The subjective experience of taking antipsychotic medication: a content analysis of Internet data

Moncrieff, Joanna; Cohen, David; Mason, J. P.

doi:10.1111/j.1600-0447.2009.01356.x

Cited by 112 publications

(103 citation statements)

References 50 publications

(81 reference statements)

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“…This inconsistent assessment of non-neurological effects replicates the conclusions of existing surveys, 22,[50][51] despite concerns about the substantial impact of nonneurological AEs on factors like physical attractiveness, 52 feelings of reduced intelligence and creativity, 53 and social stigma and ridicule. 54 Furthermore, while sedation was generally well-reported, affective and non-sedative cognitive AEs were referred to far less frequently, despite patient testimony that subjective effects like dysphoria (e.g., feeling 'robotic', 'emotionally empty,' 53 ) are both common and distressing.…”

Section: Assessment Of Adverse Effectssupporting

confidence: 67%

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Assessing and Reporting the Adverse Effects of Antipsychotic Medication

Longden

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2016

Clinical Neuropharmacology

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Objective: Adverse effects (AEs) of antipsychotic medication have important implications for patients and prescribers in terms of wellbeing, treatment adherence and quality of life. This review summarises strategies for collecting and reporting AE data across a representative literature sample to ascertain their rigour and comprehensiveness.Methods: A PsycINFO search, following PRISMA Statement guidelines, was conducted in English-language journals (1980-July 2014) using the following search string: (antipsychotic* OR neuroleptic*) AND (subjective effect OR subjective experience OR subjective response OR subjective mental alterations OR subjective tolerability OR subjective wellbeing OR patient perspective OR self-rated effects OR adverse effects OR side-effects). Of 7,825 articles, 384 were retained that reported quantified results for AEs of typical or atypical antipsychotics amongst transdiagnostic adult, adolescent, and child populations. Information extracted included: types of AEs reported; how AEs were assessed; assessment duration; assessment of the global impact of antipsychotic consumption on wellbeing; and conflict of interest due to industry sponsorship.Results: Neurological, metabolic, and sedation-related cognitive effects were reported most systematically relative to affective, anticholinergic, autonomic, cutaneous, hormonal, miscellaneous, and non-sedative cognitive effects. The impact of AEs on patient wellbeing was poorly assessed. Cross-sectional and prospective research designs yielded more comprehensive data about AE severity and prevalence than clinical or observational retrospective studies. Antipsychotic medication is associated with numerous adverse effects (AEs), ranging from mild and intermittent (e.g., dizziness and nausea) to incapacitating (e.g., extrapyramidal symptoms: EPS), some of which can disrupt an array of physical and psychological systems. [1][2][3] Since the institution of antipsychotics in the 1950s, it has been recognised that patients generate subjective interpretations of the sensations that attend drug consumption. However, the imperative for standardising psychiatric phenomena arguably led "to a gradual disregard of subjective experiences…which were relegated to 'soft' science." 4: p.55 Correspondingly, much research has prioritized efficacy and safety parameters rather than the more subjective construct of tolerability. Interest in the latter was advanced by the work of Hogan et al. psychometrically robust scales that patients can reliably complete has also advanced the research agenda. [13][14][15] This is important progress, given the necessity of auditing the relative prevalence and severity of AEs, and corresponding impact on patient wellbeing. In this respect, the substantial differences in AE profiles for different 5 antipsychotics (compared to robust, yet small, mean differences in efficacy) 16 makes the former an important component of prescribing choices and, in accordance with best-practice guidelines, can empower service-users in making inform...

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Section: Assessment Of Adverse Effectssupporting

confidence: 67%

“…54 Furthermore, while sedation was generally well-reported, affective and non-sedative cognitive AEs were referred to far less frequently, despite patient testimony that subjective effects like dysphoria (e.g., feeling 'robotic', 'emotionally empty,' 53 ) are both common and distressing.…”

Section: Assessment Of Adverse Effectsmentioning

confidence: 99%

Assessing and Reporting the Adverse Effects of Antipsychotic Medication

Longden

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2016

Clinical Neuropharmacology

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“…Estos grupos de autoayuda, y las psicoterapias, comparten estos supuestos, y seguramente no es extraño que obtengan resultados positivos: la escucha, el apoyo compasivo, y la creación de un espacio para la esperanza pueden ser mejores que un modelo de enfermedad centrado en el uso más o menos coercitivo de fármacos que provocan malestar y entorpecen la regulación emocional (2,20,64,118,119).…”

Section: Esperanza En Que La Recuperación Es Posible B) Comprender Lunclassified

¿Hay lugar para el consentimiento informado en los tratamientos de las personas con psicosis?: una reflexión sobre el tratamiento de las psicosis

Valverde

Inchauspe

2014

Rev. Bioética y Derecho

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Esta es una revista de acceso abierto, lo que significa que todo el contenido es de libre acceso sin costo alguno para el usuario o su institución. Los usuarios pueden leer, descargar, copiar, distribuir, imprimir, buscar, o enlazar los textos completos de los artículos en esta revista sin pedir permiso previo del editor o del autor, siempre que no medie lucro en dichas operaciones y siempre que se citen las fuentes. Esto está de acuerdo con la definición BOAI de acceso abierto.

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“…Antipsychotics produce a specific state of neurological inhibition, characterised by cognitive slowing, reduced initiative and motivation and emotional restriction that is not simply attributable to their (mostly) sedative effects (Breggin, 2008;Moncrieff, Cohen & Mason, 2009). These effects are likely to reduce the intensity of emotional distress and psychotic thoughts, but may also impair global functioning.…”

Section: Using Drugs According To a Drug Centred Modelmentioning

confidence: 99%

Research on a ‘drug-centred’ approach to psychiatric drug treatment: assessing the impact of mental and behavioural alterations produced by psychiatric drugs

Moncrieff

2017

Epidemiol Psychiatr Sci

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Aims:This article explores an alternative understanding of how psychiatric drugs works that is referred to as the drug-centred model of drug action. Unlike the current diseasecentred model, which suggests that psychiatric drugs work by correcting an underlying brain abnormality, the drug-centred model emphasises how psychiatric drugs affect mental states and behaviour by modifying normal brain processes. The alterations produced may impact on the emotional and behavioural problems that constitute the symptoms of mental disorders. Methods:Arguments are put forward that justify the consideration of the drug-centred model.The research necessary to support the prescription of drugs according to such a model is explored. Results:Evidence from neurochemistry and comparative drug trials do not confirm the disease-centred model of drug action. Since psychiatric drugs are recognised to have mind and behaviour-altering properties, the drug-centred model constitutes a plausible alternative. The drug-centred model suggests research is needed to identify all the alterations produced by various sorts of drugs, both acute and long-term, and how these might interact with the symptoms and problems associated with different mental disorders. This requires detailed animal and volunteer studies and data from patients prescribed drug treatment long-term, along with placebo-controlled and comparative 3 trials that look at the overall impact of drug-induced alterations on well-being and functioning as well as symptoms. Research is also needed on alternative ways of fulfilling the function of drug treatment. The moral aspect of using drugs to modify behaviour rather than treat disease needs honest and transparent consideration. Conclusions:It is hoped this discussion will encourage the psychiatric and pharmaceutical research community to provide more of the information that is required to use psychiatric drugs safely and effectively.

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The subjective experience of taking antipsychotic medication: a content analysis of Internet data

Abstract: The generalisability of Internet data is uncertain. However, the data suggest that adverse subjective effects play a central role in the experience of taking antipsychotic drugs and may be related to the drugs' desired benefits.

Cited by 112 publications

References 50 publications

Assessing and Reporting the Adverse Effects of Antipsychotic Medication

Assessing and Reporting the Adverse Effects of Antipsychotic Medication

¿Hay lugar para el consentimiento informado en los tratamientos de las personas con psicosis?: una reflexión sobre el tratamiento de las psicosis

Research on a ‘drug-centred’ approach to psychiatric drug treatment: assessing the impact of mental and behavioural alterations produced by psychiatric drugs

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