Complementary medicines work mainly in areas where modern medicine cannot produce remarkable or immediate results (Yu, 2008). Some immigrant and refugee clients may see herbal remedies as an acceptable treatment method where treatment is not already available (Yu, 2008), or when it is viewed as more “natural” than conventional pharmacotherapy. For example, immigrants from the Caribbean may be interested in incorporating elements of “bush” or spiritual medicine into their treatment plan (McKenzie et al., 2011). It is important to enquire about whether clients are using any complementary or traditional remedies since some can interact with the metabolism of a prescribed drug and have an impact on its effectiveness or accentuate adverse reactions. Religious practices such as fasting can also alter the efficacy and tolerability of a prescribed medication.
Psychotropic medications are highly stigmatized in some societies and may be seen as appropriate only for those defined as “crazy.” Some newcomer clients may therefore only be willing to accept them as part of treatment when symptoms are severe. Others may insist on a prescription for a given concern, even when it might not be indicated.
For example, while the side effects of lithium are thought to be universal, some of them can convey a culturally salient meaning. Some Chinese clients may not worry about polydipsia and polyuria because these are consistent with the belief that removal of excess toxins from the body is good, but they may be more concerned about fatigue, which can be seen as a loss of vital energy (Lee, 1993, as cited in Bhugra et al., 2011).
For example, if an antidepressant does not achieve full effectiveness with the first few doses, clients may stop taking it. Others may discontinue prescribed medications due to a belief that Western medicines are too strong for them. Some clients may decide to increase or decrease the dosage or frequency of their medications due to beliefs about the drug's strength, a perceived incompatibility or a belief that the effect will be better and faster if the dosage is higher. Psychoeducation throughout the prescribing process is key.
Clients may believe they are “cured” once symptoms stop and thus discontinue their medications.
Clients who have discontinued or altered their use of a medication might not openly discuss it with their health care provider, whom they see as an authority figure, to avoid being perceived as disrespectful or displeasing.