The Creation Of Psychopharmacology

David Healy follows his widely praised study, The Antidepressant Era, with an even more ambitious and dramatic story: the discovery and development of antipsychotic medication. Healy argues that the discovery of chlorpromazine (more generally known as Thorazine) is as significant in the history of medicine as the discovery of penicillin, reminding readers of the worldwide prevalence of insanity within living memory. But Healy tells not of the triumph of science but of a stream of fruitful accidents, of technological discovery leading neuroscientific research, of fierce professional competition and the backlash of the antipsychiatry movement of the 1960s. A chemical treatment was developed for one purpose, and as long as some theoretical rationale could be found, doctors administered it to the insane patients in their care to see if it would help. Sometimes it did, dramatically. Why these treatments worked, Healy argues provocatively, was, and often still is, a mystery. Nonetheless, such discoveries made and unmade academic reputations and inspired intense politicking for the Nobel Prize. Once pharmaceutical companies recognized the commercial potential of antipsychotic medications, financial as well as clinical pressures drove the development of ever more aggressively marketed medications. With verve and immense learning, Healy tells a story with surprising implications in a book that will become the leading scholarly work on its compelling subject.

In this work Healy chronicles the history of psychopharmacology, from the discovery of chlorpromazine in 1951, to current battles over whether powerful chemical compounds should replace psychotherapy. The marketing of antidepressants is included.

The Age of Psychopharmacology began with a brilliant rise in the 1950s, when for the first time science entered the study of drugs that affect the brain and mind. But, esteemed historian Edward Shorter argues that there has been a recent fall, as the field has seen its drug offerings impoverished and its diagnoses distorted by the "Diagnostic and Statistical Manual of Mental Disorders." The new drugs, such as Prozac, have been less effective than the old. The new diagnoses, such as "major depression," have strayed increasingly from the real disorders of most patients. Behind this disaster has been the invasion of the field by the pharmaceutical industry. This invasion has paid off commercially but not scientifically: There have been no new classes of psychiatry drugs in the last thirty years. Given that psychiatry's diagnoses and therapeutics have largely failed, the field has greatly declined from earlier days. Based on extensive research discovered in litigation, Shorter provides a historical perspective of change and decline over time, concluding that the story of the psychopharmacology is a story of a public health disaster.

A psychiatrist provides an insider account on the controversial use of selective serotonin reuptake inhibitors (SSRIs) Prozac. Paxil. Zoloft. Turn on your television and you are likely to see a commercial for one of the many selective serotonin reuptake inhibitors (SSRIs) on the market. We hear a lot about them, but do we really understand how these drugs work and what risks are involved for anyone who uses them? Let Them Eat Prozac explores the history of SSRIs—from their early development to their latest marketing campaigns—and the controversies that surround them. Initially, they seemed like wonder drugs for those with mild to moderate depression. When Prozac was released in the late 1980s, David Healy was among the psychiatrists who prescribed it. But he soon observed that some of these patients became agitated and even attempted suicide. Could the new wonder drug actually be making patients worse? Healy draws on his own research and expertise to demonstrate the potential hazards associated with these drugs. He intersperses case histories with insider accounts of the research leading to the development and approval of SSRIs as a treatment for depression. Let Them Eat Prozac clearly demonstrates that the problems go much deeper than a side-effect of a particular drug. The pharmaceutical industry would like us to believe that SSRIs can safely treat depression, anxiety, and a host of other mental problems. But, as Let Them Eat Prozac reveals, this “cure” may be worse than the disease.

This searing indictment, David Healy’s most comprehensive and forceful argument against the pharmaceuticalization of medicine, tackles problems in health care that are leading to a growing number of deaths and disabilities. Healy, who was the first to draw attention to the now well-publicized suicide-inducing side effects of many anti-depressants, attributes our current state of affairs to three key factors: product rather than process patents on drugs, the classification of certain drugs as prescription-only, and industry-controlled drug trials. These developments have tied the survival of pharmaceutical companies to the development of blockbuster drugs, so that they must overhype benefits and deny real hazards. Healy further explains why these trends have basically ended the possibility of universal health care in the United States and elsewhere around the world. He concludes with suggestions for reform of our currently corrupted evidence-based medical system.

In The Rise and Fall of the Age of Psychopharmacology, esteemed historian Edward Shorter proposes that the recent history of psychiatry is that of a failed scientific discipline of medicine. Medicine generally is about the story of progress, but psychiatry's story is that of failure in diagnosis, in therapeutics, and in the ability to deliver science-based care to suffering individuals.

This provocative history of bipolar disorder illuminates how perceptions of illness, if not the illnesses themselves, are mutable over time. Beginning with the origins of the concept of mania—and the term maniac—in ancient Greek and Roman civilizations, renowned psychiatrist David Healy examines how concepts of mental afflictions evolved as scientific breakthroughs established connections between brain function and mental illness. Healy recounts the changing definitions of mania through the centuries, explores the effects of new terminology and growing public awareness of the disease on culture and society, and examines the rise of psychotropic treatments and pharmacological marketing over the past four decades. Along the way, Healy clears much of the confusion surrounding bipolar disorder even as he raises crucial questions about how, why, and by whom the disease is diagnosed. Drawing heavily on primary sources and supplemented with interviews and insight gained over Healy's long career, this lucid and engaging overview of mania sheds new light on one of humankind's most vexing ailments.

"The 2nd edition of this book was edited by David King and published in 2004. Since then there have been major advances in psychopharmacology in terms of new medications coming to the market, increased understanding of the mechanisms of drug action and new data on the efficacy, tolerability, safety and clinical effectiveness of a range of medications. Partly as a result, clinical guidelines for many psychiatric disorders have altered. As such, a new edition of this textbook was essential and we were delighted when the College approached us to edit the 3rd edition. This was a major endeavor that was only possible with the commitment and expertise of the authors"--