Comments on: Self-Medicating with Over-The-Counter Medicines for Mental Illness

By: Mary E Scott,RPh, CGP

Mary E Scott,RPh, CGP — Mon, 30 Jun 2008 15:11:19 +0000

I absolutely agree with you concerning the widespread tendency to use OTC meds for self-diagnosed conditions without healthcare provider input, esp when it comes to insomnia. People use and abuse OTC antihistamines such as Benadryl and Tylenol PM (which contain diphenhydramine). This med is not recommended for use in the elderly (>65) and yet many of the cognitively impaired residents newly admitted to the nursing facilities I do consulting at are on this and probably have been taking this for years. When their family is told that this may be a cause of their cognitive impairment, they are shocked “Why didn’t her doctor take her off this??”
When the resident is taken off this, and their sleep patterns are examined, it is usually found that they don’t need it, the underlying cause of the insomnia is fixed (pain issues, sleep apnea, GERD,etc), and surprise, surprise, their cognitive function improved, sometimes to an extent that they can be discharged.
I am not blaming the physicians because chances are the patient never told the doctor they were taking this. Usually, they see it advertised on TV, or a well-meaning neighber recommends it, “It works great for me!”

By: Jeffersondavis

Jeffersondavis — Mon, 30 Jun 2008 04:01:33 +0000

I couldn’t disagree more. My modus operandi is that of human freedom. This includes “cognitive freedom”. People should have the freedom to control their own brain function if they so desire. No one seems to object to the legality of alcohol, revealing a bit of the hypocriticality of this outmoded, lingereringly paternalistic line of thinking. Are engineers denied the right to produce their own computer code (other than copyright by the monoliths?) Are people denied the right to represent themselves in court without hiring an attorney? Are woman even denied the right to kill off their own babies (”fetuses”). What I see here is mostly defensiveness over the physician’s last remaining dominion of entitlement, with a potential economic motive creating an inherent conflict of interest that is flagrantly ignored. Don’t worry, there is plenty of money to go around. Many people have no interest in pursuing cognitive improvement of their own, and many will suffer side effects to feed the medical bureaucracy its piece of pie (like the heroin addicts with endocarditis, or the coming hepatitis C epidemic to maintain the transplant industry.

By: Suzanne Go4Counseling

Suzanne Go4Counseling — Wed, 18 Jun 2008 12:48:58 +0000

I’m really glad you used the term “health care provider”. Unfortunately, most people associate this term with their physician. So, I’m not sure the answer to this dilemma. As a body psychotherapist and psychologist I’ve seen problems at both ends. And, from this perspective I own up to a bias against wholeheartedly endorsing clients to see their physicians, when a Chinese herbalist or a naturopath is, in my opinion, is often the better option.

I’ve certainly seen clients who are mixing OTC with their prescription medicines with little regard to interaction effects. So the need for guidance is certainly there. But by far I’ve seen the opposite, questionable “guidance” for clients who are prescribed medication by their physicians when available psychotherapy would have been the more long-lasting solution. In many cases, psychotherapy isn’t even mentioned by their doctor. Yet, some of these clients will be on medication for years for problems that are best treated faster and more effectively by psychotherapy.

I’ve also seen clients being directed to make dramatic changes in dosages and medications by their physicians with little regard to the level of activation present in the client and the impact on the nervous system. I can understand this. Physicians are not trained to notice the level of activation. As a body psychotherapist, that’s my job.

Maybe it’s problems like these that have lead folks to take matters into their own hands. Alternative treatments such as acupuncture, Chinese herbs, naturopathy, bodywork treatments offer a less invasive and gentler approach that complements my work. But these treatments are rarely mentioned by family physicians.

By: charakan

charakan — Tue, 17 Jun 2008 20:22:19 +0000

Good I agree.Self medicating in mental illness is dangerous as the chance for addiction is high and tendency to suicide may also be there if some of these medicines are stopped suddenly..You can question the diagnosis of your doctor and get a second or third opinion but better not to self mediciate..

By: s

Wed, 11 Jun 2008 19:50:57 +0000

While of course I agree that getting professional advice is helpful, it’s simplistic and unrealistic to advocate that nobody should ever self-medicate. The truth is, most people actively use at least some psychoactive substances - caffeine and alcohol being the most common - to modulate their mood, improve concentration, deal with stress, reduce anxiety or enhance experiences. Extending this behavior to other substances is not intrinsically problematic.

Many people can’t afford professional help, or are leery of a medical system that may later stigmatize them for any diagnosis they are given. Moreover, medications are often prescribed with brutal disregard for their psychoactive properties - the common contraceptive pill being a classic example. Lastly, the range of medications likely to be suggested by professionals is highly restricted due to legal and commercial factors: many highly effective psychoactive substances are illegal, while others are not promoted due to lack of financial incentives.

Demystifying the functions of psychoactives through public education is far more helpful than simply saying, do nothing unless advised by a professional. Professionals are not necessarily accessible, knowledgeable or trustworthy, and a self-aware individual can often obtain more effective treatment via personal research.