What are the advantages and disadvantages of psychopharmacology?

Answer 1

Advantages

1) Medication can provide quick relief from symptoms. This is useful if the patient's problem is severe but occurs only rarely (e.g. seizures or occasional panic attacks), or if the patient is in immediate physical danger (suicide risk).

2) Some disorders (typically those with a clear biological basis) don't respond to therapy and can only be treated pharmacologically. Again, seizures are an example.

3) Medication is cheaper and less time consuming than therapy.

4) Medication is, to an extent, effective regardless of the patient's attitude. The patient gets better without facing difficult personal issues they would rather ignore.*

Disadvantages

1) Psychiatric drugs can have unpleasant or dangerous side effects. For example, psychosis is a possible side effect of stimulants; it occurs more frequently than people realize.

2) Many drugs are ineffective in the long term if taken regularly. This is certainly the case for antipsychotics and stimulants, and probably also for selective reuptake inhibitor type antidepressants and benzodiazapines. Often you get ~5 years of improvement, then symptoms return. The patient ends up dependent on the drug and worse off than they started.**

3) Psychiatric drugs cause brain damage. Stimulants, and SSRIs are known to be neurotoxic with prolonged use, and benzodiazapines may be as well. Antipsychotics are especially dangerous in this regard: around 20% of regular users develop tardive diskinesia, a permanent movement disorder similar to Parkinsons. They may also impair creativity, empathy, and higher reasoning.

4) Patients are sometimes medicated against their will to control undesirable or inconvenient behavior, even if they aren't a danger themselves or others. This typically happens in mental hospitals or nursing homes.***

5) Minors are given medication before they are capable of understanding the risks and benefits and making a reasoned decision.

6) Stimulants and benzodiazapines can be addictive.

*It's worth asking whether this is truly an advantage. The popular position is that all thought is reducible to physical processes in the brain, so if medication and therapy are equally effective, the end result is equivalent. You can probably tell I disagree..

**The treatment of schizophrenia is a good example of short term benefits and long term damage from medication - the prognosis at 1 year is best in America and Europe, but at 5 yrs and 10 yrs it is better in developing countries where antipsychotics aren't available.

***See: http://www.mindfreedom.org/campaign/media/mf/wsj-forced-psychiatric-drugs