament—a long-term reliance on medications that often work best only in the short term—is all too common, even if these more mundane problems of antidepressants don t get the public attention of the notorious suicides and psychotic episodes that were associated with Prozac in the early 1990s. Although I do prescribe antidepressants to my patients who need them, I also feel concerned about what I see as the overreliance on medication among psychiatrists, primary-care doctors, and other health professionals. For some people, antidepressants may indeed be a kind of wonder drug, balancing their 

When I was first learning to practice psychiatry, the pharmacological repertory was fairly limited. The standard treatment for depression was to prescribe one of two classes of drugs, MAO inhibitors and tricyclic 

Then came the new class of antidepressants, and it seemed like a miracle. These new medications were significantly more specific in rebalancing only those aspects of brain chemistry whose imbalance was causing depression. 

---