Friday, January 30, 2009
Antipsychotics: History - Then and Now
January 29, 2009 — Your Friend
Modern mind medicines begin to lose luster
January 27, 2009
Hundreds of years ago, people with mental illness might be burned at the stake or locked away in a dungeon. In the early 20th century, some patients with schizophrenia were lobotomized with an ice pick to blunt emotions and reduce agitation.
Other treatments included padded cells, straitjackets, cold wet sheets and electroshock therapy. Mental institutions in the first part of the 20th century were sometimes referred to as “snake pits.”
It was in this barbaric context that the first antipsychotic drugs were developed. In 1952, when Thorazine (chlorpromazine) was first introduced, it was hailed as a breakthrough.
Other drugs such as Stelazine (trifluoperazine), Mellaril (thioridazine) and Haldol (haloperidol) followed. Although these antipsychotic medications were popular with psychiatrists, patients often thought of them as chemical straitjackets.
Such drugs helped reduce hallucinations and agitation. But there was a high price to pay for the apparent benefits. The drugs made people feel sedated and slowed them down, resulting in a zombielike shuffle.
Other side effects included dizziness, slurred speech, seizures and a variety of movement disorders such as severe neck muscle spasms causing head twitches or uncontrollable rhythmic movements such as sticking out the tongue. Urinary retention, constipation and sexual difficulties also contributed to the drugs’ unpopularity with patients, who often discontinued their medicines as soon as they were discharged.
A newer generation of schizophrenia drugs was introduced in the early 1990s with great fanfare. Drugs like Clozaril (clozapine), Risperdal (risperidone), Zyprexa (olanzapine), Seroquel (quetiapine), Geodon (ziprasidone) and Abilify (aripiprazole) are known as atypical antipsychotics.
Psychiatrists hoped that these medications would be better tolerated and much more effective than older antipsychotics. Some even believed the new drugs would help schizophrenic patients return to normal.
More than $13 billion is spent on antipsychotic medications each year. They are prescribed for a range of conditions beyond schizophrenia, including Alzheimer’s and dementia, bipolar disorder, insomnia, autism, obsessive-compulsive disorder, ADHD and major depression.
Despite the initial enthusiasm, there is growing consternation about the safety and effectiveness of these powerful mind medicines. A few years ago, a study found that the newer and far pricier drugs were no more effective or less likely to cause troublesome side effects than an older antipsychotic (New England Journal of Medicine, Sept. 22, 2005). A new study in the same journal (Jan. 15, 2009) reported an alarming rate of sudden cardiac death linked to the newer drugs.
It’s no wonder that patients and families are nervous about these medicines, especially when you consider that they can cause other complications such as dramatic weight gain, diabetes, strokes and irregular heart rhythms. Children and older people may be particularly vulnerable.
People with mental illness deserve much better treatment than they have received to date. Although lobotomies and straitjackets are no longer used, modern medications leave a lot to be desired.
Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert.
Thursday, January 29, 2009
Time is an interesting concept. You realize, if you can grasp it, that there is no past, really. We create it out of stuff which we keep around, either paper (such as that which must be collected for the tax man), posessions, or memories (good and bad).
Long ago when I was young, I thought you never escaped your past. But you do, constantly, you know. Time is a concept.
For instance, we assume that we have barriers beyond which we can't reach. One is space, another time. And yet, the Internet, the phone, the TV, the webcam -- all are defeating space. And time -- ha! I've sometimes been in better communication with the author of a good book than with my neighbors.
There are those who believe we are dust unto dust. I am quite sure (myself) that I am apart from the physical universe and can transcend it, even so simply as in the reading of a book. And when I write, I am reaching out to you. Do you hear me?
Here's more on the relationship of spirit and the world.
Tuesday, January 27, 2009
As I got older, I felt a bit guilty that I hadn't "written," "kept up with..." etc. Took me a while to realize that the other party hadn't either.
I believed (still do) that if you like someone, you are inevitably going to run into them again. Although now I think that it may be next lifetime.
The electronic age, however, has caught up. Networking on the Internet is all the rage. I've just succumbed to the 3rd invitation by someone to join facebook. I entered my address book as a *.csv (comma separated value) file. Suddenly, hundreds of names and emails and pictures popped up and I was asked if I wanted to add some as "friends" or just select all. Well, I went through and selected some 50-100 names that I recognized.
What will this lead to? I am breathless. Could there be too much of a good thing?
Monday, January 26, 2009
Here's a site that has some useful advice.
Saturday, January 24, 2009
We hear about the extraordinary worldwide collapse of national economies. At the same time, the psychiatrists are making hay with their diagnoses and prescriptions. Are you depressed? Stressed? Well, they have the solution. Or do they? The video I've blogged here is very enlightening. (By the way, the crimes of psychiatrists are beginning to come to light. We need a concerted effort by all of us to expose this fraud.)
Oh, and, by the way, maybe you should be depressed!