The real story of psychiatry
Content
- Asylum drugs and patient restraint
- Psychiatry’s credibility was in trouble
- The introduction of psychotropic drugs
- Enormous profits and commercial dominance
- Pharmaceutical companies take control of the subject
- Addressing symptoms, not causes or cures
- Diagnosis based on opinions, not science
- Placebo, the mystery variable
- ‘Antipsychotics’, the chemical straightjacket
- Antidepressants, marketing before science
- Appalling side effects played down or not mentioned at all
- When drugs fail, electroconvulsive ‘therapy’
Asylum drugs and patient restraint
Drugs had a use in the 19th century in the management of asylum patients. It was almost universally accepted that these drugs had one purpose, which was to make the patients tractable and able to be controlled by asylum staff.
These drugs, to a great degree, merely replaced mechanical physical restraints that were often cruelly used to control patients.
There was never any serious suggestion that these drugs were of any therapeutic value and many are no longer used in any fashion due to their causing serious side effects.
“Mechanical restraint, except under surgical necessities, was formerly abandoned…because it was deemed better for the patient to let him have the relief and self-respect of pretty free exercise than to keep him tied up like a mad dog…but it may be doubted whether its coarse bond did as much harm as has been done by the finer means of chemical restraint which have been used to paralyse the brain and render the patient quiet.”
Psychiatrist, Henry Maudsley. 1895 1
Psychiatry’s credibility was in trouble
Part 2 of this series, Rockefeller Foundation and the failure of psychiatry as a science, described the lack of a scientific foundation that existed within psychiatry throughout the first half of the 20th century.
After World War II major changes were introduced regarding what was the purpose of psychiatry. The reputation of German psychiatry with its close association with NAZI racial hygiene, had been badly damaged. There was a movement, particularly among American psychiatrists, toward what was called ‘dynamic psychiatry’ (with its major clinical application being psychotherapy), and ‘social psychiatry’ or psychiatry moving beyond the asylums towards influencing almost all aspects of an individual’s life and the society he lived in.
This change toward psychotherapy ran into a considerable problem in that just as with biological psychiatry, there was still no scientific foundation for the entire subject despite whatever clinical application was being attempted. Psychiatry had flipped to another clinical application that was beset by supposition and opinions while major questions like ‘what was mental illness really?’ were left unanswered.
From the early 1950s through to the early 1970s, confidence in the credibility of psychiatry was very low. Diagnosis of mental illness could vary wildly depending on the country one was in or the particular school of thought the psychiatrist favored. News of the appalling ‘treatments’ being used in asylums and hospitals under the ‘biological psychiatry’ banner caused a public recoil. Despite the resurgence of the subject, studies found the results from psychotherapy were no more effective than no treatment at all. 2 3 4
The resurgence of psychoanalysis and psychotherapy also involved long courses of treatment with non-exact results, resulting in criticism from insurance companies and others having to pay for it all.
“The Medical Director of the APA at the time, Melvin Sabshin, recalls that private insurance companies and the federal government began to view psychiatry as a “‘bottomless pit-a voracious consumer-of resources and insurance dollars-because its methods of assessment and treatment were too fluid and unstandardized.”
Melvin Sabshin, from Rebecca A Johnson. “Pure” Science and “Impure” Influences: The DSM at a Scientific and Social Crossroads 5
The Rockefeller Foundation’s realization that psychiatry promised a lot but delivered very little had become obvious to all, including the general public. Yet there it was, since 1933 foisted on medicine as a supposed science based on few unproven theories and most importantly, unable to cure a single individual or even state with certainty what was the actual cause of any mental illness.
The introduction of psychotropic drugs
The introduction of these drugs was eagerly welcomed by some psychiatrists desperate to move the subject beyond the often lethal buffoonery of lobotomy, electroconvulsive therapy, insulin shock, or any of the other nonsense that was passing for psychiatry in those days. 6
The psychotherapy of Sigmund Freud, Josef Breuer, and others made advances in popularity after World War II, particularly in the USA. The introduction of these drugs, however, eventually produced a massive shift away from psychotherapy and toward that which was trumpeted as a ‘neo-Kraepelin age’ of biological psychiatry over the last 40 or so years.
Serendipity or simply no science
You will often hear that serendipity is referred to concerning the development of psychiatric treatments and indeed serendipity played a part in the ‘discovery’ of what is said to be the original psychotropic drug types. 7
And so it took 50 years from the discovery of the first mass-produced pharmaceutical, Aspirin, before a mass-produced psychotropic drug was used in the field of mental health. The reason why is that these discoveries were not based on any existing scientific foundation for psychiatry of established causes of mental illness predicting potential treatment and cures – they were being arrived at by industrial chemists outside psychiatry, with a psychiatric application only being arrived by chance.
Chlorpromazine – the first antipsychotic
For example, versions of the drug that was chlorpromazine, the first psychotropic drug, an antipsychotic, were used as dyes from the end of the 19th century. In the 1930s the drugs were modified by chemists and were used as antiseptics and antihistamines. Later versions of the drug chemistry in 1949 and 1950 resulted in drugs that produced a type of extreme anesthesia – an ‘artificial hibernation’ effect useful to calm patients undergoing surgery. It was not until 1952 that someone had the idea of extending the drug’s tranquilizing properties to people who were mentally ill. But of course, the drug did not address psychosis, merely ‘tranquilized’ symptoms.
The drug has been described as:
‘their introduction in therapeutic use is more like the story of a drug in search of an illness’
López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. 8
Imipramine – the first antidepressant
Based on the chance discovery of chlorpromazine as an ‘antipsychotic’, chemical companies went back over old drug lists looking for drugs that could have possible psychiatric applications. As a result, the chemical company J.R. Geigy located in Basel, looked again at a chemical they had hoped unsuccessfully would be a dye and then as an antihistamine and hypnotic. The chemical was later named imipramine. A psychiatrist asked the company for any drugs for testing on psychotic patients. The company sent him the drug they hoped would find a psychiatric use however it failed miserably with psychotic patients and made them worse. It was accidentally noted however that those psychotic patients who were depressed seemed to improve in their depression and so the first antidepressant was ‘discovered.’ 9
Wonder drug or “psychiatric aspirin”?
The introduction of chlorpromazine was lauded as one of the ‘great advances in 20th-century medicine and the history of psychiatry’. It was said to be one of the events that brought about what was hailed as a ‘psychopharmacological revolution.”
“chlorpromazine initiated a revolution in psychiatry, comparable to the introduction of penicillin in general medicine.”
Edward Shorter, from López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. 10
Other respected psychiatrists who still held hope for the subject resurrecting itself as a scientific activity were not so sure:
“The advent of chlorpromazine, derided by some of the great figures of psychiatry at the time, such as Henry Ey – who refered to it as ‘psychiatric aspirin’.”
López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. 11
What can be said about the introduction of chlorpromazine is that it did deter the use of lobotomy and other psychiatric viciousness on patients.
“Although chlorpromazine not infrequently produced a kind of apathy or indifference, similar to that produced by lobotomy, it was the drug’s ability to replace the irreversible surgery that led to its occasional description as a “chemical lobotomy”
Rick Mayes, Allan Horwitz. DSM-III and the revolution in the classification of mental illness. 12
Otherwise, even allowing for the state of desperation in psychiatry due to its lack of any scientific foundation, these glowing descriptions of the introduction of chlorpromazine are more akin to bombastic marketing than any serious scientific report.
Chlorpromazine was not developed based on any understanding of what psychosis is and its cause. That drug, nor any other antipsychotic, does not address the cause of ‘psychosis’ nor cure it. It took until the late 1960s/1970s for the drug class to be marketed as ‘antipsychotics. Up until then, the drugs were correctly described as a type of tranquilizer. Today ‘antipsychotics’ are being prescribed to suppress symptoms of such things as Anxiety, Attention-Deficit Hyperactivity Disorder, Dementia and Severe Geriatric Agitation, Depression, Eating Disorders, Insomnia, Obsessive-Compulsive Disorder, Post-traumatic Stress Disorder, Personality Disorders, Substance Abuse, and Tourette’s Syndrome – all as a tranquilizing agent and curing nothing. 13
The first controlled test of chlorpromazine occurred in 1954 at the University of Birmingham, England. The test reported that 25.9% of patients had recovered and a partial improvement appeared in 40.7%. The test results were then qualified with a statement that:
“In no case was the content of the psychosis changed. The schizophrenia and paraphrenic patients continued to be subject to delusions and hallucinations, though appeared to be less disturbed by them.”
López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine.14
Chlorpromazine has potentially serious side effects which can commonly include: Hypertonia, tardive dyskinesia, tardive dystonia, extrapyramidal syndrome, akathisia, parkinsonism, motor restlessness, drowsiness, convulsion/convulsive seizures (petit mal and grand mal), lowering of the seizure threshold, acute dyskinesia or dystonia and more… 15
The only significant change from the 19th-century asylum ‘chemical restraint’ drugs was the nature of the tranquilizing effect – the person could still maintain some basic social functions rather than be unconscious.
…the drug “calms excited or overactive patients without sedating them to the level where they could not function. Patients lost their agitation level but not their consciousness. They could talk about themselves and eat and sleep without difficulty.”
Ruth Koeppe Kajander. 1954. London, Ontario, Mental Hospital from López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine.16
This drug was indeed a ‘psychiatric aspirin’ and could have been used wisely to buy psychiatry enough time to establish a scientific foundation for the subject. However, the subject was incapable of doing so and by the mid-1950s was dancing to the tune of other masters.
Enormous profits and commercial dominance
During the 1950s alone all of the major psychotropic drugs classes were discovered by pharmaceutical companies. In other words, drugs were being discovered and their very existence would then go on to define areas of treatment. The beginning of the pharmaceutical industry’s dominance of the subject.
Chlorpromazine was developed from a $350,000 investment. In 1953 sales reached $53 million and by 1954 four million patients in the United States had used it. The drug produced profits exceeding $75 million in 1955. By 1970 sales had reached an astronomical figure of $347 million.
The $347 million yearly figure in 1970 would convert to almost $3 billion in today’s money. For a pittance in development and production costs the companies concerned could reap fortunes in profit.
The commercial success of the first antipsychotic, chlorpromazine, a single drug, provided a very clear message to the pharmaceutical industry and to those who controlled it, that the psychiatric market held the greatest profit potential of all. 17
Pharmaceutical companies take control of the subject
Looking for further influences in the implementation of chlorpromazine and later drugs finds, of course, the large footprint of pharmaceutical company marketing and the multi-million dollar prize.
At the time there were two areas of clinical psychiatric application. The first was asylums where it was far easier to integrate the new drugs. The second was a far larger number of patients being influenced under the ‘dynamic psychiatry’ and ‘social psychiatry’ banners, where the new drugs were first resisted, then attempted to be used as adjuncts to psychotherapy and then finally used on their own amid changes to diagnosis and particularly from the influence of the DSM III (1980).
Initial marketing was done by the French company which developed the drug. The rapid rise in use in the USA and internationally was not due to demands from within psychiatry (which at least in the United States considered chlorpromazine as ‘just another sedative’, were resistive and wanting to continue along psychotherapy lines).
It was directly and only as a result of the drug being marketed by a pharmaceutical company called Smith Kline and French into asylums, to psychiatrists convincing them the drug ‘worked’ and then obtaining U.S. Food and Drug Administration approval.
The result was that by 1964, some 50 million people around the world had taken the drug. And Smith Kline and French revenues doubled three times in 15 years. 18 19
The pattern for this and all subsequent releases of ‘psychiatric’ drugs were and are the same and the role of psychiatry under the dominance of pharmaceutical marketing had been established.
The “psychopharmacological era” had begun and wave after wave of new psychotropic drugs defined psychiatric ‘treatment’.
Any hope of establishing a scientific base for psychiatry was thoroughly crushed under the weight of billions in profits.
Addressing symptoms, not causes or cures
Simply, where they work at all, any drugs used by psychiatry only mask the symptoms of mental illness. None of these drugs were developed based on the discoveries of the cause of any mental illness and none actually address mental illness beyond suppressing symptoms.
All research for psychiatric drugs to date has been done toward suppressing symptoms, not finding causes of mental illness or cures.
In fact, research on psychiatric drugs is done in the reverse of what an actual science would do.
Rather than finding the reason for a mental illness and then finding a treatment to handle that, types of drugs are found that will mask symptoms. Then, knowing a type of drug that can mask symptoms, more similar drugs using the same mechanism are looked for. The result is a seemingly endless cycle of more drugs for symptoms rather than the cause of mental illness isolated and cured.
For example, the first ‘antipsychotic’ drugs were found to act to block the neurotransmitter dopamine in the brain but produced severe side effects. Later ‘antipsychotics’ using the same mechanism, not only blocked dopamine but another neurotransmitter, serotonin in an attempt to block the side effects. 20
Antipsychotics – a horrible replacement for even worse alternatives
Chemical imbalance – psychiatry as a pharma marketing tool
Diagnosis based on opinions, not science
The Diagnostic and Statistical Manual of Mental Disorders (DSM) which was started to be revised in 1974 and published in 1980 as version III, was based on the introduction of psychotropic drugs into clinical psychiatry. With the emphasis placed on psychotropic drugs addressing symptoms of mental illness, the need for a diagnosing system became very important. What were the symptoms that the drug would address? This prompted an extensive revision of the Diagnostic and Statistical Manual (DSM) toward that end and what was called a ‘neo-Kraepelin revolution’ for psychiatry.
The authors of the Diagnostic and Statistical Manual (DSM) version III, which would provide this diagnostic system for psychotropic drugs, had no scientific basis for their decisions for what was to be the largest revision of the manual to date.
This revision which would subject millions of people to psychotropic drugs and cost billions wasn’t based on science at all – merely the opinions of its authors.
The following quotes are from interviews with DSM Task Force members obtained by James Davies, a Reader in medical anthropology and psychology at the University of Roehampton in London and made available in the paper How Voting and Consensus Created the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), 2016: 21
“[As] psychiatry is unable to depend on biological markers to justify including disorders in the DSM, we looked for other things – behavioural, psychological – we had other procedures… Our general principle was that if a large enough number of clinicians felt that a diagnostic concept was important in their work then we were likely to add it as a new category. That was essentially it. It became a question of how much consensus there was to recognise and include a particular disorder.” (Interview with author 2012)
Robert Spitzer, head DSM III task force
“I don’t have specific recollections, some things were discussed over a number of different meetings, [which would sometimes be] followed by an exchange of memoranda about it, and then there would simply be a vote… people would raise hands, there weren’t that many people. (Interview with author, 2012)”
Henry Pinsker, DSM III task force
“There was very little systematic research, and much of the research that existed was really a hodgepodge—scattered, inconsistent, and ambiguous. I think the majority of us recognised that the amount of good, solid science upon which we were making our decisions was pretty modest. (Angell 2009, 29).”
Theodore Millon. DSM III task force
“There are very few disorders whose definition was a result of specific research data. For borderline personality disorder there was some research that looked at different ways of defining the disorder. And we chose the definition that seemed to be the most valid. But for the other categories rarely could you say that there was research literature supporting the definition’s validity.” (Interview with author, 2012)
Robert Spitzer, head DSM III task force
DSM IV and later editions are built on DSM III with no attempt made then or since to replace these opinions with anything remotely based on science.
Placebo, the mystery variable
The placebo effect and why it really does matter
An important part of looking at psychiatry’s address of mental illness symptoms is the subject of placebo or the placebo effect. The placebo effect is the patient getting better and yet the reason cannot be assigned to the treatment he or she is receiving. 22
An aspect of the placebo effect, the intention of the patient to get well, has been seen in the subject of mental health going back centuries, i.e. many people in asylums when treated with decency and not abused could get well on their own accord.
It is also relevant in trials of drugs (or any treatment) to see if they really work. For example, it is acknowledged that 35% to 40% of the response rate to antidepressants is due to the placebo effect. 23
Although a very, very significant ‘mystery variable’ in anything to do with mental health, psychiatry does not know why the placebo effect works and it is mostly ignored. More evidence of psychiatry’s lack of scientific foundation and yet this subject could be a place to start if they were honestly intent on producing one.
Yet, understanding placebo potentially could cost billions in drug profits – would those who actually now control the subject permit it?
‘Antipsychotics’, the chemical straightjacket
These types of drugs were originally correctly labeled as powerful tranquilizers, with the label of ‘antipsychotics’ arriving later. These drugs do not cure psychosis, merely suppress its symptoms. Psychiatry has no idea what causes psychosis let alone what would cure it and so use these drugs as they have nothing else.
The mechanism involves suppression of the neurotransmitter dopamine and with later versions, serotonin as well. Parts of the brain are blocked off and while a person could remain psychotic, they could not appear to be nor act psychotic. Thus the ‘chemical straitjacket’ label these drugs have been given. Remove the drug and the person could again manifest the symptom of psychosis, i.e. the psychosis had never been addressed, let alone cured. 24
The drugs have a shotgun effect as while they can suppress psychotic symptoms they can also suppress many other features of a person’s personality. The shotgun effect also results in notable side effects beyond psychotic symptoms.
“People (both with mental illness and volunteers) who’ve taken antipsychotics also report a state of physical, mental and emotional suppression. Those suffering from mental disorders describe how the drugs can help to diminish disturbing thoughts and experiences, but at the cost of stifling important aspects of their personality such as initiative, motivation, creativity and sexual drive.”
Joanna Moncrieff. Story of antipsychotics is one of myth and misrepresentation 25
Antipsychotics – a horrible replacement for even worse alternatives
Antidepressants’, marketing before science
Antidepressants are by far the largest example of the use of psychotropic drugs and yet are also the most controversial.
Common antidepressant drugs these days – selective serotonin reuptake inhibitors – suppress the natural function of nerve endings absorbing the neurotransmitter serotonin (the process of ‘reuptake’) in the brain. The reasons a person is depressed are never looked for nor handled. As with ‘antipsychotics’, antidepressants mess with brain chemistry and bring about a whole catalog of disturbing side effects, and are very difficult to withdraw from. 26
Considerable marketing occurred with the release of these drugs from the 1960s forward including the completely false statement that depression was caused by a lack of serotonin in the brain – a chemical imbalance – which psychiatrists, working with pharmaceutical marketing, used to make the drugs popular.
This ‘theory’ began to unravel with the first observations some of the results of these antidepressant drugs’ were simply a placebo response:
“We identified 252 placebo-controlled trials (26 324 patients on placebo) done between 1978 and 2015. There was a structural break in 1991, and since then, the average placebo response rates in antidepressant trials have remained constant in the range between 35% and 40%”.
Placebo response rates in antidepressant trials: a systematic review of published and unpublished double-blind randomised controlled studies. Furukawa TA et al. 2016. 27
Then it was found that one-third of all patients said to have major depressive disorder simply did not respond to antidepressants – explained by a new label: Treatment-Resistant Depression 28
And in 2022 a major review of all available evidence regarding the serotonin theory of depression found there was no scientific evidence at all:
“This review suggests that the huge research effort based on the serotonin hypothesis has not produced convincing evidence of a biochemical basis to depression. This is consistent with research on many other biological markers. We suggest it is time to acknowledge that the serotonin theory of depression is not empirically substantiated.”
Moncrieff J, et al The serotonin theory of depression: a systematic umbrella review of the evidence. 29
Chemical imbalance – psychiatry as a pharma marketing tool
Appalling side effects are often played down or not mentioned at all
As psychotropic drugs mess with the natural brain chemistry, they will produce side effects.
Common side effects of antipsychotic and antidepressant drugs can include compulsive movement (akathisia) and twisting of body parts (dystonia).
Patients with schizophrenia were found with 24% having chronic akathisia and 18% “pseudoakathisia” (only having objective symptoms).
Studies of groups of persons who were taking antidepressants for a bipolar, or manic depression diagnosis found they will develop akathisia in 10 to 18% of cases. 30
Other major side effects can include weight gain, sexual dysfunction, conditions resulting in heart, lung, and kidney failure, pneumonia, and death.
Patients are not always informed of the potential side effects of the drugs they are being prescribed. A 2019 study found that 70% of more than 800 persons surveyed could not recall they had been informed of drug side effects when prescribed and 70% had tried stopping the drugs due to concerns over side effects (64%) and their long-term physical health (52%). 31
In some cases, side effect information from drug trials is not made available. The risk of akathisia with SSRI antidepressants was known and yet withheld for years until finally disclosed. For example, it was known that 3.5% of Prozac patients either attempted or committed suicide due to the stresses of akathisia.
At the time a Pfizer employee, Roger Lane, stated in a 1998 paper:
“It may be less of a question of patients experiencing fluoxetine-induced suicidal ideation than patients feeling that ‘death is a welcome result’ when the acutely discomforting symptoms of akathisia are experienced on top of already distressing disorders.”
Roger Lane, from Evelyn Pringle. SSRI-Induced Akathisia’s Link To Suicide 2007. 32
Some side effects will clear up when the drug is no longer taken however some will take months or years to resolve or as is the case of tardive akathisia or tardive dyskinesia (uncontrolled body movements and twisting) can be untreatable and permanent.
Again, psychiatry does not know enough about the drugs that they are prescribing to say why these side effects occur in some people. It is simple Russian roulette.
Electroconvulsive ‘therapy’
When the drugs fail to suppress symptoms psychiatry reverts to the barbarity of electroconvulsive therapy, ECT.
Do not look for any science here as psychiatry has no understanding of why ECT works, when it does. And, here again, what is occurring is merely the suppression of symptoms, absolutely no cures, and again playing ‘Russian roulette’ with a long list of potentially debilitating side effects.
ECT has long been proclaimed as a treatment of last resort where to keep the patient alive, the brutality of the treatment and resulting side effects were somehow justified. And yet, a 2022 study found the reverse to be true. The study found there was no significant protection from the risk of suicide in the 30 days after treatment. In fact, typically in psychiatry, the actual result of receiving ECT included a 30% greater risk of suicide in the following year compared to those who had not received treatment. 33
Another ECT myth debunked, again
- Psychiatrist, Henry Maudsley. 1895. From Joel T. Braslow and Stephen R. Marder. A History of Psychopharmacology. 2019.
- Rebecca A Johnson. “Pure” Science and “Impure” Influences: The DSM at a Scientific and Social Crossroads DePaul J. Health Care
- Shorter E. The history of nosology and the rise of the Diagnostic and Statistical Manual of Mental Disorders. Dialogues Clin Neurosci. 2015.
- Rick Mayes, Allan Horwitz. DSM-III and the revolution in the classification of mental illness. Journal of the History of the Behavioral Sciences. 2005.
- Rebecca A Johnson. “Pure” Science and “Impure” Influences: The DSM at a Scientific and Social Crossroads
- López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. Ann Clin Psychiatry. 2005
- Ban TA. The role of serendipity in drug discovery. Dialogues Clin Neurosci. 2006.
- López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. Ann Clin Psychiatry. 2005
- López-Muñoz F, D’Ocón P, Romero A, Guerra JA, Álamo C. Role of serendipity in the discovery of classical antidepressant drugs: Applying operational criteria and patterns of discovery. World J Psychiatry. 2022.
- López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. Ann Clin Psychiatry. 2005
- López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. Ann Clin Psychiatry. 2005
- Rick Mayes, Allan Horwitz. DSM-III and the revolution in the classification of mental illness. Journal of the History of the Behavioral Sciences. 2005.
- More and more off-label, criminal use of antipsychotics. Per Lanterna
- López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. Ann Clin Psychiatry. 2005
- Chlorpromazine Side Effects https://www.drugs.com
- López-Muñoz F, Alamo C, Cuenca E, Shen WW, Clervoy P, Rubio G. History of the discovery and clinical introduction of chlorpromazine. Ann Clin Psychiatry. 2005
- Rick Mayes, Allan Horwitz. DSM-III and the revolution in the classification of mental illness. Journal of the History of the Behavioral Sciences. 2005.
- Glenn E. Ullyot, Barbara Hodsdon Ullyot, and Leo B. Slater The Metamorphosis of Smith–Kline & French Laboratories to Smith Kline Beecham: 1925-1998 Bull. Hist. Chem.2000.
- PBS. Drug for treating schizophrenia identified. 1952.
- Li P, Snyder GL, Vanover KE. Dopamine Targeting Drugs for the Treatment of Schizophrenia: Past, Present and Future. Curr Top Med Chem. 2016
- James Davies. How Voting and Consensus Created the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) 2016.
- Emma Bryce. Video. The powder of the placebo effect.
- Furukawa TA, Cipriani A, Atkinson LZ, Leucht S, Ogawa Y, Takeshima N, Hayasaka Y, Chaimani A, Salanti G. Placebo response rates in antidepressant trials: a systematic review of published and unpublished double-blind randomised controlled studies. Lancet Psychiatry. 2016 Nov;3(11):1059-1066.
- Li P, Snyder GL, Vanover KE. Dopamine Targeting Drugs for the Treatment of Schizophrenia: Past, Present and Future. Curr Top Med Chem. 2016
- Joanna Moncrieff. Story of antipsychotics is one of myth and misrepresentation. The Conversation. 2013.
- National Library of Medicine, USA. Selective Serotonin Reuptake Inhibitors
- Furukawa TA, Cipriani A, Atkinson LZ, Leucht S, Ogawa Y, Takeshima N, Hayasaka Y, Chaimani A, Salanti G. Placebo response rates in antidepressant trials: a systematic review of published and unpublished double-blind randomised controlled studies. Lancet Psychiatry. 2016.
- V Popova, E J. Daly, M Trivedi, K Cooper, R Lane, P Lim, C Mazzucco, D Hough, M E Thase, R C Shelton, P Molero, E Vieta, M Bajbouj, H Manji, W C Drevets, J B. Singh. Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study 2019. American Journal of Psychiatry.
- Moncrieff J, Cooper RE, Stockmann T, Amendola S, Hengartner MP, Horowitz MA. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry. 2022
- Haitham Salem, Caesa Nagpal, Teresa Pigott and Antonio Lucio Teixeiraa. Revisiting Antipsychotic-induced Akathisia: Current Issues and Prospective Challenges Curr Neuropharmacol. 2017.
- Read J, Williams J. Positive and Negative Effects of Antipsychotic Medication: An International Online Survey of 832 Recipients. Curr Drug Saf. 2019
- Evelyn Pringle. SSRI-Induced Akathisia’s Link To Suicide 2007.
- Watts BV, Peltzman T, Shiner B. Electroconvulsive Therapy and Death by Suicide. J Clin Psychiatry. 2022