Medication use during psychoanalysis: a survey.
BACKGROUND
Historically, the psychoanalytic community has rejected the use of psychotropic medication, on the basis of the belief that using medication to suppress symptoms such as depression and anxiety would obstruct access to psychic conflict and thereby impede the progress of analytic treatment. However, it would appear that many psychoanalysis have reconsidered this point of view and are now combining medication with psychoanalytic treatment. This paper reports the first systematic survey of medication use in psychoanalysis.


METHODS
Forty-five training analysts at the Columbia University Center for Psychoanalytic Training and Research were sent questionnaires that asked how many patients in analysis they had seen in the past 5 years and for details about any of those patients who had taken psychotropic medication.


RESULTS
The analysts reported that in the past 5 years, 51 (18%) of 277 patients in analysis were also taking psychotropic medication. Most of these patients had been diagnosed with a unipolar mood disorder and were treated with some type of antidepressant. In 84% of patients (36 of 43) with a unipolar mood disorder who had been treated with medication, the psychoanalyst judged that both the mood disorder and the analytic process improved.


CONCLUSIONS
The use of medication in combination with psychoanalysis is no longer an uncommon practice. Analysts who prescribe medication find that, in general, the effect is to enhance rather than undermine the psychoanalytic process.
Donovan
S J
SJ
New York State Psychiatric Institute, N.Y., USA.
Roose
S P
SP
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001689:Biological Psychiatry; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy / Q000193:education; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013663:Teaching; D016896:Treatment Outcome
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D017367:Selective Serotonin Reuptake Inhibitors