By John Shin, MD

If given in the appropriate way, medication use for psychiatric illnesses can be highly effective. That is we need to optimize the conditions in which medication is taken. There are three major reasons medications do not work or do not work well over time. These are: 1. The need to take medications consistently; 2. The negative impact of drugs and alcohol on psychiatric medications; and, 3. The interaction of stress on medications.

If one does not take medications in a consistent fashion medication intervention simply will not work. There are several reasons medications are not taken consistently including but not limited to forgetting to take the medicine, unpleasant side effects, and impatience waiting for positive benefits of the medication to be noticed or experienced. Forgetting to take medication can be corrected by use of pill boxes or use of phone reminders. Being educated about the side effects of medication is critical and knowing how to best counteract mild side-effects is often helpful. Medication side-effects may make it challenging to take medications in the first place. Many times medications side-effects often are short-lived but if they persist, the medication can often be changed to one that is better tolerated. Also, medication effects may take weeks to work and patience may be needed. The beneficial effects may be noted first by others and the patient may be the last one to know. Asking others if they observe initial progress may encourage the patient to take medications longer until the patient notes the positive effects for themselves.

Another barrier to effective use of medications is the use of drugs or alcohol. The use of alcohol and other drugs can counteract the effectiveness of any psychiatric medication. It would be best not to use any drugs or alcohol, which can decrease the positive impact of the psychiatric medication. The use of certain prescription medications can make treatment of psychiatric conditions harder to accomplish. Also use of supplements, synthetic or herbal, may interact negatively or cause undue side-effects when combined with psychiatric medications. It is critical for a psychiatrist or medical professional trained and knowledgeable in use and possible interactions with psychiatric medications be aware of all other chemicals substances and supplements of any kind a person might be using in combination with psychiatric medications to reduce risk and maximize benefit.

The impact of stress cannot be understated. If stress level rises, higher dose of medication may be needed, leading to more exposure to side-effects. Thus, the ability to handle stress is paramount to ensure medication work for the long-term. We can accomplish stress reduction in several ways. We can ensure we eat healthy, sleep well and be physically active. Fast food and junk food may feel good at the time when we eat, but over time is a drag on our mood. Our mood state is worsened with poor sleep. Keeping physically active can help us deal with stress better and also help us feel more energetic and elevate our mood. Doing things we enjoy gives us meaning in life and helps us manage stress better. Talking to a friend, participating in psychotherapy, being spiritually active are all ways that help with stress management.

Use of psychiatric medications can help treat mental illness effectively, but we need to ensure we set ourselves up for success. In order to be most successful with medication intervention for treating psychiatric illnesses, we need to take medications consistently, not use drugs or alcohol, and be able to deal with stress effectively. These strategies will help ensure we make best use of psychiatric medication to more effectively manage mental health disorders. John Shin, MD at Behavioral Healthcare Associates, LLC is available to assist patients of all ages with psychiatric medication evaluation and management. His colleagues are available to provide mental health evaluations and psychotherapy interventions. You can call 919-292-1464 for more information or to schedule an appointment.