The Scoping Group must bear in mind that there is no consensus within the profession as to the merits of different forms of treatment. For example, a patient with a bipolar mood disorder may well be placed under a community treatment order for refusing to take the drug lithium on a long-term basis, since this is supposed to prevent relapses. It is now clear that withdrawal of lithium may actually cause episodes of mania. This calls into question the usual assumption that lithium acts to prevent relapse. There are therefore good reasons why patients may wish not to take lithium treatment.
Similar arguments apply to the use of long-term neuroleptic medication in psychoses.
Psychiatrists interpret this as a 'relapse' of illness, when in fact it may be a disordered physiological state brought about by rapid discontinuation of neuroleptic drugs. As patients become more aware of these risks they will become much less likely to want to take long-term medication. In our view, this evidence casts sufficient doubt over assumptions two and three. The benefits of psychotropic drugs are not clear-cut. We believe that many psychiatrists overestimate their benefits and pay too little attention to the serious side effects of these drugs.