The Limits of Medication
Prescription treatment for mental health conditions is usually helpful, sometimes a necessity, but often has significant limitations.
Generally speaking, psychiatric medications havefairly good outcomes. But unfortunately, these outcomes are usually not especially great. They often leave quite a large gap of unimproved symptoms and levels of suffering. They also do very little to reverse the poor habits and behavioral patterns which have built up over time as a result of having such conditions. This is where the CNS concept of multi-faceted care comes in: we attempt to target and improve the areas in which traditional care has been unsuccessful in improving (in addition to providing traditional care, of course).
In a recent and extremely large national study on the treatment of depression (STAR-D), the results show the following: after the doctor prescribes the first anti-depressant, only about 35% of patients have significant improvement! For those who did not respond, after the doctor switches to a different prescription, a total of about 60% of patients show significant improvement. Further attempts with different prescription medications generally yield a modest improvement. As one can see,depressive symptoms in a lot of individuals have not improved, and even among the individuals who have improved there remains many unimproved residual symptoms.
Another example of the limits of medication can be seen in patients with bipolar disorder. For bipolar disorder, only about 30% of individuals need only one medication to maintain health. The majority of individuals with bipolar disorder, roughly 70%, need multiple medications to maintain their health, sometimes two or three or even more. Another example is ADHD. For individuals with ADHD, one common class of medication treatments results in only 30-50% improvement rates. Another type of medication results in approximately 50-70% improvement rates, and finally a third class of treatment has much better results of 70-90% improvement. However, even in the case of the latter more effective drugs, there are often more adverse side effects. Also, there are entire symptom areas which are not traditionally improved. For example, even with the highly effective drug treatment options, hyperactive symptoms do not improve as much as inattentive ones. Certainly, none of these medications do anything to reverse the engrained poor habits that have built up over time: the poor studying or work habits, explosive fights in relationships, and nonexistent time management skills.
As can be seen in our “Science of CNS” webpage, the use of non-medication therapies in combination with medication and traditional care results in better outcomes for individuals struggling with these difficult conditions. Better outcomes leads to better functioning, and more overall improvement, and sometimes, less of a need for medications.