The sterility of modern psychopharmacology - 'Mania' by David Healy

From 'Mania' by David Healy, Johns Hopkins University Press, 2008 - pages 225-6.

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"In psychiatry, branding depends heavily on neuroscientific research funded by government and research-granting bodies. Without this research, there would be very little understanding of what the pill does in the brain and, as a result, very little language available with which to describe the effects of drugs for marketing purposes.

"From the point of view of marketing, the advantage in a flourishing neuroscience is not that it might lead to better drugs, or a better understanding of how brains work, but rather that it provides concepts and languages for marketers to use.

"For this reason, when the first psychotropic drugs emerged in the 1950s, the pharmaceutical industry had little option but to bankroll 'academic' organizations to help grow the necessary language.

"When in the 1990s neuroscience threw up colorful images of the brain, marketers found these invaluable for purportedly showing the cleaner effects of SSRIs compared to older antidepressants. There was little neuroscientific value to the images, but they provided wonderful marketing copy.

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"This marketing process stands the science of psychopharmacology on its head. Tom Ban first noted in the 1980s the increasing gap between the former hope that new psychotropic drugs would help carve nature at its joints and the reality of psychiatric practice, which was that the neuroleptic drugs had become antipsychotic agents that it was impossible not to give to all psychotic patients despite good evidence that many would not benefit.

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"We have now arrived at a point that is almost the precise inverse of the original hope. Rather than drugs being used to carve nature at its joints, nature is instead being used to differentiate drugs whose differences are essentially trivial.

"A psychopharmacology of this sort will inevitably be sterile and is capable of rescue only by serendipity."