Psychotherapy
Psychotherapy is an interactive process between a person and a qualified mental health professional (psychiatrist, psychologist, clinical socia...

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Interactions

Interactions with Drugs

Psychotherapy is often accompanied by treatment with drugs to help reduce psychological symptoms. This requires supervision by a psychiatrist or physician, as the other mental health disciplines cannot prescribe drugs.

Drugs may reduce the need for psychotherapy. Effective psychotherapy may reduce the need for drugs, or may make lower doses, and hence fewer side effects, possible.

Drugs may interfere with the effectiveness of psychotherapy if mental functioning is impaired as a side effect of the drug. This applies to both psychiatric medications and medications for medical conditions.

Some forms of medication for medical conditions (prescription and over-the-counter) have psychological or emotional side effects such as anxiety, depression, impaired cognitive functioning, or impaired sleep. These problems may be better treated by modification of dosage of the medication rather than psychotherapy. Patients should speak with a doctor about side effects of medications and adjusting dosage to reduce side effects if possible.

Interactions with Herbs and Dietary Supplements

Certain herbs are reputed to be beneficial for mental health conditions (e.g., St. John's wort/hypericum for depression). When used properly, these may reduce the need for psychotherapy. However, herbs and prescription medications can interact and have adverse effects, including exaggerating or interfering with each other's effects. They should not be mixed without consultation with a qualified healthcare professional.

Like drugs, some herbs may also have psychological or emotional side effects. These may be better treated by reducing use of the herb rather than pursuing psychotherapy.

People interested in using herbs with psychotherapy should inform the therapist of this. Depending on the seriousness of the condition, referral to a psychiatrist may be recommended to monitor the use and effects of herbs and determine whether medication may be more appropriate.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): William Collinge, PhD (Collinge & Associates); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Nicole Giese, MS (Natural Standard Research Collaboration); Lisa Scully, PharmD (Massachusetts College of Pharmacy); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Barbato A, D'Avanzo B. Marital therapy for depression. Cochrane Database Syst Rev 2006 Apr 19;(2):CD004188.

Belanoff JK, Sund B, Koopman C, et al. A randomized trial of the efficacy of group therapy in changing viral load and CD4 counts in individuals living with HIV infection. Int J Psychiatry Med 2005;35(4):349-62.

Borkovec TD, Sibrava NJ. Problems with the use of placebo conditions in psychotherapy research, suggested alternatives, and some strategies for the pursuit of the placebo phenomenon. J Clin Psychol 4-12-2005;61(7):805-818.

Costa EM, Antonio R, Soares MB, et al. Psychodramatic psychotherapy combined with pharmacotherapy in major depressive disorder: an open and naturalistic study. Rev Bras Psiquiatr 2006 Mar;28(1):40-3.

Cuijpers P, Brännmark JG, van Straten A. Psychological treatment of postpartum depression: a meta-analysis. J Clin Psychol 2008 Jan;64(1):103-18.

Frank E, Kupfer DJ, Thase ME, et al. Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Arch Gen Psychiatry 2005 Sep;62(9):996-1004.

Hunkeler EM, Katon W, Tang L, et al. Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care. BMJ 2006 Feb 4;332(7536):259-63.

Jackson H, McGorry P, Edwards J, et al. A controlled trial of cognitively oriented psychotherapy for early psychosis (COPE) with four-year follow-up readmission data. Psychol Med 2005 Sep;35(9):1295-306.

Linehan MM, Comtois KA, Murray AM, et al. Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Arch Gen Psychiatry 2006 Jul;63(7):757-66.

Lipsitz JD, Gur M, Miller NL, et al. An open pilot study of interpersonal psychotherapy for panic disorder (IPT-PD). J Nerv Ment Dis 2006 Jun;194(6):440-5.

Margolin A, Avants SK, Arnold R. Acupuncture and spirituality-focused group therapy for the treatment of HIV-positive drug users: a preliminary study. J Psychoactive Drugs 2005 Dec;37(4):385-90.

Mohr DC, Hart SL, Julian L, et al. Telephone-administered psychotherapy for depression. Arch Gen Psychiatry 2005 Sep;62(9):1007-14.

Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane.Database Syst Rev 2005;(2):CD001007.

Wagner B, Knaevelsrud C, Maercker A. Internet-based cognitive-behavioral therapy for complicated grief: a randomized controlled trial. Death Stud 2006 Jun;30(5):429-53.

Weisz JR, McCarty CA, Valeri SM. Effects of psychotherapy for depression in children and adolescents: a meta-analysis. Psychol Bull 2006 Jan;132(1):132-49.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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