PHARMACOLOGY AND MENTAL STATE

Throughout my career, I have often observed how, in the pharmacological treatment of psychiatric disorders in adulthood, clinical efficacy is typically assessed in terms of symptom reduction and mood stabilisation, while the qualitative transformations of the state of consciousness arising from the chronic administration of psychotropic drugs are underestimated especially in complex and treatment-resistant clinical presentations.

It is important to note that psychotropic substances do not merely modulate neurotransmission; they directly affect the phenomenological configuration of consciousness, redefining the structure of subjective experience by altering not only the baseline affective tone and the narrative cohesion of the Self but also the parameters of temporal perception and the modulation of conscious intentionality.

Many patients report frequent experiences of emotional blunting, subclinical derealisation, a sense of intra-psychic estrangement, or an increased metacognitive distance from their own mental states.

One could therefore speak of hybrid states of consciousness, as these configurations though not pathological are profoundly altered, leading the individual to experience themselves in a discontinuous or hyper-structured manner.

What is the cost of pharmacological stabilisation? How can we discern between therapeutic effect and the disintegration of perceived identity, and to what extent can functional improvement justify a loss of existential spontaneity?

Advanced neuropsychiatric practice requires a pharmacological alliance based on the co-construction of a mentally tolerable state not only in terms of symptomatology, but above all in experiential terms, with full respect for human identity".

- 𝐷𝑟. 𝐿𝑖𝑛𝑜𝑔𝑒 𝑆𝑎𝑚𝑎𝑠 𝑆𝑝𝑒𝑛𝑐𝑒𝑟

𝑆𝑝𝑒𝑐𝑖𝑎𝑙𝑖𝑠𝑡 𝑖𝑛 𝑁𝑒𝑢𝑟𝑜𝑠𝑢𝑟𝑔𝑒𝑜𝑛, 𝑁𝑒𝑢𝑟𝑜𝑝𝑠𝑦𝑐ℎ𝑖𝑎𝑡𝑟𝑦 𝑎𝑛𝑑 𝑃ℎ𝑎𝑟𝑚𝑎𝑐𝑜𝑙𝑜𝑔𝑦