Journal of Medicine and the Person

, Volume 13, Issue 3, pp 187–193 | Cite as

Changing my mind: one professor’s story of rethinking psychotropic medication

  • Amber M. Gum
Original Article


Over the past few years, I have reconsidered the evidence base for psychotropic medications. Although not widely publicized or recognized, persuasive evidence suggests that psychotropic medications are less effective and more harmful than most believe. This is an emotionally charged topic that threatens the professional identity and livelihood of many individuals, leading to cognitive dissonance and cognitive biases of which we may be unaware. Personally, I experienced distress and cognitive dissonance in response to this new information, and I have begun to change my research goals and other professional activities as a result. I encourage others to: (a) examine divergent bodies of research literature and your reactions to this literature; and (b) be empathic when discussing and writing about these topics. If we can engage in open-minded, critical self-assessment and discourse, then we may ultimately improve how we care for each other during times of distress and suffering.


Antidepressants Psychotropic medication Dissonance Mental health 



I would like to thank friend and colleague, Mariaelena Bartesaghi, PhD, for inviting me to write this article and for her editorial contributions. I also would like to thank Amy J. Berman, BS, RN, Gary P. Epstein-Lubow, MD, and Brandon A. Gaudiano, PhD, who provided helpful feedback on earlier drafts. Acknowledging their efforts does not imply their endorsement or agreement with my statements in this manuscript.

Compliance with ethical standards


I received no funding related to writing this article. I have no conflicts of interest (financial or otherwise) involving the references I cited or recommended for further reading. The one conflict of interest involves my interests in psychotherapy and behavioral interventions. It benefits my guild (psychology) to promote the use of behavioral interventions. Also, I have received payment to train clinicians in problem-solving therapy, and I have done research on the effectiveness and delivery of behavioral interventions (funded by pilot grants from my university and the Retirement Research Foundation).


  1. 1.
    Whitaker R (2010) Anatomy of an epidemic: magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America. Crown Publishers, New YorkGoogle Scholar
  2. 2.
    Kohn R, Gum AM, King-Kallimanis B (2009) The epidemiology of major depression in geriatric populations. In: Ellison JM, Kyomen H, Verma SK (eds) Depression and mood disorders in later life, 2nd edn. Informa Healthcare, New York, pp 37–64Google Scholar
  3. 3.
    Fava G, Offidani E (2011) The mechanisms of tolerance in antidepressant action. Prog Neuro-Psychopharmacol Biol Psychiatry 35:1593–1602CrossRefGoogle Scholar
  4. 4.
    Fava G (2014) Rational use of antidepressant drugs. Psychother Psychosom 83:197–204PubMedCrossRefGoogle Scholar
  5. 5.
    Angell M (2011) The epidemic of mental illness: Why?. New York Review of Books, New YorkGoogle Scholar
  6. 6.
    Angell M (2011) The illusions of psychiatry. New York Review of Books, New YorkGoogle Scholar
  7. 7.
    Kirsch I (2011) Do psychotropic drugs cause mental illness? Am J Psychol 124(3):372–374CrossRefGoogle Scholar
  8. 8.
    Gotzsche PC (2015) Does long term use of psychiatric drugs cause more harm than good? Br Med J 350:h2435CrossRefGoogle Scholar
  9. 9.
    Gotzsche PC (2013) Deadly medicines and organized crime: how big pharma has corrupted healthcare. Radcliffe Publishing Ltd., LondonGoogle Scholar
  10. 10.
    Insel T (2013) Transforming diagnosis. Accessed 20 July 2015
  11. 11.
    Dowrick C, Frances A (2013) Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit. Br Med J 347:f7140CrossRefGoogle Scholar
  12. 12.
    Breggin PR (2015) Rational principles of psychopharmacology for therapists, healthcare providers and clients. J Contemp Psychother. doi: 10.1007/s10879-015-9307-2 Google Scholar
  13. 13.
    Moncrieff J, Cohen D (2009) How do psychiatric drugs work? Br Med J 338:1535–1537CrossRefGoogle Scholar
  14. 14.
    Moncrieff J, Cohen D, Porter S (2013) The psychoactive effects of psychiatric medications: the elephant in the room. J Psychoact Drugs 45:409–415CrossRefGoogle Scholar
  15. 15.
    Breggin P (2013) Psychiatric drug withdrawal: a guide for prescribers, therapists, patients and their families. Springer Publishing Co., New YorkGoogle Scholar
  16. 16.
    Gawronski B (2012) Back to the future of dissonance theory: cognitive consistency as a core motive. Soc Cognit 30:652–668CrossRefGoogle Scholar
  17. 17.
    Whitaker R, Cosgrove L (2015) Psychiatry under the influence: institutional corruption, social injury, and prescriptions for reform. Palgrave Macmillan, New YorkCrossRefGoogle Scholar
  18. 18.
    Kirsch I, Deacon B, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT (2008) Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS ONE 5:260–268Google Scholar
  19. 19.
    Pigott HE (2011) STARD: a tale and trail of bias. Ethical Hum Psychol Psychiatry 13(1):6–28. doi: 10.1891/1559-4343.13.1.6 CrossRefGoogle Scholar
  20. 20.
    Spielmans GI, Kirsch I (2014) Drug approval and drug effectiveness. Annu Rev Clin Psychol 10:741–766. doi: 10.1146/annurev-clinpsy-050212-185533 PubMedCrossRefGoogle Scholar
  21. 21.
    Pigott HE, Leventhal AM, Alter GS, Boren JJ (2010) Efficacy and effectiveness of antidepressants: current status of research. Psychother Psychosom 79(5):267–279. doi: 10.1159/000318293 PubMedCrossRefGoogle Scholar
  22. 22.
    Huedo-Medina TB, Johnson BT, Kirsch I et al (2012) Kirsch et al.’s (2008) calculations are correct: reconsidering Fountoulakis and Möller’s re-analysis of the Kirsch data. Int J Neuropsychopharmacol 15(8):1193–1198. doi: 10.1017/S1461145711001878 PubMedCrossRefGoogle Scholar
  23. 23.
    Areán PA, Gum AM (2013) Psychologists at the table in health care reform: the case of geropsychology and integrated care. Prof Psychol Res Pract 44(3):142–149. doi: 10.1037/a0031083 CrossRefGoogle Scholar
  24. 24.
    Gum AM, Hirsch A, Dautovich ND, Ferrante S, Schonfeld L (2014) Six-month utilization of psychotherapy by older adults with depressive symptoms. Community Ment Health J 50:759–764. doi: 10.1007/s10597-014-9704-0 PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Fishleder S, Gum AM, Schonfeld L, Tyler S, Guerra L (2015) One-visit behavioral intervention for older primary care patients with mild-moderate depressive symptoms: a pilot study. Poster presented at the annual meeting of Academy Health, MinneapolisGoogle Scholar
  26. 26.
    Dunning D (2015) Motivated cognition in self and social thought. In: Mikulincer M, Shaver PR, Borgida E et al (eds) APA handbook of personality and social psychology: attitudes and social cognition, vol 1. APA handbooks in psychology, American Psychological Association, Washington, DC, pp 777–803. doi: 10.1037/14341-025 CrossRefGoogle Scholar
  27. 27.
    Clabby JF (2011) Two minute talks to improve psychological and behavioral health. Radcliffe Publishing Ltd., LondonGoogle Scholar
  28. 28.
    Gum AM, Dautovich ND, Greene J, Hirsch A, Schonfeld L (2015) Improving home-based providers’ communication to primary care providers to enhance care coordination. Aging Ment Health 19:921–931. doi: 10.1080/13607863.2014.977772 PubMedCrossRefGoogle Scholar
  29. 29.
    Gum AM, Greene J, DeMuth A, Dautovich ND (2013) Primary care physicians’ attitudes regarding collaborating with home-based depression care managers. Home Health Care Manag Pract. doi: 10.1177/1084822313480178 Google Scholar
  30. 30.
    Elliott R, Bohart AC, Watson JC, Greenberg LS (2011) Empathy. Psychotherapy 48(1):43–49. doi: 10.1037/a0022187 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  1. 1.Department of Mental Health Law and Policy, Louis de la Parte Florida Mental Health InstituteUniversity of South FloridaTampaUSA

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