about treatment and where to get help

What about herbal medications?
Many people feel that while medications from a pharmacy are synthetic, herbs are in some way a more natural alternative. It is certainly true that a range of plant products can be useful for mood and anxiety symptoms. However, the contrast of synthetic medications and natural herbs is too simplistic. For one thing, many medications were in fact originally developed from plants. And conversely, many herbs work in very similar ways to medications, and so have similar benefits and side effects. What is crucial to understand here is how very specific are the chemicals that help treat the mood and anxiety symptoms. To use the metaphor described above, there are only a few locks and a few keys known to turn off depression and anxiety.

How long will I need to take medication?
One of the main concerns that people have about taking medication is the question of how long they will need to be on medication. It is important to emphasize that the antidepressants are not associated with dependence and so can be stopped at any point in time. On the other hand, it should also be emphasized that discontinuing medication too early is associated with a high risk of relapse. All too often, people feel better after taking 3 or 4 months of medication and so stop their medications at that point. Unfortunately, symptoms frequently return a few weeks later.

Three principles that need to be considered when taking psychiatric medications. First, medication should be continued for at least 6 to 9 months after symptoms have responded to treatment. This will lower the chances of relapse once the medication is no longer present. Second, medication should be tapered gradually rather than discontinued abruptly. This not only avoids certain physical symptoms that can be seen after abrupt discontinuation of some antidepressants, but it also provides the person a chance to gradually accommodate to life without medication. Third, the use of cognitive-behavioural therapy has been shown to decrease the chances of relapse after medication discontinuation. Thus, it would be worthwhile learning the principles of this therapy prior to discontinuing medication, and making sure that these are applied during the discontinuation period.

For more information about medication or any other mental health issue contact the
Mental Health Information Centre of South Africa, tel +27 21 938-9229.
You can also ask your GP for a copy of the Medications chapter in the False Alarm! How to conquer the Anxiety Disorders patient guide.

Further references / resources

• Food and Drug Administration (USA)
  HFI-40, Rockville, MD, 2087
  Tel: 1-888-463-6332, Internet: http://www.fda.gov
• Medicines Control Council (England)
  10-2 Market Towers, 1 Nine Elms Lane
  London, SW85NQ, UK
  Tel: (020) 7084 2000 or (020) 7210 3000/ Fax: (020) 7084 2353, E-mail: info@mhra.gsi.gov.uk
• Medicines Information Centre (South Africa)
  University of Cape Town, Dept of Pharmacology,
  Medical School, Observatory, 7925
  Tel: (021) 406 6280 / Fax: (021) 448 3202

Books about psychiatric medications
The Complete Guide to Psychiatric Drugs: Straight Talk for Best Results. Edward H. Drummond. John Wiley & Sons, 2000.
Consumer’s Guide to Psychiatric Drugs. John D. Preston, John H. O’Neal and Mary C. Talaga. New Harbinger Publications, 2000.
The Essential Guide to Psychiatric Drugs (3rd ed.). Jack M. Gorman. St. Martin’s Paperbacks, 1998.