I really don’t think they are (all bad). They get over-prescribed. I also think psychiatrists turn to new drugs that have little track record, rather than using older, less flashy drugs that are at least known quantities. One reason for turning to novel substances is that the old medications don’t work that well; usually, however, the new ones don’t either. The more pernicious reason for prescribing the recently released chemicals is the drug company demand for profit margin.

Anyone who spends time in a psychiatric ward as clinician or observer rather than a patient (I’ve been on the ward in all three capacities at different times), can see that medications really are necessary in some cases. There is a perception that the meds are just to control behavior, and they do get used that way; more often, however, there is genuine suffering going on, and the drugs help.

The same is true in outpatient settings. Sometimes people are in such pain that more conservative measures have no chance of success. Medications are needed to bring the symptoms down to a level where a person can engage his or her recovery. The problems come up when too much medication is prescribed for too long a time. In particular, I suspect that many people could eventually be weaned off most (not necessarily all) medications over time. However, there is little incentive to try. The drug companies discourage the loss of sales; the doctors don’t want the extra work of handling patients who might decompensate, and often the patient (or family) is frightened of setbacks. It takes time, work and commitment to get someone off medications. It is so much easier to just leave them as-is: heavily medicated.

So my message is not that drugs are bad. Just that new ones should be used cautiously, and all drugs should be used in the lowest dose for the shortest time possible.

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