Psych patient refuses medication but can't tell me why...what now?

  1. 0
    I have a patient who has been diagnosed with clinical depression and anxiety, understands the diagnosis, is alert, oriented and otherwise reasonable in demeanor but absolutely flat out refuses to take an antidepressant to help themselves. I've asked this person why they won't (side effect concerns? cost?) and this patient cannot tell me why other than "everything I read about them says they don't work or is negative and I do have good days here and there." This patient is not trying to be difficult, attention seeking by non-compliance - he really does not know why he is so opposed except the basis of what he has read on the internet or in magazines. He even admitted he knows people who have been or are on SSRI's or SNRI's that have been helped by them. Before seeking treatment he said he used over the counter and natural type products but things just got worse. I don't know how to get through to him or even if I can. I've told him more people are likely to write about a negative experience than a positive one and studies have shown the medications are effective but he continues to refuse. Any suggestions?

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  2. 12 Comments...

  3. 6
    Accept his decision and work on how he is going to cope with the depression. He has made his decision and there really is nothing you can do but provide him with info.
  4. 4
    Respect their decision, but continue to support, and to teach.
    Acknowledge that the meds may or may not work, but they certainly won't work if not taken.

    Ask them what they plan to do to address their depression, and suggest they consider trialling the medications as an adjunct to whatever other modalities they will be utilizing.
    Meriwhen, marydc, elkpark, and 1 other like this.
  5. 3
    He did tell you why--because he's heard negative things and that they don't work. That's a huge reason. Isn't it a good enough reason to you? It's good enough to him! If it's set in his mind, you're not likely to overcome it, but the suggestions others have listed might help some, especially if nothing else works...
    psu_213, elkpark, and Meriwhen like this.
  6. 0
    I would educate him on as much as you know on the medication. If her still refuses then document it and notify the doctor I suppose.
  7. 0
    I educate, discuss the decision, and notifiy the physician if the patient still refuses.
  8. 2
    As long as he's legally competent and not court-ordered to receive medications, he can refuse as much as he likes. Just like everyone else has said, all you can do is keep educating, document the refusals, and notify the prescriber.

    When I have a patient that refuses medication even after education, I tell them that I respect their decision...but that I still have to continue to offer the medication to them each time it's due because it's my job. That helps them feel less like I'm nagging them.
    elkpark and Whispera like this.
  9. 0
    Keep educating him on the fact that there are many meds out there, and like others said find other ways to help him cope. Does he have a hobby or did he have a hobby? Find something out from him that he used to see as important in one part of his life and start talking to him about everything and anything that he is interested in. Once you have a good relationship maybe he would be open to at least trying a type of medication. I know many women have weight gain worries and many people do worry about side effects and having to be dependant on meds to make it through the day, Also if he is younger he may have worries about his libido and that is important to many.
  10. 1
    It is his choice - respect that - work with him in other ways to manage depression and reduce stress.
    elkpark likes this.
  11. 0
    My husband has suffered from clinical depression and extreme anxiety since grad school. He's on meds for both and has been for about a decade and a half. He also meditates several times a day plus when I tell him he seems hyper. It really seems to help calm him down and makes him less depressed. Occasionally, he'll gripe about having to take an antidepressant and if he's really reluctant to take it, I have discovered that if he'll just take an extra Buspar, he'll usually relax enough to take his Zoloft. He has Buspar ordered 1 bid and he may take as many as 2 more per day PRN. He is fine as long as he takes his meds, meditates regularly, eats regular meals, and gets enough sleep. One late night and he's a mess! Something that might be an issue that no one has thought of is how meds taking was regarded in his birth family. My husband was reared in a Christian Science-believing family and for him to be able to take any meds was a huge hurdle. I'm sorry about the italics and terrible spacing. My new computer has windows 8 and it's being difficult!

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