title: Critical thinking about adverse drug effects: lessons from the psychology of risk and medical decision-making for clinical psychopharmacology.
abstract: Systematic biases in decision-making have been well characterized in medical and nonmedical fields but mostly ignored in clinical psychopharmacology. The purpose of this paper is to sensitize clinicians who prescribe psychiatric drugs to the issues of the psychology of risk, especially as they pertain to the risk of side effects. Specifically, the present analysis focuses on heuristic organization and framing effects that create cognitive biases in medical practice. Our purpose is to increase the awareness of how pharmaceutical companies may influence physicians by framing the risk of medication side effects to favor their products.
authors.affiliation: Depression and Bipolar Clinical and Research Programs, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. anierenberg@partners.org
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Nierenberg
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Smoller
authors.forename: Polina
authors.initials: P
authors.lastname: Eidelman
authors.forename: Yelena P
authors.initials: YP
authors.lastname: Wu
authors.forename: Claire A
authors.initials: CA
authors.lastname: Tilley
mesh_terms: D000329:Advertising / Q000941:ethics; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D016265:Conflict of Interest; D003661:Decision Support Techniques; D004345:Drug Industry / Q000941:ethics*; D004992:Ethics, Medical; D019317:Evidence-Based Medicine / Q000941:ethics; D006801:Humans; D040541:Marketing / Q000941:ethics; D001523:Mental Disorders / Q000188:drug therapy*; D000077152:Olanzapine; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use; D011406:Propaganda; D011570:Psychiatry / Q000941:ethics*; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic / Q000941:ethics; D012107:Research Design; D018570:Risk Assessment; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use; D014481:United States
chemical_list: D010879:Piperazines; D011619:Psychotropic Drugs; D013844:Thiazoles; D001569:Benzodiazepines; C092292:ziprasidone; D000077152:Olanzapine