Joanna Moncrieff: Psychiatric Drug Mechanisms of Action

June 27, 2017

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This week we interview Doctor Joanna Moncrieff.

Dr. Moncrieff is a psychiatrist, academic and author. She has an interest in the history, philosophy and politics of psychiatry, and particularly in the use, misuse and misrepresentation of psychiatric drugs. She is one of the founding members and the co-chair person the Critical Psychiatry Network. The Critical Psychiatry Network consists of psychiatrists from around the world who are sceptical of the idea that mental disorders are simply brain diseases and of the dominance of the pharmaceutical industry.

We discuss Dr. Moncrieff’s work to address the realities of psychiatric drugs and the groundbreaking RADAR study which focuses on antipsychotic drugs.

In this episode we discuss:

How Dr. Moncrieff became interested in Psychiatry
That, while working as a junior Psychiatrist, Dr. Moncrieff came to realise the dominance of drugs as a psychiatric treatment
Why Dr. Moncrieff founded the Critical Psychiatry Network
That it is often difficult to challenge the status quo in Psychiatry
Dr. Moncrieff’s work to formulate a drug centred model as an explanation of how drugs work in the body and the comparison to a disease centred model
How the chemical imbalance theory of depression is not supported by evidence
That psychiatric drugs are mind altering substances in themselves, in other words they alter normal thinking, emotion and behaviour
That much of the research over the decades has ignored the fact that these drugs alter the way that people feel and behave
That these drug-induced effects in themselves mean that placebo controlled trials cannot demonstrate that drugs target an underlying biological problem
Psychiatric drugs are not sophisticated or targeted treatments for mental illnesses, their effects are general in natureHow patients tend to stay on the drugs because withdrawal is difficult or they feel they may struggle without the effect of the drug
As a general principle, people should take the minimum dosage of these drugs for the shortest possible time
How case studies of people who have struggled with withdrawal are very important to demonstrate the difficulties and to help with guidance and support
How psychiatric drugs cause adaptations in the brain as the brain moves to compensate for the effects of the drug and that this compensation is often responsible for withdrawal effects when the drug is stopped
The RADAR study (Research into Antipsychotic Discontinuation and Reduction) which looks at long term use of antipsychotic drugs and provides support to gradually withdraw users from their drugs
How this study will both help patients withdraw and also build up experience and knowledge to help others in future
The concerns around long term use of antipsychotics and possible harm to the brain