Polemics & Exchanges

On Meds and Mental Illness

As a practicing child psychiatrist, I agree with some of B.K. Eakman’s points regarding psychotropic medications (Cultural Revolutions, May) but not with the main thrust of her argument.

Before the mid-1950’s, there were no effective treatments for mental illness.  None.  Psychotherapy was, of course, in full flower, and psychoanalytical theorists (Freud and his followers) ruled the field.  Unfortunately, their practices were largely oriented to the “worried well.”  The state hospitals were crammed full of the severely psychotically ill who suffered terribly.  When the first antipsychotic drug, chlorpromazine, and first antidepressant, imipramine, appeared, the results were so startling that thousands of patients were able to be discharged from mental hospitals.

These early drugs work well to this day, but they (like all drugs) have side effects.  Thus science (and, yes, that includes pharmaceutical corporations) has strived to find drugs that might work better with fewer, or less bothersome, side effects.  The Prozac generation of antidepressants came along in the late 80’s.  The big improvement over the older drugs is the relative lack of danger in case of overdose.  They also cause fewer “nuisance” side effects, such as weight gain.  Whether they...

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