Drug treatments

Since the 1950’s effective drug treatments have revolutionised the management of many psychiatric disorders. However, there is no such thing as a “miracle cure” and the use of drugs in psychiatry requires psychological as well as pharmacological skills. Because of the sensitivity and complexity of the central nervous system interactions and adverse effects with psychotropic (i.e. psychologically active) drugs are common. The pharmacokinetics and pharmacodynamics of these compounds must therefore be understood. It is not obvious to patients that drugs can improve their psychological difficulties, especially if insight is impaired, and steps to encourage compliance are vital.

Psychosocial effects of taking medication may be positive (e.g. placebo effect) or negative (e.g. less motivation in psychotherapy because tablets are seen as a panacea). Medication is often just one component of a treatment plan that also includes psychosocial therapies. The place of drugs in this combined approach should be explained to the patient.

Resources

Handout
Psychopharmacology handout (.pdf)

Blog
Link to blog posts featuring use of medication

Internal video resources

External links
— Ben Goldacre talking about the placebo effect
httpvh://www.youtube.com/watch?v=wsFTgirKXHk
— …and then about the nocebo effect
httpvh://www.youtube.com/watch?v=O1Q3jZw4FGs
— …and with a whole host of posts on his Bad Science website about placebos
NICE guidance for treatment of mental and behavioural disorders
SIGN (Scottish) guidelines for mental disorders