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  • Print publication year: 2008
  • Online publication date: August 2009

14 - Integrating theory, practice and economics in psychopharmacology


Critiques and reservations regarding the role and contribution of psychotropic agents in the care of psychiatric patients notwithstanding (Moncrieff, 2001; Healy, 2002), there is little doubt that the advent of modern psychopharmacology in the 1950s has vastly and profoundly altered the landscape of psychiatry. Phenothiazines and related compounds in the past half century have enabled millions of severely mentally ill patients to escape the fate of lifelong confinement. “Antidepressants” and mood stabilizers, equally serendipitously discovered around the same time, often effectively, and at times truly miraculously, lifted millions from various forms of misery. Together they also helped to change (albeit not fast enough and still a long way to go) the public's perception of the mentally ill as well as the professions charged with their care, helping to destigmatize behavioral and emotional problems. Irrespective of the extent of their therapeutic effects, the fact that simple chemical compounds could so profoundly alter behavior was itself inspiring for a new generation of scientists, who helped to usher in a new era of intensive research for the biological substrates of psychiatric phenomena, resulting in the blossoming of biological psychiatry and neuroscience in the last few decades (Carlsson, 1988; Bloom & Kupfer, 1995).

To be sure, examined at closer range, the effect of this “paradigm shift” on the profession and for society is far more complex and nuanced. Advances on the biological front not infrequently have been regarded as threats for our field's expertise in the psychosocial domains.

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