Most mentally ill people get intervened early, and because of mood instability are given drugs until they stabilize, usually lithium despite the medical risks.
IMHO the thinking of most psychiatrists is that Omega-3 in fish oils as supplementation takes too long (six weeks).
However, most meds lose their efficiency in 6 weeks due to the placebo effect.
Indeed, most meds work because of the placebo effect.
In short, it is the patient's belief in getting well which results in recovery.
However, in Canada, most patients eventually get status as person with disabilities under welfare. Depending on the severity of symptoms, this qualifies a patient for either Plan C (most medications are free even if you don't have PWD) or Plan G (all psychomeds are free as is the trip to the psych ward).
However, if a patient has relief of his anxiety handled by obsolete medication (antihistamines), he has to pay for the cost himself (including OTC antihistamines).
It looks like a lot of meds under American Medicaid/Medicare are not covered, or closer to the truth, most SSI recipients do not know which meds are covered.
I wouldn't agree to SSRIs because of them worsening anxiety and causing nausea, along with the risk of serotonin syndrome.
Relief of insomnia is foremost in preventing hypomania and its probable evolution into mania and psychoses. Therefore I look for a hypnotic effect in medication. It must have an antihistamine action. Next I look for safety and tolerance.
This is what led me to mirtazapine (Remeron), mainly because of those mentoined effects and the fact that in most meta-analyses of mirtazapine versus the SSRIs, TCAs and other antidepressants, mirtazapine exhibited a profile which is no better than placebo.
I've also researched gabapentin and realized that it would cause glaucoma or at the least, ruin my sight.
Yet at the six-week mark, 15 mg of mirtazapine no longer makes me sleepy. This makes me determined to continue my psychotherapy and see how well the drug has made me of mind.
If I am only using mirtazapine after its effects have plateaued, then I would have to consider the side effects of extended use of mirtazapine to decide if they outweigh its use as placebo.
2012-12-27: Today I stopped using mirtazapine a year ago. At the moment I use flexeril and gabapentin, which helps keep me sedated. The gabapentin in particular improves deep sleep better than benzodiazepines. Flexeril's sedation helps induce sleep.
These medications work for me, since I stopped believing in the DSM as a useful guide which involves arbitrary pigeon-holing of mental health consumers. The only use the DSM I feel is to manufacture mental illness.
However, I am anti-psychiatry. but believe in medication to deal with insomnia and mild aches and pain. Also, I am an advocate of vigourous physical exercise (brisk walking for more than one mile).
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