Polypharmacy Treatment Requires As Much Faith As Science
As I’ve said, mental illness treatments often don’t work. And you have to keep trying treatment anyway. Because without doing anything new, you are condemned to being stuck in the same mental illness mire you are currently in.
But in all honesty, mental illness treatment requires faith. Trying psych med after failed psych med requires a belief that something will work in spite of the evidence to the contrary. It requires a belief that is not based on personal experience.
I hate that.
Why Does Mental Illness Treatment Require Faith?
Faith has several definitions, one is:
A strong or unshakeable belief in something, especially without proof or evidence.
And let’s face it, that describes a lot of what we do in mental health treatment. Don’t get me wrong, that doesn’t mean it isn’t going to work, but it does mean that trying treatment after failed treatment requires more faith than logic.
Faith in Polypharmacy (Multiple Medications)
Seriously-ill folks, often with bipolar, schizophrenia and treatment-resistant depression, are typically on lots of medication: One or two antipsychotics plus one or two mood stabilizers plus an antidepressant. Some of us get by with less medication, but many don’t.
And there is little evidence about the efficacy of polypharmacy, or indeed, how to go about applying it.
And yet, many people are on multiple psych meds.
[push]For bipolar, there was a recent recommendation against antipsychotic polypharmacy stating multiple antipsychotics are not more than effective than one, and they pose greater side effect risks.[/push]
Sure, you could blame an evil drug company conspiracy, but I suspect the answer is much simpler: it just works better for some individuals. But those people need faith to believe that. These people need faith that using these medications provides their best treatment outcome.
And all those people on antipsychotics plus anticonvulsants plus antidepressants are really going it alone. These just are no studies in these situations.
Studies on Polypharmacy
But of course there are few studies on polypharmacy. There are innumerable combinations and trying to find funding for this kind of research is extremely difficult. And even if you could, the outcome would be extremely hard to interpret due to the number of variables involved.
(There are a few exceptions. For example, fluoxetine (antidepressant) and olanzapine (antipsychotic) have been tested and approved together under the name Symbyax. Of course that is only two medications and not the many on which many of us find ourselves.)
You Gotta Have Faith
(Feel free to hum George Michael at this point. I can’t seem to stop doing it.)
My personal cocktail is on the ridiculous side of treatment. It’s that kind of cocktail doctors despise. And my doctor, being responsible, would like to reduce the number of meds.
I get it. I do.
But I really, really don’t want to get worse. Or, you know, dead.
So I have to have faith. I have to have faith that making an alteration to this cocktail will be beneficial in the long run.
But I Hate Faith
But I’m not big on faith. I’m not big on anything that isn’t logical and evidence-based. Unfortunately, that just isn’t an option here.
I have to fake faith. The idea of which make me smile.
I suspect if George had written that oxymornic statement, his song wouldn’t have been such a hit.
(Of course, he was faking heterosexuality, so maybe he’d appreciate the irony.)