Creative, Person-Centered Psychopharmacology for Treatment Resistance in Psychiatry

  • Miro Jakovljevic


Treatment resistance in psychiatry is one of the most important issues facing psychiatrists and their patients alike. It is not only a highly important topic but a very hot and controversial one as well. There is no generally accepted agreement of what defines treatment resistance for any of the individual mental disorders; thus it is a metaphor with different meanings which implies negative, pessimistic, and frightening connotations. This metaphor complicates treatment in psychiatry as well as the lives of patients with the so-called treatment-resistant mental disorders. Treatment resistance as a construct should be reconsidered as well as delaying “wait-and-see” and “monotherapy before polytherapy” treatment strategies. Changing treatment philosophy may be a critical step toward overcoming what some sign as “therapeutic stagnation in psychiatry” associated with a high rate of treatment failures. A “paradigm shift” is needed from the mechanistic, formistic, and reductionistic ways of thinking of technical, nomothetic, and impersonal psychopharmacology to contextual, systemic, and creative thinking with a new treatment holodigm of individualized and person-centered psychopharmacology. The best treatments are those that timely utilize and integrate multiple therapeutic modalities. The concept of creative, person-centered narrative psychopharmacotherapy gives a hope for increasing treatment effectiveness and efficiency in psychiatry and thus overcome treatment failures and resistance.


Treatment failures and resistance Difficult-to-treat mental disorders Resilience and resiliency Placebo and nocebo Therapeutic narratives Creative person-centered psychopharmacology 


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Miro Jakovljevic
    • 1
  1. 1.Department of PsychiatryUniversity Hospital Centre ZagrebZagrebCroatia

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