It may sound simple: if antipsychotics reduce your symptoms, they work. Done? Not quite. Reducing symptoms matters, but it does not tell the whole story. What if your medication does reduce your symptoms, but leaves you so drowsy that you hardly get out of bed? Or so indifferent that you hardly take an interest in the people around you? Or, worse, that you start smoking more to make up for that indifferent feeling?
Symptom control
What I mean is that improving symptoms is one thing. Leading a meaningful life, in which you have social contacts and do things you enjoy, is at least as important.
Unfortunately mental health care does not always look at this wider impact of antipsychotics. Sometimes it is automatically assumed that these medicines ‘are always good’. Research shows that for 20 to 40% of participants antipsychotics work hardly or not at all. This group is often prescribed them all the same, although the medicines do not add to their wellbeing and often have considerable side effects.
This is a persistent phenomenon that gets too little attention.
A change of course
Fortunately things are starting to change. More and more psychiatrists are aware of the need to look more critically at the prescribing of antipsychotics. It is time to look beyond symptoms and to focus on what is best for the person.
Jim van Os
Prof. dr. Jim van Os, Chair Division Neuroscience, Utrecht University Medical Centre. Jim works at the interface of ‘hard’ brain science, health services research, art and subjective experiences of people with ‘lived experience’ in mental healthcare.
Jim has been appearing on the Thomson-Reuter Web of Science list of ‘most influential scientific minds of our time’ since 2014. In 2014 he published his book ‘Beyond DSM-5‘, and in 2016 the book ‘Good Mental Health Care’. In 2026 he published 'Wat psychisch lijden is'.
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Blogs by Jim van Os can be read here
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