An Evidence-Based Critique
E-Book, Englisch, 224 Seiten, E-Book
ISBN: 978-1-119-99402-2
Verlag: John Wiley & Sons
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)
--Roger P. Greenberg, Ph.D. Distinguished Professor andHead, Psychology Division Dept. of Psychiatry & BehavioralScience SUNY Upstate Medical University, NY, USA
The message of this book is that psychiatrists have some verygood drugs, but can expect bad results when they are over-used,prescribed outside of evidence-based indications, or given to thewrong patients. While acknowledging that many current agents arehighly effective and have revolutionized the treatment of certaindisorders, Joel Paris criticizes their use outside of an evidencebase. Too many patients are either over-medicated or aremisdiagnosed to justify aggressive treatment. Dr. Paris calls formore government funding of clinical trials to establish, withoutbias, the effectiveness of these agents. He has written this bookfor practitioners and trainees to show that scientific evidencesupports a more cautious and conservative approach to drugtherapy.
After describing the history of psychopharmacology, includingits early successes, Dr. Paris reviews the relationship betweenpsychiatry and the pharmaceutical industry. This problem hasreceived considerable popular attention in recent years and Dr.Paris documents initiatives to increase transparency and decreasethe influence of pharmaceutical marketing on diagnosis andprescribing habits.
Dr Paris then examines some major controversies. One is the factthat newer drugs have not been shown to be superior to olderagents. Another is that while the number of prescriptions forantidepressants has increased dramatically, meta-analyses show thattheir value is more limited than previously believed. Still anotheris the widespread prescription of mood stabilizers andantipsychotic drugs for patients, including children andadolescents, who do not have bipolar illness. Polypharmacy is anespecially contentious area: very few drug combinations have beentested in clinical trials, yet many patients end up on a cocktailof powerful drugs, each with its own side effects.
Dr Paris briefly considers alternatives to pharmacology andagain calls for more clinical trials of these approaches. He alsodiscusses the current trend to medicalizing what many woulddescribe as normal distress and states succinctly: Some things inlife are worth being upset about.
Autoren/Hrsg.
Weitere Infos & Material
Foreword.
Introduction.
Part I OVERVIEW.
1 The History of Psychopharmacology.
2 The Science of Psychopharmacology.
3 The Pharmaceutical Industry.
Part II DRUGS IN PRACTICE.
4 Antipsychotics: For Better or For Worse.
5 Mood Stabilizers and Mood Instability.
6 Antidepressants.
7 Prescribing for Children and Adolescents.
8 Polypharmacy.
Part III PERSPECTIVES.
9 Alternatives to Drugs.
10 Medicalizing Distress.
11 The Future of Psychopharmacology.
References.
Index.