Here you can read what psychopharmacology comes down to. Psychopharmacology is the study of the effect of medicines on mental functions.
You can see all psychopharmacology as experimental
You can see all the medicines used in psychiatry as experimental. We know too little about the brain and about the long-term consequences of these medicines. We do not know well how they work, and we do not know well what they will do for the person, positively and negatively.
What it comes down to
Rule 1
The prescribing doctor or psychiatrist understands, and is aware of, the experimental character of prescribing an antipsychotic, antidepressant or mood stabiliser. The doctor is not misled by the idea that everything has been safely laid down in guidelines and protocols that are valid for everyone at all times.
Rule 2
When the doctor prescribes an antipsychotic, antidepressant or mood stabiliser, he or she makes sure that the effects are carefully tracked, evaluated and taken seriously. Above all from the perspective of the person and their network.
Rule 3
The doctor is well aware that, besides therapeutic effects, unwanted side effects can occur that take all kinds of forms. This includes mental symptoms such as depression, psychosis, mania, anxiety and many other things.
Rule 4
The doctor does not hesitate to stop the medicine again if it turns out not to work, or only minimally, or if there are too many unwanted side effects.
Rule 5
The doctor understands well that many of the therapeutic effects that occur when a medicine is prescribed are not so much caused by the medicine itself, but by hope, perspective, positive expectations and the healing effect of the medical ritual and the supportive relationship with the care provider (the placebo effect).
This matters, because if the placebo effect plays a large part, the dose of the medication can be minimised or even stopped.
Rule 6
The doctor understands that long-term use of an antipsychotic, antidepressant or mood stabiliser brings about changes in the brain. Because of this people cannot simply stop, and can promptly get ‘rebound’ when the medication is reduced or stopped.
The doctor then understands that this is not a relapse of the original susceptibility, but the consequence of brain changes that can be summed up under the heading ‘oppositional tolerance‘.
Rule 7
The doctor is an expert in prescribing medication and also in tapering off medication. This is called deprescribing: helping people off medication safely, without chasing them back into a psychosis, depression, mania or anxiety attack.
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'.
Want to read more?
Blogs by Jim van Os can be read here
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