Theoretical assumptions about how psychotropic drugs ‘work’ are rarely discussed explicitly. In a ‘disease-centred model,’ drugs are believed to work by acting on a disease process. In contrast, in a ‘drug-centred model,’ the characteristic physiological, behavioural and subjective effects of drugs are used to define drug action. The therapeutic value of a drug stems from the usefulness of these effects in clinical situations. The disease-centred model appears dominant but has weaknesses: (1) it cannot logically justify the use of drugs since major pathophysiological hypotheses were derived from selectively observed actions of drugs; (2) comparisons between drugs believed to have specific effects in certain conditions and drugs thought to have non-specific effects fail to support it; (3) outcome measures for various disorders include items responsive to non-specific drug effects; (4) studies with healthy volunteers describe characteristic drug-induced states independently of a psychiatric diagnosis; (5) animal tests show effects with agents not usually thought of as specific treatments for the conditions modelled by tests. This article offers suggestions to develop a drug-centred model and discusses its potential impact on clinical practice.
Dr. Joanna Moncrieff
Mascalls Park Hospital
Mascalls Lane, Brentwood
Essex CM14 5HQ (UK)
Tel. +44 1277 302695, Fax +44 1277 302696, E-Mail firstname.lastname@example.org
Number of Print Pages : 9
Number of Figures : 0, Number of Tables : 0, Number of References : 68
Psychotherapy and Psychosomatics
Vol. 74, No. 3, Year 2005 (Cover Date: Released April 2005)
Journal Editor: Fava, G.A. (Bologna)
ISSN: 0033–3190 (print), 1423–0348 (Online)
For additional information: http://www.karger.com/pps
Article / Publication Details
Published online: 4/11/2005
Issue release date: April 2005
Number of Print Pages: 9
Number of Figures: 0
Number of Tables: 0
ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)
For additional information: http://www.karger.com/PPS
Copyright / Drug Dosage
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.