I have a simple theory that I like to follow when it comes to psychotropic meds: “Simple is Better.” Pretty straight-forward.
When I inherit a new patient with a list of meds the length of the Declaration of Independence AND they’re still depressed despite all the designer brand name drugs at their disposal, I don’t think it takes a medical degree to figure out that something’s not right.
Question 1: Question the diagnosis. Question 2: They’re still depressed—what the heck am I supposed to do about it?
Whereas most might seek comfort in adding yet another miracle drug to the list, I was inspired by one of my Attendings and made a goal to venture in the opposite direction of the less anxiety-provoking intervention and instead take a medication out (slowly, of course, before withdrawal throws them into a far worse state) and maximize the therapeutic benefit of a truly helpful medication at the same time.
And, the outcome? Well, it’s worked out in many of my patients thus far. Maybe my warmth and reassurance helps as well. Only thing I need now is the research to show it (my next residency venture).
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