A patient-centered model of the action of psychotropic drugs

BackgroundPsychotropic medications are widely used to treat a variety of mental disorders, but a unifying explanation of their modes of action remains obscure.ObjectiveTo examine the limitations of existing models of psychotropic drug action, and to propose an integrative, patient-oriented model that explains the wide spectrum of actions of psychotropic medications.MethodThe traditional “disease-centered” model of psychotropic action, and its most logical contemporary alternative, the “drug-centered” model – are critically analysed, and their limitations identified. An alternate model, which acknowledges the importance of patient-related factors in determining drug effects is outlined. The two processes involved in this model, and the evidence in its support, are explained at length with reference to specific psychiatric disorders.ConclusionThe patient-centered model proposed in this paper, though provisional, provides a broad-based, unified framework for understanding the actions of psychotropic drugs, and can enhance clinical practice and research.