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Phelps discută în general patru principii cu pacienții săi înainte de începerea oricărei terapii medicamentoase: de ce sugerează tratamentul, care sunt alternativele, care sunt riscurile și orice întrebări pot avea.

Riscul versus recompensaJanet și-a exprimat îngrijorarea cu privire la creșterea în greutate a Katie pentru numeroși medici, dar cei mai mulți au spus: „Dacă simptomele sunt mai bune, o creștere în greutate nu este o problemă mare”. După cum se dovedește, a fost o afacere mare. După ce a fost pe medicamente timp de aproape șase ani, colesterolul Katie, trigliceridele (grăsimea din sânge) și alte măsuri metabolice au început să crească până la niveluri nesănătoase.

Doctorul Grcevich, care a început să o vadă pe Katie la aproximativ trei ani după ce a început să ia risperidonă (și nu este în prezent medicul ei), a recomandat să o îndepărteze de medicamente, dar a devenit violent și sinucidător. Părinții ei au plasat-o pe Katie, care de atunci a fost diagnosticată cu o serie de afecțiuni de dezvoltare, neurologice și emoționale - într-o unitate de tratament rezidențial, unde acum primește îngrijiri pentru a fi îndepărtată cu succes de risperidonă.

Dacă creșterea în greutate este o problemă potențial gravă cu antipsihoticele atipice, de ce tot atât de mulți psihiatri le prescriu? Răspunsul este simplu: Pentru mulți pacienți, medicamentele sunt eficiente.

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