Psychiatria pre prax 2/2009

Psychodynamic aspects of pharmacotherapy

Incredible advances in neurobiological sciences and psychopharmocology could create an illusion of a psychiatrist as the objective scientist and of patients as only biological objects who simply respond biochemically to medication and get well. From a complex biopsychosocial point of view we can consider also the psychological aspects of pharmacotherapy. The paper is centred on some transference and countertransference aspects of the doctor-patient relationship and on the unconcious meaning of medication for the patient. It also takes note of the possible contribution of resistence and negative therapeutic reply to noncompliance and hypersensitivity to side effects. Understanding of these „irrational“ factors may be used to deepen the pharmacotherapeutic alliance and improve the effect of therapy.

Keywords: psychopharmacotherapy, compliance, side effects, transference, countertransference, resistence, negative therapeutic reaction, projective identification