By: Chris Anderson Psy.D.

Most of us know how many medications there are from the endless barrage of television commercials. The staggering number of medications the FDA has approved is over 19,000 medications. Many people wonder, given the wide variety of medications to choose from, how a psychiatrist will pick the medication that is best suited to your particular needs and circumstances. Let’s explore some of the decision-making processes for making a selection.

What Class of Medication?

In some ways, this is probably one of the most straightforward decisions in the process of whittling down a selection. Psychiatrists are exceptionally knowledgeable and conversant in psychotropic medications, which are the several groups of medicines designed to treat mental health and substance abuse disorders. They mainly cover anti-depressants, anti-anxieties, mood stabilizers, anti-psychotics, and psychostimulants. Psychiatrists evaluate a client’s symptoms to arrive at a diagnosis. This diagnosis determines which group of psychotropic medications will likely be used. As some of the class names suggest, depressive disorders are usually treated with anti-depressants, and accordingly, schizophrenia and psychotic disorders with antipsychotic medications. Mood stabilizers are typically used for bipolar disorder, and psychostimulants for ADHD. Interestingly, many anxiety disorders respond very well to anti-depressant medications and will be used often before an anti-anxiety medication from the benzodiazepine family. Psychiatrists are also skilled at knowing what type of other medication classes may be effective with specific diagnoses. In some instances, beta-blockers, antihistamines, or other groups of medications can produce surprising results.

How is the Decision Further Narrowed?

The class of medication designed for a particular group of mental health issues is pretty intuitive. Within each class group, there can be dozens of options. Here are some of the additional variables used in coming to a decision about choosing a specific medication to prescribe:

  • Previous Medication Trials: Psychiatrists routinely inquire about what other medications a client may have tried in the past and will also want to know how well it worked. For instance, certain anti-depressants share some common features and mechanisms of action. If one failed poorly or produced some particular negative side-effects, this may help your psychiatrist rule out some possible choices.
  • Family History and Efficacy: It is not uncommon that certain conditions, such as depression, anxiety, ADHD, and bipolar disorder, run in families. In many cases, other family members are treated for the same condition. Psychiatrists want to know what medications other family members have tried and how well they worked, which can also help guide the decision-making process. Because family members share a percentage of the same genetics, there is a higher probability that a medication that works well for your mother may also work well for you.
  • Symptom Presentation: Some conditions can have very different presentations. Some depressions can present with psychotic features, some with very vegetative symptoms, and some with very impairing focus and concentration. Certain medications can be particularly good at targeting specific symptoms with a diagnosis. Your psychiatrist will evaluate your symptoms’ presentation to narrow their selection further.
  • Gene Sight Testing: Historically, the reality of psychiatric care is that people play a certain amount of human guinea pig with themselves. Psychiatrists know what these medications do for most people, but until we put them in our bodies, we don’t have a clue what they will do. Gene Sight testing is not yet FDA-approved but is gaining in popularity. A simple cheek swab collects some of your DNA, which is sent in for analysis, and a report is generated that will tell you with around 99% accuracy which medications will be most effective in your body. Your genes provide information on how medications will break down in your system and can give information about the probable responses and side effects to specific medicines. This often takes the guesswork and trial and error approach in selecting medications. The report you receive from this testing breaks down all the medication classes and which medications you will respond best and worst to. Having this information for your psychiatrist can make treatment much easier.

If you want to meet with a psychiatrist to explore treating your concerns, feel free to contact IPC so you can schedule an appointment with one of our psychiatric providers for a more thorough assessment.  Please call us now at 763-416-4167, or request an appointment on our website: WWW.IPC-MN.COM so we can sit down with you and complete a comprehensive assessment and help you develop a plan of action that will work for you. Life is too short to be unhappy. Find the peace of mind you deserve.

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