Balancing Textbook Psychopharmacology With Patient Individuality

In this video from the 2023 Psych Congress NP Institute, Rakesh Jain, MD, MPH, a distinguished member of the Psych Congress steering committee, offers some thoughts on how to balance the technical knowledge of psychopharmacology with the unique circumstances that surround every individual patient. 

Don't miss these other recent clinical pearls from Dr Jain:

>>Approaching Psychedelics for Depression With Both Caution and Optimism

>>The Importance of an Exit Plan: Deprescribing in Psychiatry

For more information and to register for the 2024 Psych Congress NP Institute, visit the meeting website.

Read the Transcript

Psych Congress Network: How can practitioners apply effective technical treatment while keeping in mind that “every patient is their own textbook”?

Rakesh Jain, MD, MPH: Hello, friends and colleagues. This is Rakesh Jain, a proud member of the Psych Congress Steering Committee. I'm very much looking forward to speaking to you on a topic that I personally find to be of great importance, which is the need for us practitioners, no matter where we are in our career, first year or 40th year, to know our psychopharmacology really well, but to also know every patient's individuality. Certainly, there are textbooks of psychopharmacology. No doubt in my mind that your bookshelves are filled with that, but every patient is a textbook in their own right. They have their own individual signature on what works for them, what doesn't work for them, and obviously, what they think about the medication, what is their opinion about it.

In terms of improving your psychopharmacology knowledge, my advice to you is you really want to start at the level of understanding the disorders, not just in terms of their DSM symptoms, that's important enough, but also knowing their underlying neurobiology. Then, we shift our attention to knowing our individual medications, and their doses, and their side effects, but very importantly, also knowing their mechanism of action. By the way, may I just advise you, every time you start a medication, make sure you have an efficient exit strategy in place.

At the end of the day, let the patient be the master of it all, in the following sense. All of that book knowledge, while it might be of incredible help to us for that individual patient, we are going to have to be humble and flexible. That patient's needs, biopsychosocial needs, and the medication to match it is, of course, what we desire to do. This is a message from me, of encouragement, to be very smart in terms of academic knowledge, but also be very emotionally intelligent in appreciating the fact that patients are their own textbooks, and that textbook needs to be followed thoroughly. Thanks for allowing me to share some thoughts with you, and I wish you and your patients the very best.

Rakesh Jain, MD, MPH, attended medical school at the University of Calcutta in India. He then attended graduate school at the University of Texas School of Public Health in Houston, where he was awarded a “National Institute/Center for Disease Control Competitive Traineeship”. His research thesis focused on the impact of substance abuse. He graduated from the School of Public Health in 1987 with a Masters of Public Health (MPH) degree.

Dr Jain served a 3-year residency in Psychiatry at the Department of Psychiatry and Behavioral Sciences at the University of Texas Medical School at Houston. He followed that by obtaining further specialty training, by undergoing a 2-year fellowship in Child and Adolescent Psychiatry. In addition, Dr Jain completed a postdoctoral fellowship in Research Psychiatry at the University of Texas Mental Sciences Institute, in Houston. He was awarded the “National Research Service Award” for the support of this postdoctoral fellowship.