A comparison between medication and therapy
Both
forms of treatment seek the same result, for the patient to have a balanced
mental life. However, both of them come with different pros and cons that allow
the patients to decide what the best option would be for them. In the case of
medication, one of them is side-effects. An example of this would be the
outcome the Food and Drug Administration (FDA) obtained when they conducted a
review in 2004. The results of the metanalysis suggested that, for children
with major depressive disorder (MDD), antidepressants double the risk of
suicide attempts (NIHM, n. d.) This is why antidepressants that are given to
children have a black box as a warning signal, the black box warns parents
about the worsening of other symptoms such as asocial activity and insomnia.
However, this is not only limited to antidepressant medications, but rather to
every form of drug therapy. An example of this is PTSD medication, which the
side effects include convulsions, sudden loss of consciousness, loss of bladder
control, muscle spams, blurred vision, dry skin, chest pain. weight gain or
loss, hair loss, heartburn, indigestion, and, but not limited to, insomnia
(Sertraline, n. d.).
This
falls into greater contrast when it is compared to one of the biggest criticism
therapy receives, which is that it takes too long. Usually, people start
observing the effects of antidepressants after two weeks, but some forms of
therapy take years to complete. However, this is not true for every mental
disorder. For example, a study found that the symptoms of Attention Deficit
Disorder with Hyperactivity (ADHD) were managed in therapy in a shorter time
when compared to methylphenidate, also known as Ritalin, which is the most
common medication for the disorder mentioned above. In the study,
psychoanalytic therapy was able to aid patients with ADHD in twenty-five months
and for the drug it was twenty-nine (Laeser, 2015).
This
creates a very important advantage for therapy. One one hand, medication
creates side effects that make the patient's life more complicated and
sometimes it worsens the very thing it is trying to treat. On the other hand,
therapy does not have side effects and in at least one mental disorder it helps
treat it faster. In addition, once people were done with therapy they reported
an effect of their disorder that was the same compared to those that were still
taking methylphenidate. In other words, once patients completed therapy they
were able to manage the symptoms of their disorder, however, people taking
Ritalin could not stop taking it, otherwise, they would relapse to their
original selves.
Turner
(2008) found that between 1987 and 2004, out of 78 studies of antidepressants,
38 were positive and all of them, except one, were published. On the other
hand, 36 were negative and only three were published as unsuccessful. The
majority of the positive studies had an effect sizes of .37 and the unpublished
ones had a .15 effect size. In summary, between 1987 and 2004, 49% of studies
of antidepressants had negative results, which were mostly left unpublished,
but the positive ones show that antidepressants have a smaller effect on
helping people with depression.
On
the other hand, the Cochrane Library conducted a study of psychoanalytic
therapy discovering that it had a large average effect size of .97 (Shedler, n.
d.). This was an average across all mental disorders, but specifically speaking,
it had an effect size of .59 for depressive symptoms, .81 for somatic ones, and
1.08 for anxiety. This is a great contrast compared to the average effect size
of .15 of unpublished antidepressant studies. It is even greater than the
published studies that had an average effect of .37.
Moreover,
the study looked at patients after nine months of completion and they
discovered that patients kept improving. The effect sizes were .98 for
depressive symptoms, 1.35 for anxiety, and 2.21 for somatic ones. This finding
gives an advantage to therapy when it is compared that people have to stay on their
medication or they fall into a relapse of their disorder. This looks worrisome
when the number of people that receive medication is compared to those who
attend therapy. In the United States, in 2012, 78 million Americans consumed
medication to aid with their mental health at some point during that year.
However, the American Psychological Association reported only 58 Americans
attended therapy. Now the question is why? Well, the drug industry spends more
money on marketing than they do on research and development of their drugs.
According to the PEW research center, the
industry spent $27 billion on marketing. From that budget $24 was marketed
directly to doctors. This means that physicians have three options. One is to
redirect their patients to a therapist, but they lose the patient and thus the
money. Two, they themselves give the therapy (only psychiatrists are allowed to
do this, and if they are not specialized in this branch of medicine, they would
have to redirect their patients, which means they lose patients and thus
money), but they would see less patients per day which equals to less money. Or
three, they can prescribe medication, thus, seeing more patients per day, and
prescribing the medications of the highest bidder.
In
conclusion, more patients are receiving medication as their form of treatment
for their mental disorder when compared to therapy. Even though in some
disorders, therapy was faster, more effective, and did not have side effects.
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