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Dynamic informed consent processes vital for treatment with antidepressants
Abilash A Gopal1, Lisa Cosgrove, Itay Shuv-Ami
1Department of Psychiatry at the University of California, San Francisco, United States.
International Journal of Law and Psychiatry
|October 6, 2012
Summary
Informed consent for antidepressant medication is hindered by industry influence and cognitive biases. A dynamic, dialog-based approach is needed for better patient understanding and outcomes.
Area of Science:
- Medical Ethics
- Clinical Pharmacology
- Patient Communication
Background:
- Technological advances improve clinician access to information on antidepressant risks and benefits.
- Pharmaceutical industry influence can impede the informed consent process for psychotropic medications.
- Emerging adverse effects of newer antidepressants highlight the need for enhanced informed consent.
Purpose of the Study:
- To review the evolution of informed consent in clinical practice.
- To identify recent side effects of second- and third-generation antidepressants.
- To analyze impediments to adequate informed consent during patient encounters.
Main Methods:
- Literature review on informed consent evolution and antidepressant side effects.
- Analysis of clinical encounter barriers, including industry influence, cognitive bias, and time constraints.
- Proposal of a dynamic informed consent model.
Main Results:
- Newer antidepressants have potentially dangerous side effects not always fully disclosed.
- Industry influence, cognitive biases, and time limitations significantly hinder informed consent.
- A static, checklist approach to informed consent is insufficient.
Conclusions:
- Revisiting informed consent is crucial given antidepressant safety concerns and existing barriers.
- A dynamic, ongoing dialog between clinician and patient is essential for empowerment.
- Strengthening the therapeutic alliance through shared decision-making improves treatment outcomes.
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