Joanna Moncrieff: Psychiatric Drug Mechanisms of Action


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

Relevant links

Dr. Joanna Moncrieff

The myth of the chemical cure

What is critical psychiatry

Inconvenient Truths About Antipsychotics: A Response to Goff et al

The RADAR study