An Alternative Approach to Drug Treatment in Psychiatry

Abstract

This article explores an alternative understanding of how psychiatric drugs work that is referred to as the “drug-centred” model of drug action. Unlike the standard “disease-centred” model, which suggests that psychiatric drugs work by correcting an underlying brain abnormality, the drug-centred model emphasises how psychiatric drugs affect mental states and behaviour by modifying normal brain processes. The alterations produced are superimposed on the emotional and behavioural problems that constitute the symptoms of mental disorders. The chapter examines research into drug action to show the dearth of support for the disease-centred model. It then explores the clinical implications of adopting a drug-centred model of drug action. This requires a detailed understanding of the mental and physical alterations produced by individual drugs and an exploration of how those alterations might interact with particular sets of symptoms and problems. Drug-centred approaches to the drug treatment of psychosis and depression are presented as examples. It is concluded that any benefits due to being in an altered state need to be carefully balanced against the damage that may occur with long-term exposure and that we need further research to elucidate all the consequences of using drugs in this way.