Antipsychotic Medication for Everything

CLPsych has an interesting post on a study that found that among patients with Medicaid in Oregon who were prescribed antipsychotic medication, only a minority actually had a diagnosis of a psychotic disorder or bipolar disorder (15% vs 27%).  The rest had diagnoses of depression, anxiety, or PTSD.  I think I’d like to add to this the fact disorders are often diagnosed for the medication as I’ve written about before (On Diagnosis, Symptoms, and Medication; Diagnosing for the Medication).  In other words, there are times when the diagnosis is given in order to justify the medication that is prescribed.  This doesn’t happen all the time, but it does happen.

http://clinpsyc.blogspot.com/2008/09/atypical-antipsychotics-for-all-oregon.html

On Antipsychotic Medication and Intellectual Disabilities

Recent research shows that antipsychotic medication is no more effective than placebo in reducing aggression in individuals with an intellectual disability.  This type of medication is often prescribed for individuals with mental retardation, but the data now show that this type of intervention is no more effective than placebo.  It should be noted that all interventions reduced symptoms, but placebo was the most effective.  People should be amazed at the power of their own minds and expectations in producing changes even with intellectually disabled individuals.  Intellectually disabled individuals seem to show some of the most impressive treatment gains in psychotherapy (this based on my experience).  It seems likely that they are more accustomed to following directives than individuals without an intellectual disability, and are thus, less defensive.  One of the most wise individuals I have ever worked with had an IQ of 66 (mild mental retardation).  IQ does not mean that an individual possesses wisdom no matter what the IQ level is.