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Research on a 'drug-centred' approach to psychiatric drug treatment: assessing the impact of mental and behavioural alterations produced by psychiatric drugs

Moncrieff, J; (2018) Research on a 'drug-centred' approach to psychiatric drug treatment: assessing the impact of mental and behavioural alterations produced by psychiatric drugs. Epidemiology and Psychiatric Sciences , 27 (2) pp. 133-140. 10.1017/S2045796017000555. Green open access

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Abstract

AIMS: 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 current 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 may impact on the emotional and behavioural problems that constitute the symptoms of mental disorders. METHODS: Arguments are put forward that justify the consideration of the drug-centred model. The research necessary to support the prescription of drugs according to such a model is explored. RESULTS: Evidence from neurochemistry and comparative drug trials do not confirm the disease-centred model of drug action. Since psychiatric drugs are recognised to have mind- and behaviour-altering properties, the drug-centred model constitutes a plausible alternative. The drug-centred model suggests that research is needed to identify all the alterations produced by various sorts of drugs, both acute and long term, and how these might interact with the symptoms and problems associated with different mental disorders. This requires detailed animal and volunteer studies and data from patients prescribed drug treatment long term, along with placebo-controlled and comparative trials that look at the overall impact of drug-induced alterations on well-being and functioning as well as symptoms. Research is also needed on alternative ways of fulfilling the function of drug treatment. The moral aspect of using drugs to modify behaviour rather than treat disease needs honest and transparent consideration. CONCLUSIONS: It is hoped this discussion will encourage the psychiatric and pharmaceutical research community to provide more of the information that is required to use psychiatric drugs safely and effectively.

Type: Article
Title: Research on a 'drug-centred' approach to psychiatric drug treatment: assessing the impact of mental and behavioural alterations produced by psychiatric drugs
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S2045796017000555
Publisher version: https://doi.org/10.1017/S2045796017000555
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: psychopharmacology; psychotropic drugs; research design and methods; antidepressants; antipsychotics; drug mechanism of action
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10047105
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