Chapter 1 The place of drug treatments in psychiatry
The publicity given to the benefits of psychiatric drugs like Prozac and Ritalin, and the idea that people with psychiatric problems have ‘chemical imbalances’, have persuaded many people that they need psychiatric drugs in order to be normal. Hence the pressure to prescribe psychiatric drugs now comes not just from professionals but also from patients, and potential patients, who have become convinced that they have a brain disorder and that drugs offer a solution to their difficulties. This has been a boon for the pharmaceutical industry, which has seen sales of antidepressants rocket since the early 1990s, (Page 16)
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during the 1950s and 1960s a new range of drugs was introduced into psychiatry and views about how they worked gradually transformed. They came to be seen not simply as inducing useful but crude states of sedation and passivity, like the older style drugs, but as acting to reverse underlying psychiatric diseases. (Page 17)
The view of psychiatric disturbance as a disease of the brain or body has constantly been challenged by some recipients of psychiatric care, but in the 1960s the antipsychiatry movement articulated philosophical and political objections to the very concept of psychiatric disorder as a medical illness. (Page 17)
the modern concept of depression was not widely accepted until the development of the idea of an antidepressant drug. (Page 18)
The pharmaceutical industry has been influential in shaping the modern landscape of psychiatric treatment in other ways as well. It conducts a majority of the research on psychiatric drugs, including most of the trials that supposedly establish whether a drug is effective and beneficial or not. (Page 19)
In this book I will challenge the erroneous assumption that underpins the current use of psychiatric drugs: the assumption that drugs reverse an underlying medical disease. I will then present an alternative approach to the use of psychiatric drugs that emphasises the fact that they are psychoactive substances that induce states of intoxication. I believe this view provides a better way of assessing the balance between possible benefits and harmful effects of drugs. (Page 20)
Chapter 2 How do psychiatric drugs work?
This view of the nature of psychiatric drugs can be called the disease-centred model of drug action. Although this is now the dominant view of what psychiatric drugs do, this model is actually relatively new. It developed during the 1950s and 1960s when most of the drugs we are familiar with in psychiatry were first introduced. (Page 22)
Nota con el concepto.
Antidepressants are thought to act by stopping the reuptake and deactivation of the neurotransmitters serotonin and noradrenalin, leading to an increase in the levels of these chemicals in the synapses. However, as explained in Chapter 5 it has not been demonstrated that these drugs do reliably increase levels of these transmitters. (Page 24)
Although scientists acknowledge that these are merely theories, which are far from being proven, there is a widespread public perception that the biochemical origins of various psychiatric disorders have been clearly identified. (Page 24)