What is really known about psychological alterations produced by psychiatric drugs?

Abstract

This paper argues that information about psychiatric drugs derived from conventionally conducted randomized controlled clinical trials (RCTs) is inadequate to form an accurate picture of drug‐induced psychological alterations. Two main lines of argument are presented. The first concerns the disparity between adverse effects established in RCTs and the broader range of adverse drug reaction reports which derive from non‐RCT formats. The second concerns the contention that information about drug‐induced psychological alterations obtained from RCTs is too limited to address the meaning of observed “target symptom” reduction which occurs during the course of the (typically very brief) investigation. The paper considers the possibility that nominal “therapeutic” drug effects may only be part of a larger, inadequately discerned picture of drug‐induced psychological toxicity.