Healthy Skepticism Library item: 15738

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Moncrieff J, Cohen D
How do psychiatric drugs work?
BMJ. 2009 May 29; 338:b1963:
http://www.bmj.com/cgi/content/short/338/may29_1/b1963

Abstract:

Drugs for psychiatric problems are prescribed on the assumption that they mostly act against neurochemical substrates of disorders or symptoms. In this article we question that assumption, proposing that drugs’ action be viewed rather as producing altered, drug induced states, a view we have called the drug centred model of action. We believe that this view accords better with the available evidence. It may also allow patients to exercise more control over decisions about the value of pharmacotherapy, helping to move mental health treatment in a more collaborative direction.

The widespread use of psychiatric drugs is justified by the idea that they work by correcting, or helping to correct, underlying biological abnormalities that produce particular psychiatric symptoms. We have called this view the disease centred model of psychiatric drug action (table). Most drugs used in medicine can be understood as working according to a disease centred model-even analgesics, for . . .