The Psychoactive Effects of Psychiatric Medication: The Elephant in the Room

Abstract

The psychoactive effects of psychiatric medications have been obscured by the presumption that these medications have disease-specific actions. Exploiting the parallels with the psychoactive effects and uses of recreational substances helps to highlight the psychoactive properties of psychiatric medications and their impact on people with psychiatric problems. We discuss how psychoactive effects produced by different drugs prescribed in psychiatric practice might modify various disturbing and distressing symptoms, and we also consider the costs of these psychoactive effects on the mental well-being of the user. We examine the issue of dependence, and the need for support for people wishing to withdraw from psychiatric medication. We consider how the reality of psychoactive effects undermines the idea that psychiatric drugs work by targeting underlying disease processes, since psychoactive effects can themselves directly modify mental and behavioral symptoms and thus affect the results of placebo-controlled trials. These effects and their impact also raise questions about the validity and importance of modern diagnosis systems. Extensive research is needed to clarify the range of acute and longer-term mental, behavioral, and physical effects induced by psychiatric drugs, both during and after consumption and withdrawal, to enable users and prescribers to exploit their psychoactive effects judiciously in a safe and more informed manner.

Recovery from psychosis: physical health, antipsychotic medication and the daily dilemmas for mental health nurses

“…) and adverse effects of psychotropic medication, including those experienced when medication is discontinued (Foley & Morley , Moncrieff et al . ).…”

Who’s Talking About Us Without Us? A Survivor Research Interjection into an Academic Psychiatry Debate on Compulsory Community Treatment Orders in Ireland

“…This does not happen for people with intellectual disability, with dementia, or psychosocial disabilities. There are concerns about the coercive misuse of psychotropic medications as behavioral control measures in all institutional settings where people with cognitive disabilities have been historically congregated (Moncrieff et al 2013;Peisah and Skladzien 2014;Tsiouris 2010). The thrust of de-institutional efforts is to dismantle the total institution and ensure people have the resources they need to live in the community (Fabris 2011).…”

Chronic Traumatic Encephalopathy: Connecting Mechanisms to Diagnosis and Treatment

“…Although this study chiefly focused on the ability of lithium to reduce the presence of beta-amyloid plaques in the brain, a feature that is more consistent with Alzheimer's disease, the fact that an attenuation of tau neuropathology was also observed suggests that these findings may also be relevant to CTE. Additional research on using lithium as a treatment for brain injury and CTE is warranted as lithium is known to have psychotropic effects, including producing symptoms of dysphoria and cognitive slowing (Moncrieff, Cohen, & Porter, 2013). Considering that cognitive disturbances and depression, which are often accompanied by dysphoria, are symptoms of brain injury and CTE, these effects of lithium may pose obstacles for its usage as a treatment method.…”