Sanity and Madness

The impact of psychopharmacology on the American Psychiatric Association has proven to be both profound and contentious.  While significant strides in psychiatric care are evident due to the impact of pharmaceutically driven care, no few practicing psychiatrists have raised protesting voices due what they perceive as an “unholy union” between pharmaceutical companies and psychiatrists. An example is psychiatrist Loren Mosher who resined from the A.P.A. “claiming that some of his colleagues are too quick to hand out drugs in what he terms an “unholy alliance” between psychiatrists and drug companies. A substantial number of cases of misdiagnosis and fraud support his view that patient care may be in jeopardy.” (Mosher, 1999, p. 40) Evidence for Mosher’s assertions can be pointed to without much trouble, particularly in the area of economics. Pharmaceutical companies “finance major symposia at the two predominant annual psychiatric conventions,” as well as spending “an average of $10,000 per physician, per year, on education.”  (Mosher, 1999, p. 40) These kinds of obvious and sweeping influences in addition to documented cases of misdiagnosis and the alleged suppression by psychiatrists of the common side-effects which accompany typically prescribed drugs, form the basis of what has been termed the “Calvinist” vision of psychopharmacology.

Opposing Mosher’s (and others’) assertions are the well known data regarding the efficacy of pharmaceuticals: “It is now so well-established that illnesses such as schizophrenia and bipolar disorder generally require medication, that many countries no longer allow a placebo group in clinical trials with these disorders.” (Mosher, 1999, p. 40) While the possibility for corruption and incompetence exists within any clinical treatment, it seems likely that psychopharmacology will continue to evolve and play a central role in the treatment of mental disorders.