A COMPARISON BETWEEN MEDICATION AND THERAPY
Just imagine in some disorders, therapy is faster, more effective, and did not have side effects. And still most prescripted help is medication.
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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