Is taking medication harmful? — The real risk
We often come across the rejection of medications by many patients, motivated by unfounded fears or misinformation. It is not uncommon to hear statements such as, "I don't want to take medications because they are harmful," or "I don't want to start taking medications because they will make me addicted." Unfortunately, these are widely held beliefs based on non-scientific information or unfounded biases.
Instead, it is crucial to understand that medications can be an important resource for treating several disorders, such as Depression, Anxiety Disorders, Obsessive-Compulsive Disorder (OCD), and many others.
What negatively affects a person's life is not the medication taken for a specific treatment, but the disorder itself from which the individual suffers, which compromises one's ability to make choices, personal stability, and the capacity to fully enjoy life. A mental disorder can substantially affect an individual's entire existence.
For this reason, the choice to use medications represents the opportunity to lead an autonomous life, free from the burden of the disorder. This enables people to make clear decisions and pursue their goals without the conditioning of the disease. Maintaining treatment even after the initial symptoms have disappeared is essential for maintaining full positive control over one's life.
The Origin of Medications — Remedy or Poison?
A key element to consider is the origin of the medications themselves. In ancient Greek, the word for "medication" is "pharmakon", indicating a preparation that can be both a remedy and a poison.
Even the ancient Greek physician Andromachus, by adding a viper to his Theriaca andromachi, introduced the concept "similia similibus curantur," meaning that "a poison can also be a cure." Subsequently, Paracelsus ― a physician, alchemist, and astrologer of the sixteenth century ― stated «Everything is poison. There is nothing without poison. Only the dose makes it so that the poison does not take effect.»
This is an extremist perspective, but it captures the essence of the concept: the same substance can be both a remedy and a toxin, useful and harmful, depending on the chosen dosage and the way it is taken. As a result, there are no medications that are harmful in themselves: it is only improper usage that can turn a medication into a toxic substance.
The secret to effective pharmacological therapy is personalization of care.
Learn more about the complex process required to achieve significant therapeutic goals: disappearance of symptoms and improvement of life.
There are no inherently harmful medications ― The danger of alarmism
Thinking that there are medications that are harmful in themselves can be very damaging as it builds a false belief. Changing the way we perceive medications is, therefore, of paramount importance.
One of the reasons behind the alarmism and excessive concerns that have arisen around the use of medications for the treatment of mental disorders is the uncontrolled and irresponsible use that has developed over time with some substances. A fitting example pertains to antibiotics, the uncontrolled consumption of which has led to the phenomenon of bacterial resistance and sometimes to significant disruptions in the intestinal flora, endangering the immune system. This does not imply, of course, that antibiotics are intrinsically harmful, but only that they must be used appropriately, following precise intake instructions and maintaining the minimum therapeutic dose for a time frame limited to the strictly necessary.
It is important to understand that it is NOT the medications themselves that are harmful, but rather their improper use. Alarmism phenomena provide no help and can, on the contrary, be highly counterproductive.
An example: Esketamine for Treatment-Resistant Depression
For example, Esketamine, recently approved by the US FDA, is considered a genuine lifesaver for patients with treatment-resistant depression. However, despite the abundant scientific evidence demonstrating its efficacy and safety, and the long process that led to the approval of this medication, there are still many scientifically unfounded criticisms stigmatizing its use, sometimes even going so far as to compare its sale to theft!
Of course, this does not mean that all medications should be taken lightly without precautions. Staying with the example of Esketamine, its administration must necessarily take place in a specialized healthcare facility characterized by constant and adequate monitoring and must be preceded by careful screening. However, if this occurs in the absence of unnecessary and harmful alarmism, it can represent a valuable resource for many patients: quite the opposite of a poison!
Innovative medications and therapies: pioneering research on Psychedelic Substances
Throughout the world, psychedelic and psychoactive substances have always aroused widespread interest for a variety of reasons. From ancient times when people around the world used hallucinogenic mushrooms, cannabis, and ayahuasca to alter their senses for religious and sacred ritual purposes, to modern synthetic or semi-synthetic substances like LSD and ecstasy used to achieve psychoactive effects, the debate on these compounds has always been intense.
Often, these substances have been labeled as extremely dangerous due to their broad ability to interfere with the functions of the nervous system, altering its biological balance and risking addiction phenomena. However, the history of these substances is constantly evolving.
In the past, when the mechanism of action of these substances was not yet known, some American clinicians experimented with their clinical effects without adequate scientific control. Due to the lack of significant therapeutic results, this research was abandoned by the late 1960s.
Recently, however, in Europe and the United States, controlled studies on the safety and efficacy of psychedelic substances in the treatment of psychiatric disorders such as Depression and Post-Traumatic Stress Disorder (PTSD) have emerged. The results of some of these studies are quite promising, once again confirming that it is the correct or incorrect method of administration that determines whether a substance is a medicine or a poison.
When safely and professionally administered, psychedelic therapy holds great promise for the treatment of some very serious mental health conditions.
Informed choices and effective therapies ― The importance of Education
On the journey towards optimal health, proper education about medication is a key resource for achieving empowerment. Every medication, including those available at the supermarket without a prescription, must be taken wisely without abuse. Therefore, it is essential to have the expert guidance of an updated physician who can wisely recommend the most appropriate ways to use each medication.
However, this is not a simple task because sometimes it may be necessary to prescribe medications that go beyond the information provided in the package insert, adopting what is known as "Off-Label" use. This practice is based on advanced scientific research and can only be adopted by experienced physicians like Dr. Stefano Pallanti, through continuous updates on the latest scientific data regarding the most effective treatments. Only such knowledge can enable the doctor to explain why a specific medication should be prescribed to a particular person at an equally specific moment.
Responsible medication use for improved quality of life
When medications are chosen and prescribed correctly, the benefits that can be obtained from their use far outweigh the potential risks.
Proper medication use involves several key elements, including:
A targeted selection for a defined clinical goal: The treatment must, therefore, focus on a specific dimension of the disorder, such as impulsivity, fatigue, or sleep disturbances, without trying to address the entire clinical picture.
Achieving the minimum therapeutic dose.
The intake for an appropriate period.
Usage under well-defined circumstances.
The new psychiatric medications are not just molecules used to sedate or control a patient; they act as powerful therapeutic tools, effectively configuring themselves as "psychotherapeutic" drugs. They allow individuals to cope with the challenges imposed by their illness and regain their self-esteem and self-efficacy, significantly improving their quality of life.
When a disease is present, the risk-benefit ratio is a very important index in making treatment decisions. For example, before approving a new product or medication, the United States Food and Drug Administration (FDA) carefully evaluates whether the overall benefits of such a product or drug outweigh the associated risks. The FDA tends to approve products or medications that, while carrying some calculated risk, offer significant potential benefits that outweigh possible side effects.
When used responsibly, the new psychotherapeutic medications are the best tool to enable the recovery of a normal life.
What does "Off-Label" mean?
Dr. Stefano Pallanti offers his patients the most innovative and effective therapies ever, around 20 years ahead of hospitals and clinics that rely on outdated guidelines for treatment choice.
Medications and quality of life ― A personal choice
When facing medical decisions, it is important to understand that each one carries an element of unpredictability, and the outcome of each choice can vary significantly from person to person.
Each individual responds differently and unpredictably to therapies, and one must therefore consider several unique factors that concern each person in his or her uniqueness. This process requires the evaluation of all aspects of a person's life, who needs to overcome any fears about treatments to regain control of the situation.
Even when doing our best to minimize side effects, perfection is not always achievable. For this reason, in medical practice, we often have to deal with some side effects caused by the medications taken. This situation confronts people with a choice:
Accept the side effects of medications (almost always tolerable) while continuing to lead a normal life...
Suffer the consequences of an untreated illness and be subjected to it?
The importance of personalized care ― It's not the medications that heal
According to the definition provided by the World Health Organization (WHO), medications are «Any chemical substance or product used to modify or examine physiological functions or pathological states for the benefit of the patient.»
It should be remembered that medications alone do not guarantee healing. The benefit derived from taking a medication depends on the specific situation in which the person finds themselves, the dimension of the problem, and the time in the patient's life when it is used.
No medication is universally beneficial or harmful in all circumstances. What truly makes a difference is not the medications or medical tools themselves but the doctor's ability to choose, calibrate, and share the treatment path with the patient. This process starts with a Precision Diagnosis that can be adapted, subtyped, further specified, or broadened over time, depending on treatment developments and the individual's situation.
Additionally, each person's history, their family history, and the biological and external events that have influenced the disorder are all relevant factors that have an impact on the course of the disorder and, above all, on the individual's life. Each individual is unique, with distinct physical, medical, immunological, family, and genetic characteristics that must be considered when making medical decisions.
Moreover, factors such as age, gender, marital status, and predisposition to specific treatments also need to be taken into account. The doctor must also consider the communication style, and individual expectations, and ensure that the therapeutic goal is shared with the patient.
Medical treatments are successful only when all these factors are carefully evaluated and shared with patients, allowing for a high level of personalization of care based on the needs of the individual.
Questions about Pharmacological Therapies
Biennial course on Anxiety Disorders organized by the European College of Neuropsychopharmacology
A unique opportunity to expand your knowledge and experience in the field of Anxiety Disorders.
Dr. Stefano Pallanti will lecture on Neuromodulation Therapies during the 4th module of the course.