Doctor please, no more of these

I have been working as a psychiatrist for over 28 years and the one question I get on regular bases from my patients is “doctor, would I get addicted to antidepressants?”

And despite saying no and citing the evidence, people still stop their medication even when are just starting to get better which leads them to experience a relapse of their symptoms and we have to restart the process all over again and again.

People from different backgrounds hold this misconception that antidepressants are addictive, you could be talking to a chain smoker or someone addicted to hard drugs like heroin and cocaine but when it comes to prescribed medication they are worried about addiction.

I sometimes try to use the analog of using insulin for someone with diabetes but despite people agreeing that they will take insulin forever if advised by their doctor but they would not take antidepressants.

When asking the question, why do people stop their antidepressants?

The following can provide an explanation. First is a stigma that is associated with mental illness. People sometimes believe that someone is weak or not religious enough when they say they are experiencing mental health problems so they tend to hide it from their families and hide the fact they are taking medication.

Some family members force the person to stop their medication even when they are helping them remain well.

The second factor is a lack of awareness about how medication work. From a scientific point of view, antidepressants need two weeks to twenty days to work fully yet so some patients stop them from the first few days because they did not understand this point when the doctor explained it.

The third reason is that, like other medications, antidepressants can cause side effects that can be troubling to the patient so they stop them without informing their doctor who can recommend an alternative.

The fourth reason that is worth mentioning is cost as some patients have to pay for their medication and can’t get it free from government hospitals.

So what can we do to help patients stay on their medication? In my opinion, having a clear conversation with patients about the role of medication and when they work is an essential step.

People have the right to know and would respect a doctor who is clear and honest with them.

Also one should allow the patient to ask questions and encourage them to do that. I personally make it a point to ask the patient toward the end of our session if he or she has any questions and suggest writing their questions if they have any after they have left the clinic so we can discuss them in the following session.

Some patients prefer to read about the medication before taking them in that case.

I recommend to them scientifically trusted websites to read from and not any angry patients who may have had one unpleasant experience which makes their opinion biased.

Finally, it’s important to provide the patient with psychological therapy that is appropriate to his or her condition and explain that for some patients, therapy alone is not enough and a combination of medication with therapy gives them a better chance of recovery.