10 - Managing Major Adverse Drug Effects: When to Avoid, Switch, or Treat Through

Summary

We hope that things have changed for the better since the time of Sir Francis Bacon’s seventeenth-century appraisal of medical treatment risks and benefits. Drugs themselves may not know the differences between the beneficial versus adverse effects they may exert, but prescribers should. All substances, even placebos, can cause negative effects in the minds and bodies of those who consume them, depending on expectations (e.g., past experiences, perceptions of help versus harm), underlying psychopathology (e.g., anxiety, somatization, paranoia), psychological dimensions (e.g., an external locus of control, suggestibility) as well as pharmacokinetics (e.g., delayed metabolic clearance) and, last but not least, pharmacodynamics.