Elements of dynamics II: psychodynamic prescribing.

Scientific pharmacotherapy, as it should be, is based upon the results of aggregates of patient responses to treatments of specific target conditions for drugs. Although enduring personality traits are increasingly included as targets for pharmacotherapy, in the real world of psychiatric practice transference issues and the patient's character or personality traits play a larger role in the selection, dosage, tolerability, and outcome of treatment than is generally recognized or admitted, other than to attribute undifferentiated placebo effects. Transference and countertransference issues from the marketplace are described, as well as operational parameters of character, character-based decision making, and specific suggestions for medicating according to character types. A new field of psychodynamic pharmacotherapy is encouraged along with attention to culturally informed prescribing.