Psychopharmacology: a house divided

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• The traditional specificity model in psychopharmacology assumes distinct disorders respond to drugs with specific mechanisms.
• This model is challenged by multiple drug approvals for single disorders and single drugs for diverse conditions.
• The use of antipsychotics for depression exemplifies a potential paradigm shift.

Purpose of the Study:

• To investigate the neurochemical commonalities between antipsychotics and antidepressants.
• To examine the foundation for using antipsychotics in depression treatment.

Main Methods:

• Extensive literature search on antipsychotic and antidepressant mechanisms of action.
• Identification of common neurochemical processes between these drug classes.

Main Results:

• Profound neurochemical differences exist between antipsychotics and antidepressants.
• Commonalities include neuroprotection and epigenetic changes.
• The clinical impact of these shared features remains uncertain.

Conclusions:

• Psychiatry largely adheres to the specificity model.
• Clinicians appear to adopt a dimensional model, treating symptoms with various medications regardless of diagnosis.