Paradigm Shift

Treatment alternatives to psychiatric drugs, with particular reference to low- and middle-income countries 1

Authored by: Peter Lehmann

The Routledge Handbook of International Development, Mental Health and Wellbeing

Print publication date:  June  2019
Online publication date:  June  2019

Print ISBN: 9780367027735
eBook ISBN: 9780429397844
Adobe ISBN:


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Psychiatric drugs (also known as psychotropic medications) are prescribed by psychiatrists and general practitioners to almost everyone with a psychiatric diagnosis. The effects of such drugs are associated with significantly reduced quality of life and life expectancy. Drug lists—such as the British National Formulary, the Latin American Vademecum, the US-American Physicians’ Desk Reference, the German Rote Liste, the French Vidal, and the African Dictionnaire Therapeutique —cite more or less identical risks and adverse effects for all doses of psychiatric drugs, including antidepressants, mood stabilisers, psychostimulants, and tranquilisers. The United Nations’ Sustainable Development Goal 3 (SDG3) of the 2030 Agenda for Sustainable Development 2 requires states to improve citizens’ wellbeing. However, the perpetuation of discrimination against psychiatric patients and persons in severe emotional distress through the compulsory administration of psychotropic drugs will inhibit attemps to meet it. Accordingly, this chapter will suggest alternatives to psycho-pharmacological psychiatry, and will argue that education about the risks of psychiatric drugs and problems associated with withdrawal, as well as physical health monitoring, can reduce mortality in psychiatric patients, and enhance wellbeing. Supporting the self-help efforts of people in severe emotional distress and collaborating with dedicated family members, community members, and professionals in the development of humanistically oriented support systems should be strategies of first choice for all countries in their approaches to SDG3, including lower- and middle-income countries (LMICs). Such strategies will safeguard psychiatric patients’ civil rights simultaneously.

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