I practice as a Psychiatrist and Psychopharmacologist. The science of psychopharmacotherapy continues to rapidly expand.
I conduct and evaluate Mood Disorders, Anxiety Disorders, Psychotic Disorders, ADD and other disorders in adults that require treatment with medications. The medical model serves as the foundation for the treatment of psychiatric disorders. Pharmacotherapy alone is generally insufficient for complete recovery. The earlier I can diagnose and treat a psychiatric disorder, the better the prognosis or chances of improvement. Psychiatric disorders coexist together, for example, patients may have depression, anxiety as well as insomnia and all these disorders interact or fuel each other and need to be treated individually as well as a bundle. Prompt early treatment is critically important to prevent relapses and can change the long-term outcome. Patients need to understand the risk to benefit ratio of being treated versus no treatment at all. A good example is treatment of mood disorder in a patient who plans to get pregnant in the near future – to treat or not to treat with medication is a good question. I monitor or target specific symptoms and monitor their presence or absence over an entire course of treatment. It is necessary to observe for the development of adverse effects throughout the entire course of treatment. Dosage of medications are adjusted based on response and tolerability.
As of today, there are no specific lab or brain scan tests that are approved for testing and making a diagnosis of specific psychiatric disorders. I do order lab tests and coordinate patients care with other medical specialists. I have tried using a test in the recent past which helps determine genetically which patient has a better chance of responding to a particular medication. I have found these tests to be of minimal help and not cost effective. Overall, practice of psychopharmacology is a science as well as an art. Psychiatric illnesses are brain disorders and recent imaging studies have helped towards localizing the circuits in the brain that may help understand the illness as well as the best treatment options for a disorder. I encourage my patients and family members to be better educated consumers/patients and thus help improve the quality of life as well as decrease stigma of mental illness in the community.
Pharmacotherapy alone is generally insufficient for complete recovery. I believe that educational and psychosocial intervention as well as specialized forms of psychotherapy will benefit a patient when indicated. Medications help but may have a delayed onset of action; early counseling may avoid premature discontinuation as well as provide hope hope and reassurance during this lag phase. I do my best to respond to the following questions: What is happening to me? Will I get better? What will it take? How long will it take? What are the limitations of my condition and of the proposed treatment? How much will it cost?