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The Creation of Psychopharmacology By David Healy ( Harvard University Press )
Release Date: 2004-09-15
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Product Description
"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. "
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 The Creation of Psychopharmacology -Healy ( drjohncc )
I'm embarrassed to say that I had not read this book until recently. I was aware that it existed and even had a copy laying around for over 3 years. Convergent events led me to read it and I must say that I found it particularly enjoyable. Readers will need to have more than a modicum of knowledge in several fields of science. Those that do will be rewarded with a book that is difficult to put down.
My only criticism: The editing is poor. Someone with a better knowledge of punctuation needed to have reviewed this before publication. There are also more than a few sentence fragments, misspellings, and poor word choices. In the context of his otherwise thoughtful and clearly highly educated prose, these editorial errors stuck out like a sore thumb.
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most objective, nuanced history of psychopharmaceuticals ( kalyndra )
David Healy is probably the top historian of psychopharmacology in the last three years. He tells the story of the use of neuroleptics in treating schizophrenia that shows how the interests of certain parties (ie pharmaceutical companies and psychiatrists desperate to do something about horrendous and overcrowded conditions in state mental hospitcals) came to define the nature of psychopharmaceuticals and even the nature of schizophrenia - a pretty vaguely-defined illness - itself. Somehow, chlorpromazine went from being looked at as pretty similar as lobotomy, insulin therapy, or many of the other treatments previously used for schizophrenia, in the early 1950s, to being a magic bullet, saving schizophrenics from a lifetime of insanity without side effects, which is simply not the case. As the previous reviewer notes, Healy seems to give short shrift to some evidence. However, Healy's coming from the perspective of a historian of science - a discipline that tends to begin with a critical analysis and without starting from the viewpoint that science is king, but the viewpoint of a skeptic. To use the example of the previous reviewer, Healy's point when e talks about the withdrawal symptoms of SSRI's is partially to note that, when we talk about mental illness and that fuzzy boundary between the mental and the physical, there's a lot of flexibility in where that boundary is placed in the mind of the public. The concept of withdrawal itself *is* a very fluid, unscientific one: why some classes of drugs are considered to exhibit withdrawal effects while others dont is a highly politicized question - one whose answer lies more on the side of special interests and the state of american politics than real scientific evidence. one more note: the other major history of psychopharmacology to date is judith swazey's 1974 "chlorpromazine in psychiatry: a revolution in innovation." if you read swazey's book you can see why a critical history of psychopharmacology was desperately needed. this book balances the picture and serves as an excellent introduction to the history of psychopharmacology without being overly optimistic about medicine and progress.
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 Where's The Beef? ( oberhofer )
Hopefully without offending vegetarians, my question about this book is...where's the beef? The Creation of Psychopharmacology is filled with claims which the author, David Healy, appears to believe the reader will be sufficiently knowledgeable to take at face value. But it is the claims themselves - and evidence for and against their accuracy - which presumably should be at the heart of this book. For example, at p. 170, the author states that when "SSRI withdrawal was shown to exist in the late 1990s, the medical establishment denied that SSRIs could be addictive." Nevertheless, the author reports, by the time millions were taking SSRIs, "users faced the prospect of inadvertantly being hooked." What does any of this mean? "SSRI withdrawal" presumably means withdrawing from using SSRIs just as a politician might consider withdrawing from an election campaign. If the author means SSRI withdrawal SYMPTOMS or CONSEQUENCES were shown to exist, then the part about the late 1990s is weird. Consequences exist when the use of ANY drug, perhaps any medication, is terminated. One did not have to wait for the 1990s. If you withdraw from using a nasal spray, you may have a rebound effect. If you stop drinking coffee cold turkey, you may experience withdrawal symptoms. So too with SSRIs, the use of which should not be abruptly terminated, as it says on the little plastic bottle. This is news? If the author means that in the late 1990s, it was discovered that SSRIs cause "dependence," then we might reasonably expect to be told what that means. Millions "depend" on SSRIs to cope with depression. Uh...okay. That sounds good, not bad. Something you can finally depend on! But if the author means "dependence" as in "addiction," then where's the proof? Xanax is "fiercely addictive," as Peter Kramer says, in Listening to Prozac. But the author of The Creation of Psychopharmacology offers NO evidence at all that SSRIs are "addictive" in the sense that Valium or Heroin are addictive. When is the last time you were mugged by someone desperate for money to buy Zoloft? So here you have a book by a psychiatrist who testifies on SSRIs and suicide in federal court, a book published by Harvard Univ. Press with one blurb on the back, by the noted historian Edward Shorter, which makes the extraordinary claim that millions risk "inadvertantly" (they take the medication by accident? they are being lied to by the 'medical establishment'?) becoming "hooked" (shooting Celexa with a needle?)or addicted to SSRIs without providing any proof for this claim other than the suggestion that when you stop using an SSRI, presumably gradually as advised by your physician, you may feel different than when you were taking the medication? You feel different when you stop taking aspirin for headaches (more pain in the head region) or stop eating so much ice cream and other dairy products (e.g., less congestion). Surely there must be more to addiction, being inadvertantly hooked, than this. Perhaps Harvard Univ. Press or even David Healy could straighten us out as to why this book skims along the surface, taking ever so much for granted, while supplying oh so little research. Bald statements may be enough for the historian, Professor Shorter, or even a lay person jury in a civil trial, but serious readers have a right to expext more...don't we?
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Addiction
