How evolutionary psychiatry can advance psychopharmacology

Randolph M. Nesse, Dan J. Stein

Research output: Contribution to journalArticle

Abstract

The prevailing paradigm for psychopharmacology focuses on understanding brain mechanisms as the key to finding new medications and improving clinical outcomes, but frustration with slow progress has inspired many pleas for new approaches. Evolutionary psychiatry brings in an additional basic science that poses new questions about why natural selection left us vulnerable to so many mental disorders, and new insights about how drugs work. The integration of neuroscience with evolutionary psychiatry is synergistic, going beyond reductionism to provide a model like the one used by the rest of medicine. It recognizes negative emotions as symptoms, that are, like pain and cough, useful defenses whose presence should initiate a search for causes. An integrative evolutionary approach explains why agents that block useful aversive responses are usually safe, and how to anticipate when they may cause harm. More generally, an evolutionary framework suggests novel practical strategies for finding and testing new drugs.

Original languageEnglish (US)
Pages (from-to)167-175
Number of pages9
JournalDialogues in clinical neuroscience
Volume21
Issue number2
DOIs
StatePublished - Jan 1 2019

Keywords

  • Evolution
  • Evolutionary medicine
  • Natural selection
  • Psychopharmacology

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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