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Medication


"There are no drugs that will make you
immune to stress or pain or that will by
themselves magically solve your life
problems or promote healing. It will take
conscious effort on your part to move in a
direction of healing and inner peace."
(Dr Jon Kabat-Zinn)

There is some worry concerning the use of medication to treat psychological health problems because of the perceived risks of side effects. Very few people like to take medication, but problems like chronic stress, anxiety and depression can be very severe and if untreated lower our physical health and destroy our quality of life. Not everybody's psychological health problem is severe enough to require medication, it may be treatable by self help methods and talking therapies alone. However in severe cases where the health problem is interfering with life, a GP assessment may indicate that medication is warranted.

The twin track approach of medication and talking therapy has the backing of the Royal College of Psychiatrists and The Royal College of General Practitioners.

There is a natural hesitance among people to take medication and in some cases this can mean the health problem isn't adequately treated and relieved. Research has shown 50% of people on anti-depressants do not take them properly. In some cases where medication is indicated and taken, it has literally transformed the person's life for the better.


MEDICATION MYTHS

Part of the reluctance to take medication is possibly the mis-perception that it may alter the person's personality and turn them into an addicted zombie. This is far from correct. It is true that in the early 1960's and 70's tranquiliser medications were prescribed liberally and experience revealed that people became addicted to them. New pharmaceutical prescription guidelines, put in place by the Committee for Safe Medicines, mean tranquilizers should now never be routinely prescribed, and if an individual case does warrant medication, it is usually only prescribed for a maximum of four weeks.


ANTI-ANXIETY MEDICATIONS/TRANQUILIZERS

There are a number of different classes of anti-anxiety medications such as beta blockers,so benzodiazepines are now only used as a last resort and where possible only for a few weeks because of their potential addictive nature. Some people who had taken them on a long term basis in the 1960's and 1970's became addicted to them. They work by increasing the levels of naturally occuring anti-anxiety chemicals in the brain to reduce our anxiety levels. Newer drugs are being developed that claim not to be addictive. Your GP may prescribe you an anti-depressant medication for your anxiety even though you may not be clinically depressed; the reason for this is that it has been found that in some people anti-depressants can help to lower excess anxiety.


ANTI-DEPRESSANT MEDICATION

Clinical depression is thought to be caused by low levels of a number of chemicals in the brain that normally improve mood. Anti-depressant medication works by boosting these low chemical levels. There are different types of anti-depressants and newer ones are being developed all the time, unfortunately some people who may be clinically depressed refuse to take their medication, and this potentially means that the depression is not properly treated and could actually get worse. Research shows that the more quickly your problem is identified and treated then the less severe it becomes and the higher chance of preventing a relapse.

Anti-depressants should never be used on their own but should ideally form part of a package of treatment including where appropriate the talking therapies. Research has shown that people whose illness is severe who receive medication and one of the talking therapies do better than people who receive only medication or only talking therapy. Some people won't get any benefit from the talking therapy on its own, because they are so low and severely depressed, but when the talking therapy is combined with medication they are then able to benefit from the talking therapy. Anti-depressant medications are not addictive but you should never suddenly stop medication without your GP's knowledge.


SIDE EFFECTS OF MEDICATION

There is no such thing as a 100% safe, risk free, medication. Even the the so-called herbal treatments can and do have side effects. Unfortunately life isn't risk free, everything we do has a theoretical risk. We have to balance the risk of things we do against the potential gain. Taking medication isn't ideal but we don't live in a perfect or ideal world. Chronic diseases like anxiety/depression are severe diseases that can and do wreak havoc on people's psychological, physiological and social lives and should never be treated lightly.

There can be side effects of medication in a few people, and 80% of people stop taking their medication due to side effects. Not everybody suffers side effects and in the people that do the majority of these are minor and resolve themselves after they have been taking them for a short time. It's important to discuss any side effects you may experience with your GP who may decide to try you on another different type of medication. We need to balance the potential risks of taking the medication with the risks of not taking the medication. For example in some severely depressed people who don't take medication, there is a risk of suicide. Left untreated depression can increase our risk of suffering many health problems such as heart disease. Research has shown that taking anti-depressant medication can reduce our risk of heart attack or stroke.

To come to a balanced decision we have to ensure the information we are given is accurate and up to date. The media, friends and relatives are well-meaning when they offer advice but they are not qualified health professionals and therefore do not have up to date information, so the advice they give may not be correct, despite how well meaning it is.

Drugs are not the long term, ideal solution for every case, except for serious cases. If you have any concerns discuss them with your doctor or pharmacist. It is also vital to deal with the psychological issues like chronic unresolved stress that may have played a role in the development of your health problem.

In the packet of medication you will find a leaflet that by law lists all known, potential side effects that can occur with that pharmaceutical. Don't worry it doesn't mean every person taking it may develop all these side effects. Even if only a very few people out of millions taking the drug suffered that side effect, by law it still has to be listed.


TAKING MEDICATION

Research has indicated that many people are not taking their medication as prescribed and so are not obtaining the full benefits. For example research has shown that 50% of people do not take their anti-depressant medication properly. It is important to take the medication as per instructions, check whether you have to take it before, during or after meals. This is important because this can affect the medication's absorption and therefore it's effectiveness.

You have to allow a number of weeks for the medication to build up in your bloodstream, so you may not notice benefits at first but its important to persevere and keep taking it, and you will notice the benefits. Once the medication has lifted the depression don't stop taking it, because you could suffer a relapse. The current advice is to keep taking the anti-depressant for up to 6 months. Doing this will help to prevent another flare up of depression in the future.


ALCOHOL AND MEDICATION

Also be careful what drink you use to swallow tablets. For example, if you consume grapefruit juice when taking the contraceptive pill it can reduce the pills effectiveness, so it's best to take medicines with plain water.

If you take alcohol with anti-depressant drugs it also can reduce the anti-depressant's benefit.


HERBAL ALTERNATIVES

If you decide to use herbal medicine make sure you contact a fully qualified medical herbalist from the National Institute of Medical Herbalists. At the moment the popular press if full of articles about the so-called "sunshine herb" - St John's Wort - that is claimed to have an antidepressant action. Some research indicates that it can be of help for some cases of mild to moderate depression. However caution has to be taken if you decide to use this approach. There seems to be a popular view that if a product is natural then it is 100% safe but this isn't strictly true. For example research has indicated that if you are taking certain medications like the contraceptive pill or anti-clotting medication and take St John's Wort with it, then the St John's Wort can reduce the effectiveness of the other medications. So great care has to be taken. Its never wise to self treat your own health problem. It is vital that you get an accurate diagnosis and assessment from you GP first and discuss with him the merits of St John's Wort in your particular case.

Your health problems may also need to be treated with one of the talking therapies and its wise to learn stress management techniques to adopt new ways of dealing with your problems. Many people go to their local health food shop and buy the herb over the counter. Psychological problems can be severe and complex and its vital that you obtain the right treatment. Despite what people claim some herbs can have side effects, so if you want to treat your depression with herbs its vital to consult a well qualified Medical Herbalist from the National Institute of Medical Herbalists. Their address is given on the addresses page of this site.

Psychological health problems must not be treated lightly and if you do consult a Medical Herbalist make sure you have got a diagnosis and had an assessment from your GP first because anxiety and depression can also be caused by medical conditions such as a malfunctioning thyroid gland and so will need medical treatment.

Whether you are being treated by herbs or with orthodox medication it is vital that you also make lifestyle changes such as taking regular exercise, eating a healthy diet, reducing alcohol and caffeine and learning new positive coping strategies. Never just treat the symptoms even if it is with a herb.


MEDICATION SOURCES

1. Barnes T. (1997) Dealing with Depression, Samaritans.

2. Bloomfield H.H. (1998), Healing Anxiety Naturally, Thorsons.

3. Kabat-Zinn J. (1996), Full Catastrophe Living, Piatkus.

4. McKenna J. (1999), Alternatives to Tranquilizers, New Leaf Books.

 
ARTICLES ON MEDICATION

www.nimh.nih.gov/publicat/medicate.cfm

MEDICATION DATABASES

www.nmhct.nhs.uk/pharmacy/drug_idx.htm

Electronic Medicines Compendium