The Use and Misuse of Psychiatric Drugs

An Evidence-Based Critique
1. Auflage 2010
ISBN: 978-0-470-74571-7
Verlag: Wiley

Buch, Englisch, 224 Seiten, Format (B × H): 126 mm x 198 mm, Gewicht: 240 g

"Dr. Paris has written an honest, balanced presentation of the ways in which psychiatric drugs are evaluated and prescribed. He highlights the complexity of the task, the limits of what is known and the mixed picture that research often produces. His conclusions are refreshing because they are built from an even-handed, pragmatic assessment of the empirical evidence. The result is a stimulating look at the world of treatments for emotional disorders that acknowledges the usefulness of both biological and psychosocial explanations where appropriate. His recommendations provide helpful roadmaps for patients, practitioners and researchers alike. The book is sure to serve as a welcome catalyst for the continuing debates about which treatments are likely to produce the best outcomes."
—Roger P. Greenberg, Ph.D. Distinguished Professor and Head, Psychology Division Dept. of Psychiatry & Behavioral Science SUNY Upstate Medical University, NY, USA
The message of this book is that psychiatrists have some very good drugs, but can expect bad results when they are over-used, prescribed outside of evidence-based indications, or given to the wrong patients. While acknowledging that many current agents are highly effective and have revolutionized the treatment of certain disorders, Joel Paris criticizes their use outside of an evidence base. Too many patients are either over-medicated or are misdiagnosed to justify aggressive treatment. Dr. Paris calls for more government funding of clinical trials to establish, without bias, the effectiveness of these agents. He has written this book for practitioners and trainees to show that scientific evidence supports a more cautious and conservative approach to drug therapy.

After describing the history of psychopharmacology, including its early successes, Dr. Paris reviews the relationship between psychiatry and the pharmaceutical industry. This problem has received considerable popular attention in recent years and Dr. Paris documents initiatives to increase transparency and decrease the influence of pharmaceutical marketing on diagnosis and prescribing habits.

Dr Paris then examines some major controversies. One is the fact that newer drugs have not been shown to be superior to older agents. Another is that while the number of prescriptions for antidepressants has increased dramatically, meta-analyses show that their value is more limited than previously believed. Still another is the widespread prescription of mood stabilizers and antipsychotic drugs for patients, including children and adolescents, who do not have bipolar illness. Polypharmacy is an especially contentious area: very few drug combinations have been tested in clinical trials, yet many patients end up on a cocktail of powerful drugs, each with its own side effects.

Dr Paris briefly considers alternatives to pharmacology and again calls for more clinical trials of these approaches. He also discusses the current trend to medicalizing what many would describe as normal distress and states succinctly: Some things in life are worth being upset about.

Autoren/Hrsg.

Paris, Joel

Fachgebiete

• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Suchttherapie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Pharmakologie, Toxikologie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Pharmakotherapie, Psychopharmakotherapie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Neuropharmakologie, Psychopharmakologie
• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizin, Gesundheitswesen Evidenzbasierte Medizin (EbM)

Inhaltsverzeichnis

Foreword ix

Introduction xi

Part I Overview

1 The History of Psychopharmacology 3

2 The Science of Psychopharmacology 11

3 The Pharmaceutical Industry 31

Part II Drugs in Practice

4 Antipsychotics: For Better or For Worse 57

5 Mood Stabilizers and Mood Instability 69

6 Antidepressants 85

7 Prescribing for Children and Adolescents 109

8 Polypharmacy 123

Part III Perspectives

9 Alternatives to Drugs 133

10 Medicalizing Distress 143

11 The Future of Psychopharmacology 155

References 165

Index 195

Über Autor(innen)

Joel Paris is a professor of psychiatry and former department chair who has taught in a large university for 40 years. A researcher (with over 150 publications), a clinician, and the editor of a major journal, he has written/edited 12 books. He writes in a way that can readily be understood by clinicians.
Joel Paris is an active researcher, primarily in personality disorders and child & adolescent psychiatry, and both this and his considerable practical expertise enable him to argue intelligently both for and against the use of psychotropic medications. His background as a medical investigator and broad experience in teaching young psychiatrists about the use of drugs help him to make neutral judgments about complex issues.