The Promise and Peril of Speed: Algorithmic Claims, Antipsychotic Trials, and the New Gatekeepers of Clinical Truth

AI is widely regarded as a tool to enhance the efficiency and objectivity of clinical trials, even within fields like psychiatry where uncertainty and subjectivity pose significant challenges. However, in trials for antipsychotic medications, these assumptions can distort what is considered reliable, sidelining clinical nuance and lived experience. This thesis shows that AI is not merely optimizing trial processes. It is shifting authority and judgment from clinicians and researchers to opaque systems developed by private AI companies. At the same time, the public continues to hold pharmaceutical sponsors, biotech firms, and medical professionals responsible when outcomes fall short. Although scientists and physicians carry their own biases, the rigidity of AI tools can intensify structural inequities by narrowing what constitutes valid evidence and further marginalizing patient perspectives. As AI becomes more embedded in antipsychotic drug development, it has the potential to not only alter how decisions are made but also to influence whose knowledge counts and what kinds of care remain feasible.