Fully one in five American adults are taking psychiatric medications, and antidepressants have surpassed blood pressure medication as the most commonly prescribed class of drugs. These drugs have become a normative response to almost all of psychological suffering. There is overwhelming evidence that pharmacologic treatment response is profoundly shaped by a range of psychological and social factors. The non-medical characteristics of the pill, the patient's underlying psychology, the prescriber's attributes, and, perhaps most of all, the quality of the pharmacotherapeutic alliance can make the difference between a medication that works and one that fails.
An integrated perspective has a broad range of implications for treatment. Psychodynamic Psychopharmacology, an approach to pharmacologic treatment resistance developed by Dr. David Mintz and his Riggs colleagues is one such effort. By focusing on the complex interactions of meaning and biology, emphasizing the patient’s authority, and mobilizing the healing potential of relationships, this approach endeavors to reverse established patterns of medication non-response.
In the September 11 issue of the Proceedings of the National Academy of Sciences researchers at Massachusetts General Hospital have found that placebo/nocebo effects occur at the unconscious level, challenging the exclusive role of awareness and conscious cognitions in placebo responses. [read more]