Why Does My Prescriber/Doctor Ask Me to Choose My Medication?

This is a question I hear often and one people search for frequently:

“Why is my psychiatric prescriber (Psychiatrist, Doctor, etc.) asking me to choose my medication?”

I want to answer that honestly, from the prescriber side and with a bit of humility.

For a long time, I’ve definitely said some version of:

“Here are two or three medication options. Which one do you want to try?”

My intention was never to pass responsibility onto the patient. Quite the opposite my intention was to empower my patients.

Why prescribers do this (and why I did)

In psychiatry, there is often more than one clinically appropriate medication for the same symptoms. There isn’t always a single “right” answer.

When I offered choices, I was trying to:

• Practice shared decision-making

• Respect past medication experiences

• Account for side-effect preferences

• Avoid being overly directive and rather collaborative with my patients

Those values still matter deeply to me.

But I’ve learned that intention and impact don’t always line up.

How that question can feel as a patient

When you’re dealing with anxiety, depression, ADHD, OCD, or burnout, being asked to choose a medication can feel overwhelming.

Many patients tell us they think:

• “Am I supposed to know this?”

• “What if I choose the wrong one?”

• “Does my provider not know what’s best?”

Most people want a voice, not the full burden of expertise.

The shift I’m making in my practice

Instead of asking patients to choose from scratch, I now aim to lead with a clear recommendation.

For example:

“Based on your symptoms, history, and goals, I recommend starting with X. Here’s why. If it’s not the right fit or side effects come up, Y and Z are good alternatives, here are some informational handouts. How does that feel?”

This keeps care collaborative while reducing anxiety and uncertainty.

What I want patients to know

If your prescriber has asked you to choose a medication, it doesn’t mean they don’t care or don’t know what they’re doing. In many cases, they’re trying to respect your autonomy.

That said, it’s always okay to say:

“I’d really appreciate your recommendation.”

Good psychiatric care should feel supportive, guided, and grounded in trust.

I’m always learning, listening, and refining how I show up as a provider because how we communicate matters just as much as what we prescribe.