Avoiding diminishing returns with psychotropics

At risk of stating the obvious, psychotropics are prescribed to people to treat symptoms,  not to make them feel better.  Yet many people  make the mistake of thinking that psychotropics are designed to make them feel better. We need to remind ourselves,  many miserable people sleep just fine and have lots of energy. Your prescriber certainly may want you to feel better overall, but they are precribing the pill(s) to treat certain symptoms, such as decreased sleep or low energy. They are true specialists in that sense. It is usually not a zero sum game either. If on a scale of 1-10  (10 being the best sleep possible) , your sleep as at a 2 and now it is at 4 after psychotropics, that may be all you can expect from psychotropics. Patients and prescribers often make the mistake of chasing these symptoms to try to bump up the 4 higher to 5 or 6, and even that may not satisfy them. The problem arises when frequent changes in their psychotropics cause other symptoms that lower general well-being, or the the frequent changes  distracts the patient from other approaches to improving their well-being.  Not to mention the emotional roller coaster ride it can be.

I don’t suggest giving up on psychotropics, but be clear what symptoms your prescriber is focusing on and what they generally expect from your particular pill in terms of improvement. It will help you avoid a lot of frustration and putting all your eggs in one basket.

So here is a 3 item checklist to use for each appointment with a prescriber:

1. Know symptoms they are treating

2. Know how much improvement they’d expect to see with each symptom with what they are precribing to you.

3. Know potential side effects


I wish it went without saying, but  also stay active in finding  other ways to address the issues that impact your overall well-being.

I don’t think you ought to put more than 20% of your overall change effort (time, energy, money, emotion)  into the pursuit of the right psychotropics.


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