The Creation of Psychopharmacology by David Healy

Author:David Healy
Language: eng
Format: mobi
Tags: Psychology, History
ISBN: 9780674015999
Publisher: Harvard University Press
Published: 2001-12-31T22:00:00+00:00

The fact that some patients were still able to function when ingesting massive doses was taken by some to indicate a fundamental difference between psychotic and normal people. What normal person could tolerate these doses without being horribly affected? So long as the dopamine hypothesis held sway, there was an apparent scientific basis for this perception. The alternative didn't bear contemplating: that the toxicity that normal people experienced when taking low doses of neuroleptics was being inflicted on psychotic patients in a highly intensified form. A small number of voices drew attention to the fact that some patients got dramatically worse when taking even very low doses of the drugs. But nobody wanted to hear that: not drug companies and not clinicians.

The trends toward ever larger doses culminated with the explicit formulation of megadose therapy approaches. Patients were to be rapidly neurolepticized as soon as they were hospitalized, and doses were increased to the equivalent of 5,000 milligrams of chlorpromazine per day. Haloperidol narcosis became popular. This involved giving 10 milligrams of intravenous haloperidol hourly-potentially equivalent to giving 25,000 milligrams of chlorpromazine by mouth per day. The result was a striking testimony to haloperidol's lack of lethal toxicity. But there was a rising tide of deaths in patients taking high doses of neuroleptics caused by a new and sinister condition called neuroleptic malignant syndrome, as well by dystonias that led to asphyxiation and cardio vascular collapse; in several countries such deaths were investigated by professional groups.'

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