Jürgen Margraf and Silvia Schneider, both well-known psychologists at the University of Bochum in Germany, claim that psychotropic drugs are no solution to mental health issues in an editorial for the latest issue of the journal EMBO Molecular Medicine. They argue that the effects of psychiatric drugs for depression, anxiety, and 'ADHD' are short-lived and may have negative long-term consequences.

Silvia Schneider and Jürgen Margraf

Silvia Schneider and Jürgen Margraf, Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, University of Bochum, Bochum, Germany

"There are now plenty of data and evidence that, in the long term, the drugs do not work," the authors write in their commentary, "From neuroleptics to neuroscience and from Pavlov to psychotherapy: more than just the 'emperor's new treatments' for mental illnesses?"

Margraf and Schneider begin by pointing out that the number of people in the industrialized world who are disabled because of mental health issues has been rapidly rising over the past fifty years. At the same time, they note, the common perception is that new antidepressant and anti-anxiety drugs and other new treatments have greatly improved mental health treatment.

If this "epidemic" of mental health issues causing disability is not due to an increase in overall incidence, they ask, "how can this apparent contradiction be explained?"

"Could it be," they continue, "that therapeutic progress is much less than we think or are being told? Could it be that the course of depression, anxiety, schizophrenia, or ADHD has been altered for the worse? Could it be that we cannot make therapeutic progress because the concept of mental illness and its treatment is deeply flawed? There are strong reasons to assume that all three suspicions are in fact true."

The researchers identify three conceptual mistakes that are preventing more successful treatments for mental health issues from being developed.
  • The "ill-advised biological notion of mental illnesses" and the "myth of the chemical imbalance"
  • The "reification of diagnostic constructs ('depression') as distinct illness categories" rather than as a dimension of human behavior occurring on a spectrum.
  • The emphasis on "bottom-up" causal pathways, like genetics, rather than "top down" social and psychological influences.
"After decades of proclaimed therapeutic breakthroughs and promises of imminent better treatments based on the translation of basic science into clinical practice, neither neurobiology nor neuroscience has led to measurably better long-term outcomes for any of the major mental disorders," they write. "Although psychotropic drugs are by far the most often used treatment modality in industrialized countries, there is no compelling evidence for the long-term stability of their small to moderate short-term results."

Margraf and Schneider suggest that psychologists work together to bring a renewed focus to all three levels of analysis, biological, psychological, and sociological, while pushing back against the "marketing power of Big Pharma."

"A realistic assessment of our current treatment options and the close cooperation of clinicians and neuroscientists would help us to overcome the current stagnation and put us back on the track forward," they conclude.