Ever wondered why the chemistry behind psych meds often misleads clinicians? We break down why drug mechanisms usually don’t drive treatment decisions.

In this live episode Dr. Nasir Gammi welcomes resident Daniel Herringer to argue that most psychopharmacology drugs were proven effective long before anyone knew how they worked. From chlorpromazine to modern antidepressants, the clinical trials came first and the neurotransmitter hypotheses followed, often shaping a “pharmacocentric” view that confuses symptom relief with disease causation. The conversation explores how drugs have dozens of actions—serotonin reuptake, cytokine modulation, nitric‑oxide effects—and why we cannot pinpoint a single mechanism as the source of therapeutic benefit.

The practical message is simple: prioritize robust clinical data over mechanistic speculation. Mechanisms can guide side‑effect profiles or inform drug development, but efficacy is demonstrated only in head‑to‑head trials and placebo‑controlled studies. Listeners are invited to explore deeper content on psychiatryletter.com, subscribe to the Substack for free archives, and join the upcoming live series previewing the new edition of Dr. Gammi’s psychopharmacology textbook. Sign up here: https://psychiatryletter.com/3-live-class-enroll-2nd-edition/

Follow the podcast for more evidence‑based discussions and never let a hypothesis replace a trial result.