LEC 10 - Psychopharmaceutical Revolution Flashcards
Psycho-pharamceuticals
from adjuncts to frontline treatment
1950s
People who took this compound were really calm and became sedated after that
Birth of Modern psychiatry, why?
Deinstitutionalization
Beginning of medical model’s dominance.
Accelerated decline of psychoanalysis
Sparked interest in other chemical interventions, e.g. lithium, imipramine, etc.
Miltown
Shoed how everyday aspects of life become framed as medical problem (medicalization)
- didn’t just treat women’s symptoms, but rather “symptoms of middle-class American culture” beset with anxieties about changing status of women
- shows why this was revolutionary, there was no history of people taking psychiatric drugs before this point
Naming and Branding
Over time, beliefs about nature of psychopharmaceuticals have changed
- “mood elevator” vs. “antidepressant” and “tranquilizer” and “antipsychotic.”
Medication as Consumer goods
Global market for psychopharmaceuticals worth more than $80 billion annually
Common interests for drug companies
More diagnostic categories = greater potential for growth
Higher rates of mental illness = greater customer base.
More severe language around mental illness = greater likelihood that people seektreatment
More biologically driven ideas about mental illness = greater potential for drugtreatment
Disease Mongering
Triple alliance (producers, physicians, patient groups) benefit from, and promote, particular conditions as widespread, serious, and treatable
STRATS: Medicalization, making symptoms seem worse
Female Sexual Dysfunction
Many researchers say some of these symptoms are normal, and could be tied to having a bad sexual partner
Critics: these are not a sign of inherent dysfunction, but normal experiences
Dangers of Disease Mongering
Unnecessary labelling, impacts on identity
Iatrogenic effects (when problems are caused by medical treatment itself)
Economically wasteful. Who pays for those ad campaigns
Prompts obsessions and anxiety about health
Mystifies non-biochemical explanations for suffering
Drugs and Epidemiology
1980s: Xanax –> panic disorder Mid-1990s: new SSRIs for OCD –> rates up
Late 90s: Paxil –> SAD
2000s: Sarafem –> PMDD
Psychopharms and DSM5
69% of authors have financial relationship with pharma, including authors of criteria for neurocognitive disorders (89%), childhood disorder (78%), and somatic symptom disorders (70%)
Problem of Ghost Written Science
When medical scholarship is not written by the people meant to be the author??? Many scholars degree depend on publication
Problems
Assume the medical knowledge guiding the MD is objective (we think their knowledge is not compromised by financial interest, that they want only what’s best for us)
- Patients have little insight into “interested” sources of knowledge
Why is Psychiatry deemed vulnerable
- Validity Issue (Cant prove illnesses exist)
- Many symptoms not necessarily clear signs of dysfunction
- Psychiatry’s “Desperation”
- No clear treatments for illnesses
