If you have ever worked in a hospital or community mental-health setting, you have likely seen how quickly our system turns to psychotropic medication when someone is experiencing psychosis. For some people, medication is absolutely essential. But it is just as important that individuals understand the full picture: the benefits, the risks, and the alternatives to relying on medication or involuntary hospitalization. This also raises a bigger question for all of us in the field: who is truly being served when we default to medicating or hospitalizing someone in acute psychosis? And what does it mean for our society when this approach becomes the expected norm?

 

Side Effects

• There has been increasing evidence that antipsychotic medications are also neurotoxic (e.g., Jackson, 2005). Robert Whitaker (2002) has summarized the evidence that countries that cannot afford to medicate within five years have many more long-term recoveries and far fewer chronically psychotic patients than countries where nearly every patient is medicated.

• Deikman and L. Whitaker (1979) demonstrated that a ward where no psychotic patients were medicated, but every crisis was handled psychotherapeutically, had fewer suicide attempts, fewer suicides, fewer runaways, and a lower rehospitalization rate than a comparison ward with expert psychopharmacology, more staff, and a policy of transferring their most difficult patients to the state hospital. (The psychotherapeutic ward did not transfer any patients, but treated them all.)