⚠️The Hidden Risk: Why Every Therapist Must Understand the Side Effects of Prescribed Medication
- eflbrisbane
- May 13
- 4 min read
Have you ever worked with a client who was making incredible progress, only to suddenly spiral without explanation? Or maybe you’ve wondered why certain therapeutic strategies aren't working despite a client’s best efforts.
A Personal Wake-Up Call in Practice
I’ve worked with over 1,500 clients in my career, and I take my role as a psychotherapist and CBT practitioner with deep responsibility. I’m not a prescriber. I don't diagnose or recommend medication—but something happened recently that completely shifted how I approach every session.
A client of mine, who had been steadily improving from depression and anxiety, had just returned from a lovely family holiday. She came into his session calm, reflective, and had previously rated his mood 8/10. Then, with tear-filled eyes, he revealed something that shocked both me and his loved ones: he had attempted to take her life just one day earlier.
There was no major trigger. No relational rupture. No clear psychological regression. It didn’t make sense—until I gently asked,
“Have you started any new medication lately?”
She hesitated, then said yes.
She had been prescribed Pregabalin (also known as Lyrica or Pretobelan) for nerve pain. It was only after the suicide attempt that I began researching this drug more closely.
Medication Can Impact Mental Health—Profoundly
Pregabalin is an anticonvulsant used to treat nerve pain and seizures. It works by calming overactive nerves—but for some individuals, it can also cause sudden mood changes, emotional numbness, depressive symptoms, or even suicidal thoughts.
This is not uncommon. Many medications—including hormone treatments, birth control devices, corticosteroids, stimulants, and even acne medications—can directly impact:
Mood regulation
Sleep patterns
Focus and attention
Emotional stability
Decision-making abilities
Yet, most counsellors and therapists receive minimal if any training on prescription medication during their formal education.
I hold three degrees in mental health-related disciplines. Not one of them included comprehensive education on psychotropic or general medication use and side effects.
Why I Took This Personally—and Professionally
Since graduating and beginning my private practice, I’ve made it my mission to never stop learning. I’ve taken my professional development seriously, and I’ve chosen to study not just therapeutic models, but also:
Pharmacological medications used in mental health
Substance use and addiction, both legal and illegal
The physiological and psychological effects of drugs on therapy outcomes
In our field, we’re required to complete 25 hours of professional development annually. But not all CPD is created equal. We are given the choice—and responsibility—to decide where we invest that time.
And I am deeply grateful that I chose to study these areas.
Because had I not educated myself about medications like Pregabalin, I would not have known how to support this client in time. That knowledge didn’t come from a textbook or degree—it came from my commitment to learning beyond the curriculum.
A Call for Deeper Responsibility in Our Profession
This incident became a turning point for me, and I share it not to cast blame, but to raise awareness.
As therapists, we are not separate from the broader health system—we are part of it. We work with people’s lives, their thoughts, their fears, their futures. They trust us with the most intimate parts of their journey.
So while we may not prescribe, we must absolutely understand.
We need to ask about medication.We need to stay informed.We need to be lifelong learners.
Because if we don’t, we may:
Misinterpret the effects of a drug as psychological regression
Offer strategies that are not executable due to side effects
Miss crucial cues that could prevent harm
To Fellow Therapists: Let’s Elevate the Standard
I urge my peers: take your professional development seriously.
Don’t wait for universities or regulatory bodies to give you permission—go beyond. Learn about the pharmacology, the neurology, and the whole-person factors that impact your clients.
Mental health support does not exist in a vacuum. It’s part of a complex, ever-evolving human system.
Professional development isn’t just about certificates—it’s about competency. Relevance. Integrity. And it’s the foundation of our credibility and effectiveness.
To the Public and Clients: Your Health Is Interconnected
If you are being prescribed medication—any medication—always:
Disclose your mental health history to your GP
Ask directly about side effects that may impact your mood
Be proactive in monitoring any changes in emotion, behaviour, or thoughts
Seek immediate professional help if you experience sudden shifts
If you have depression or anxiety, and you are prescribed a painkiller or nerve medication, always mention your mental health condition before accepting the medication. And if you notice any side effects—don’t wait. Seek support. My client did the right thing by reaching out.
This Blog Is Not About Blame. It’s About Awareness.
In healthcare and therapy, human error is possible. But awareness saves lives.
This blog is a call to responsibility, to empathy, and to professional integrity. Let's continue to build a community where learning, collaboration, and accountability guide our work.
We are stronger when we support one another—not just our clients, but each other as professionals.
Let’s make this our new standard.
By Indrani | Psychotherapist • Trauma-Informed Specialist • Neuro-Informed Coach
Equipping people and professionals to heal deeply, lead wisely, and connect meaningfully — through the power of faith, mind, brain, and heart integration.
References
U.S. National Library of Medicine. (2023). Pregabalin - MedlinePlus Drug Information. Retrieved from https://medlineplus.gov/druginfo/meds/a605045.html
Moreira, A. L., et al. (2019). Psychiatric adverse effects of medications: A concise overview. Primary Care Companion for CNS Disorders, 21(2). doi:10.4088/PCC.18f02342
Harvard Health Publishing. (2022). Can Medications Cause Depression? Retrieved from https://www.health.harvard.edu
Margison, F. R., & Shore, D. (2009). Prescribing and psychotherapeutic competencies in psychiatry and psychology. Advances in Psychiatric Treatment, 15(6), 459–465. doi:10.1192/apt.bp.108.006205
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