The primary-process emotional brain systems, according to Jaak Panksepp’s conceptualization, can serve as a component enabling the understanding of psychiatric pharmacotherapy

The situation in which psychiatry found itself after the publication of the work by Moncrieff et al. revealed the need for a new model on which an explanation of the translation of mechanisms of action of psychotropic drugs could be based. Despite the accumulation of new knowledge known to experts about the mechanisms of action of antidepressant drugs, simplified schemas of understanding, especially in explaining the action of drugs, based on the first monoaminergic theory turned out to be easy to challenge, and to reject all the accumulated knowledge and experience regarding the action of drugs belonging to the conventionally defined antidepressant group.

In my opinion, there is a need to reformulate the cognitive framework on which the explanation of the mechanisms of action of drugs used in psychiatry is based. The schema from the early days of pharmacotherapy, based on the assumption that the cause of certain disorders (depression, schizophrenia) is either “too low” or “too high” levels of a specific neurotransmitter (serotonin, dopamine), does not correspond to the current level of knowledge. It has long been impossible to maintain this in the context of the transdiagnostic efficacy of drug action. The new formulation of understanding the action of drugs can be provided by the concept of drug-centered psychopharmacology and Jaak Panksepp’s concept of basic emotion command systems.

Combining the cognitive thinking schema regarding pharmacotherapy based on understanding the drug’s impact profile on psychological functions with the findings and conceptualization of Jaak Panksepp can, in my opinion, provide a very useful and comprehensive basis for thinking about the use of drugs in psychiatry. It also allows for the incorporation of any emerging new therapeutic substances into an already established cognitive framework, which is expansive enough to anticipate the possibility of new modes of pharmacological action. This work is dedicated to presenting a proposal for thinking about psycho-pharmacotherapy in such a framework.