Psychopharmacotherapy of healthy people and the off-label problem in modern psychiatry

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Abstract

The article analyzes the problem of widespread misuse of therapy for mental disorders. The role of paradigmatic changes in psychiatric classifications and the introduction of a spectral approach in the formation of new psychopharmacotherapeutic strategies is evaluated. New concepts are distinguished: “psychopharmacotherapy of healthy people”, “diagnostic and therapeutic relativism”. It is argued that the emergence in the psychiatric field of the topic “psychopharmacotherapy of healthy people” is more likely to be a natural than an accidental phenomenon. It is concluded that innovations are initiated by both patients and psychiatrists. It is assumed that the appointment of mentally healthy psychotropic drugs for their desired use is possible in the presence of public and medical consensus. For the expert community, this issue poses new legal and deontological challenges. If consensus is reached, clear criteria should have been developed — what groups of psychopharmacothrapy can be used off-label and under what specific prenosological mental conditions. It is argued that psychiatry should follow the requests of clients, and not against innovations dictated by a change in human psychology.

About the authors

Vladimir D. Mendelevich

Kazan State Medical University

Author for correspondence.
Email: mend@tbit.ru
ORCID iD: 0000-0001-8489-3130
Scopus Author ID: 6602765981
ResearcherId: O-4908-2016

доктор медицинских наук, профессор

Russian Federation, 420012, Kazan, Butlerov str., 49

Кseniya V. Pyrkova

Kаzan (Privolzhsky) Federal University

Email: pyrkova_75@mail.ru
Russian Federation, 420008, Kаzan, Kremlevskaya str., 18

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Copyright (c) 2020 Mendelevich V.D., Pyrkova К.V.

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