Collaboration in pharmacotherapy implies a professional willing to prescribe an effective medication and a patient willing to adhere to the therapeutic regimen in order for both to achieve their common goal. This relationship requires trust in the relationship, collaboration in goal setting, and effective means for promoting and restoring mental health. Variables like illness insight and patients’ attitudes towards medication should be dealt within a collaborative relationship. Several methods of shared decision making, culled from the research literature and clinical experience, promote such prescriber-patient collaboration and, even more specifically, medication adherence. Detailed physician-patient interactions in 2 cases, one of a depressed patient and one of a patient suffering from schizophrenia, serve to highlight common difficulties in the management of pharmacotherapy in the context of a collaborative relationship.