The Use and Misuse of Psychiatric Drugs: An Evidence-Based Critique

• Publisher:           Wiley
  
• Number Of Pages:           224
  
• Publication Date:           2010-10-12
  
• ISBN-10 / ASIN:           0470745711
  
• ISBN-13 / EAN:           9780470745717
  

   Product Description:
"Dr.  Paris has
written an honest, balanced presentation of the ways  in  which  
psychiatric drugs are evaluated and prescribed. He highlights  the  
complexity of the task, the limits of what is known and the mixed    
picture that research often produces. His conclusions are refreshing    
because they are built from an even-handed, pragmatic assessment of the
  empirical evidence. The result is a stimulating look at the world of
  treatments for emotional disorders that acknowledges the usefulness
of    both biological and psychosocial explanations where appropriate.
His    recommendations provide helpful roadmaps for patients,
practitioners  and   researchers alike. The book is sure to serve as a
welcome catalyst  for   the continuing debates about which treatments
are likely to  produce  the  best outcomes."
—Roger P. Greenberg, Ph.D. Distinguished Professor and Head, Psychology
   Division Dept. of Psychiatry & Behavioral Science SUNY Upstate  
 Medical University, NY, USA
The message of  
this book is that psychiatrists have some very good  drugs, but can  
expect bad results when they are over-used, prescribed  outside of  
evidence-based indications, or given to the wrong patients.  While  
acknowledging that many current agents are highly effective and  have  
revolutionized the treatment of certain disorders, Joel Paris    
criticizes their use outside of an evidence base. Too many patients are
  either over-medicated or are misdiagnosed to justify aggressive    
treatment. Dr. Paris calls for more government funding of clinical    
trials to establish, without bias, the effectiveness of these agents. He
   has written this book for practitioners and trainees to show that  
scientific evidence supports a more cautious and conservative approach
  to drug therapy.
After describing the
history   of psychopharmacology, including its  early successes, Dr.
Paris  reviews  the relationship between psychiatry  and the
pharmaceutical  industry.  This problem has received considerable  
popular attention in  recent  years and Dr. Paris documents initiatives
to  increase  transparency and  decrease the influence of pharmaceutical
 marketing on  diagnosis and  prescribing habits.
Dr
Paris  then examines  some major controversies. One is the fact that  
newer  drugs have not  been shown to be superior to older agents.
Another  is  that while the  number of prescriptions for antidepressants
has   increased dramatically,  meta-analyses show that their value is
more   limited than previously  believed. Still another is the
widespread   prescription of mood  stabilizers and antipsychotic drugs
for patients,   including children  and adolescents, who do not have
bipolar illness.   Polypharmacy is an  especially contentious area: very
few drug   combinations have been  tested in clinical trials, yet many
patients end   up on a cocktail of  powerful drugs, each with its own
side effects.
Dr   Paris briefly considers
alternatives to pharmacology and again  calls   for more clinical trials
of these approaches. He also discusses  the   current trend to
medicalizing what many would describe as normal    distress and states
succinctly: Some things in life are worth being    upset about.

Table of Contents

Introduction

I Overview

1 The history of psychopharmacology

2 The science of psychopharmacology

3 The pharmaceutical industry

II Drugs in practice

4 Antipsychotics: for better and for worse

5 Mood stabilizers and mood instability

6 Antidepressants and anxiolytics

7 Prescribing for children and adolescents

8 The path to polypharmacy

III Perspectives

9 Alternatives to drugs

10 Medicalizing distress

11 The future of psychopharmacology

Bibliography

Index

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