By Rachel Egan, PMHNP-BC, Clinical Director and Co-founder of Harborside Psychiatrics

It’s a story I hear over and over from new clients: “I’ve tried everything, and medication just doesn’t work for me.” Alternatively, some people tell me at intakes that the medication they rely on causes any number of uncomfortable side effects; headaches, excessive dryness, dizziness, low libido; and so many people have received the message from providers that they simply need to live with these side effects.

In a healthcare system bursting at the seams, with providers booked for back-to-back appointments, all too often, these concerns go unheeded. I categorically reject the concept that there is anyone for whom “no medication works” or that people need to tolerate lifelong side effects from psychiatric medication.

So what do we do instead? Firstly, in the entirety of my career in psychiatric medicine, I’ve yet to meet that person who has truly “tried everything.” Sadly, I have met far too many people who have been told they have, when in fact there are entire families of medication left untried while clients suffer with ineffective relief of symptoms and/or myriad side effects. Taking sufficient time to listen to our clients’ stories and experiences is a critical first step in meeting their needs. Additionally, I have had robust success incorporating psychopharmacogentic testing in my practice. This can provide both validation for clients as well as revealing which class of medications might be best for them. Additionally, I have found it critical to assess for micronutrient deficiencies for every client when possible. Look for more discussion of this in future blog posts; for now, I’ll let the example suffice that if a client has a vitamin B12 deficiency causing symptoms of low energy/motivation, brain fog, and fatigue, no amount of fluoxetine will make that person feel better.