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pills photoIs Medication Necessary?

By Nicole Pearl, D.O. Psychiatry

Often an individual will question, either alone or together with his or her therapist, whether treatment with a psychotropic medication is needed. While this can be a complex decision, and one that should ultimately be made in conjunction with a comprehensive psychiatric evaluation, there are important guidelines that can be utilized by the individual to assist in an initial self-assessment.

The first question that should be addressed is whether one is generally functioning as usual. Aside from the routine ups and downs of life, ask yourself, “Am I struggling a lot more than I typically do?” “Are my usual coping skills intact or failing?” “Have my friends or family voiced concerns about changes in my behavior? “

Below is a list of 5 different categories into which general functioning issues are divided:

1. Somatic (body) symptoms – less energy, increased fatigue, changes in sleep and appetite.

2. Cognitive symptoms – decreased concentration and processing speed, – taking longer to perform usual tasks, memory deficits.

3. Emotional – mood changes (which can include feeling sad, worried, irritable, euphoric, angry) as well as less
enjoyment of and interest in usual activities/hobbies.

4. Social/Interpersonal– avoidance of friends, decreased tolerance of others, increased time alone – often spent
at home.

5. Professional – increase in missed days of work, decrease in job performance and efficiency, indifference toward
poor work performance.

While the presence of several of the above signs and symptoms most probably warrant a medication assessment, the decision to begin psychopharmacologic treatment should also be based on the severity of these symptoms and the degree to which they impact the individual’s life. However, if difficulties exist in all of the above categories, the individual would most likely benefit from a trial of psychotropic medication.


Nicole A. Pearl, D.O.

Psychiatrist, RCSF