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Out of the Box
Arch Gen Psychiatry. 2002;59:281.
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MODERN psychopharmacology is about a half century old. The drugs it
has spawned have saved and restored lives. But the agents we currently use
are far from perfect. We probe ill-defined disorders with empirical pharmacologic
trials. Too often, complex medication regimens are thrown at poorly responsive
clinical problems, with insufficient justification. Adverse effects can be
burdensome and serious. Real-world compliance falls far short of accepted
guidelines and international consensus.
After a heady period of drug development in the 1950s and early 1960s,
clinical psychopharmacology underwent several decades of relative quiescence
and retrenchment. By the late 1980s, the engine had started up again. Novel
antipsychotics are now largely overtaking the first generation. A wide spectrum
of depression and anxiety disorders is treated by newer antidepressants, and
many patients with bipolar disorder take multiple novel compounds, most of
which lack proof of efficacy.
The pharmaceutical industry has rediscovered psychiatric disorders with
great . . . [Full Text of this Article]
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