Psychotropic drugs or psychotherapy?

Combination of drug and psychotherapy appropriate for mental disorders

08/01/2015

Mental suffering can often be remedied by psychotherapy without medication. Sometimes, however, psychotropic drugs are also superior to psychotherapy in their effect. As a rule, a combination of medication and psychotherapy promises the greatest success, especially in the case of severe mental disorders.

Basically, the choice of the appropriate therapy depends on the type and severity of the mental disorder or the individual symptoms of the person concerned. Both psychotherapy and psychotropic drugs can be used for the treatment. This ultimately work „similar to a psychotherapeutic treatment and a drug in the brain“, cited „Mirror online“ the director of the Department of Psychiatry and Psychotherapy of the Mainz University Medical Center, Klaus Lieb. In both cases „the brain is neurobiologically altered, either through chemistry or through interaction with the therapist.“ However, the psychotropic drugs are associated with the risk of side effects, while psychotherapy is associated with a much higher expenditure of time.

Severity of mental disorder crucial
Basically, the different clinical pictures respond differently to psychotherapy and medications, reports „Mirror online“ citing the statement of the Director of the Department of Psychiatry and Psychotherapy of the Mainz University Medical Center. For example, psychotropic drugs in acute phases could help reduce tension or sleep disorders. According to the expert Klaus Lieb, the severity of the mental disorder is also an essential criterion when deciding on a medication. „Roughly speaking, the more severe the disease, the more likely it is to use medication“, will love of „Mirror online“ cited. The combination of medication and psychotherapy, however, often gave the best results.

Room for improvement
An international research team led by Maximilian Huhn from the Technical University (TU) Munich has been in the trade magazine last year „JAMA Psychiatry“ published a study in which they evaluated 61 meta-studies (consisting of 852 individual studies) to answer the question whether pharmacotherapy or rather psychotherapy would lead to the goal. The studies included data from a total of 137,126 participants with 21 different forms of mental disorders. Basically both treatment approaches showed an effect - albeit often only in the middle range. „Many pharmacotherapies and psychotherapies are effective, but there is plenty of room for improvement“, so the conclusion of the researchers. According to Maximilian Huhn and colleagues, because patients can benefit from both regimens, research should focus on how best to combine the two modalities to maximize synergies, rather than discussing whether one treatment is superior to another.

Combination of psychotropic drugs and behavioral therapy
US researchers led by Steven Hollon from Vanderbilt University in Nashville also featured in the journal last year „JAMA Psychiatry“ published a study examining in depressive patients which patients in existing medication can benefit from additional behavioral therapy. Over a maximum of three years of study, a total of 452 participants were treated, with half of the study participants receiving only medications and the other being treated with cognitive-behavioral therapy. Although the researchers found no significant differences in patients with mild depression, in severe depression, the combination of psychotherapy and pharmacotherapy was superior to antidepressant alone. Researchers conclude that the combination of cognitive-behavioral therapy and antidepressants significantly improves the chances of recovery from major depression. (Fp)