Blunders played a significant role in the early years of psychiatry and drug discoveries for psychiatric dysfunctions, largely because the process was highly random, functioning on ‘hit or miss’ procedures. Psychiatric patients were exposed to drugs and observed for effectiveness without much precautions or ethical standards, and if some effect could be seen, the medication would be quickly rushed to the market to be essentially tested in open public regardless of their danger or effectiveness (Pinel & Barnes, 2018).
The key to developing a drug is to determine the biological pathogenesis of the illness. This principle in psychiatry goes back as far as the 1930s when experiments on rodents found that brain chemicals such as high dopamine levels could cause paranoid behavior. In 1954, the FDA approved the first drug for a psychiatric disorder, the antipsychotic chlorpromazine which was marketed as a biological solution to damaged brain chemistry. Eventually, sedatives came to market in 1955 with meprobamate and Valium in 1963, both becoming best-selling drugs in America. By 1988, the famous Prozac and other SSRIs came to market.
However, the issue is that despite the significant success, there has not been definitive experimental proof establishing either the effectiveness of these culturally popular drugs as well as the proof that neurochemical imbalances are the cause of pathogenesis for mental illness. There is controversy about whether the drugs, such as SSRIs especially, have any greater effect than placebos in clinical trials (Groopman, 2019). Essentially, psychiatric drugs have been a trial and error, with professionals often noting that it works for some people but not for others. Advances in psychopharmacology have been incremental because there is potentially still the very little systematic method of determining effectiveness.
While modern medicine development must follow strict ethical and procedural parameters, undergoing clinical trials to guarantee safety, is not necessarily an indicator of effectiveness. If previously, drugmakers could learn based on trial and error methods with patients and the public, it is not possible anymore.
Despite 1 in 5 Americans taking psychiatric drugs and mental disorders are being widespread and recognized globally, the pharmaceutical industry has largely backed down or experienced a decline in finding innovative psychiatric medications. Hyman (2013) argues that because the hit or miss method or animal testing models along with a general lack of objective tests are impossible to validate the effectiveness of drugs; the daunting factors of neuroscience, genetics, and advanced therapeutics provide no feasible path of drug companies to discover and develop new effective treatments.
References
Groopman, J. (2019). The troubled history of psychiatry. The New Yorker. Web.
Hyman S. E. (2013). Psychiatric drug development: diagnosing a crisis. Cerebrum, 5. Web.
Pinel, J. P. J., & Barnes, S. J. (2018). Biopsychology (10 ed.). Pearson.