Psychoanalytic perspectives on the use of medication for mental illness.

The author examines the use of psychoactive medication from the psychoanalytic perspective. He notes that medication has psychological meaning and acquires additional mental representation, and that pharmacotherapy interventions may obscure the differentiation between direct effects of medication on patients and neurotic conflicts in patients. He discusses specific factors involved in the decision to prescribe medication, including the patient's and the clinician's own readiness to use medication, medical countertransference, and common pharmacotherapy interventions (suggestion, manipulation, and inexact interpretation). A case report illustrates issues involved in combined psychoanalytic and neurobiological treatment.