Medications exert effects not only through biological mechanisms but also through the meanings that they carry. While positive effects (e.g., the placebo effect) are broadly recognized, psychiatry is often less attuned to the negative effects that are mediated through the meaning of medications. These negative effects may be especially pronounced when noxious meanings and countertherapeutic aspects of medications are incorporated into the unfolding development of a child and not countered by psychotherapeutic experiences that allow iatrogenic meanings to be placed in context. In this paper, psychosocial mechanisms, by which medications may cause harm, are explored. These include adverse effects on identity, impaired agency, impaired affective competence, and negative effects on the patient's relationship with care. When such harm has occurred at the level of meaning, it is best addressed at the level of meaning. Examples of psychotherapeutic work with young adults is offered to demonstrate the process of reworking developmental harm related to the meaning of medications.