Antipsychotics, the heartland of clinical psychopharmacology?

Clinicians of a certain vintage will recall discussion about the ‘heartland’ of psychiatry; the predominant view being that, ‘schizophrenia’, in all its myriad forms, should be the focus of clinical services and research, with others countering that bipolar disorder, arguably a more important disorder, had often been neglected particularly within British psychiatry (Goodwin and Geddes, 2007). Is there a similar heartland for clinical psychopharmacology? Some may assume, due to their widespread use and clear efficacy, that antidepressants are the heartland of psychopharmacology (McAllister-Williams, 2008; Young and Moulton, 2020). We would, however, argue that this term has been considered de facto to apply to the ‘antipsychotics’. The term ‘antipsychotic’ itself is archaic, stating their heterogenous effects with many neurotransmitter systems involved in different degrees. Mirroring the above bias seen in clinical psychiatry, antipsychotics are still associated with schizophrenia, despite evidence of efficacy of different antipsychotics across a range of psychiatric disorders.

https://journals.sagepub.com/doi/10.1177/02698811211043599

firemonkey. what do you think when they say that bipolar is more important? it pisses me off. jjudy

I think they mean ‘more important’ in the way it occurs relatively more frequently, and that it’s much easier to define/give a description of something like mania.

1 Like

I think maybe with our current world where it’s incredibly isolating we are over prescribing anti depressants? Like don’t get me wrong. There’s some serious issues with stress and things like ptsd we are only touching the tip of the problem but gp’s prescribing pills for psych problems is a problem in itself…

I’ve found gp’s to be so far out of the game with their responses. Yes I have a serious clinical condition but they don’t have the training or experience to help seriously mentally ill people. So. Ap’s prescribed by psychs like they should and thus a more indicative selection of what is happening?

Just a different perspective. Ps. I didn’t read the article!