The invention of these drugs also stopped the proliferation of the lobotomy. Thankfully I believe this treatment is outlawed.
The major tranquiliser, as it was known then, achieved the same desired effect from a lobotomy or leucotomy. Rather than ripping up parts of a humans brain doctors switched to pills which caused the same result.
I don't know if when they were invented if there was any evidence or aim of treatment related to reduction of delusions and hallucinations - the effect which most people unexposed to psychopathology ideas expect from a drug called an antipsychotic (this, in my belief, is the commonly held belief of public and patients however I have not yet found a suitable trial which asks what patients expect from their treatment). As far as I am aware the drugs were, for most of their life, called major tranquilisers. Antipsychotics is a neologism and I don't know its history.
I liberally use the terms antipsychotic, major tranquiliser, chemical cosh, chemical straitjacket and sometimes neuroleptic as synonymous in my blog. The terms have different shades of meaning though.
Put simply and concisely, it may be possible the only active effect of so called antipsychotic drugs is to suppress behaviour. They make people relaxed and docile. That's it. Any effect on delusions and hallucinations may be purely a placebo response.
There is currently no significant research I am aware of which proves or disproves what I'm talking about. At least as far as I've seen. I'm not a doctor, academic or even a qualifed researcher in mental health.
The problem is not that I've come up with a theory no one has heard of. Many people in mental health know about the chemical cosh. Many scientists would agree it is something which hasn't been proven yet. There are no modern placebo controlled trials. The closest proxy isn't great. They're the studies of low dose, no dose or medication postponement in first episode psychosis. In a systematic review of soteria and a broader review the alternatives being tested showed promising results compared to treatment as usually however there were few studies and sample sizes were small. They also weren't controlled experiments to determine the placebo effect. They're just my argument for the possibility of a trial. The ethical question can be side stepped by offering placebo meds to those in the low dose group at any of these experimental sites.
There's the retrospective analysis of measures of delusions and hallucinations in studies for treatments of schizophrenia. Using meta analysis it will be possible to see which is the most effective treatment for these measures alone. I haven't found thius study yet but someone must have done it already. Its just no one knows about it. Probably. Or perhaps not. The study doesn't need new research to be done. It's just going baxk into old study data. There is the possibility of some very clever maths here I think but I haven't worked it out yet. I mean the basic idea. What I'm thinking is the other measures could be collected too. Different papers use different measures (the two I've read are panss and bprs) within them and the results make aggregated scores. They're not uniform and there's where the need for some clever maths and thinking which is beyond my capability at the moment. But what I'm trying to say is someone like dr joanna moncrieef and richard bentall could use the other individual symptom measures and sort of see if the big bit of the effect is from the other bits. The measures other than the effect on delusions and hallucinations may be higher and overshadow the small or non existent active effect on delusions and hallucinations. This is basically admission of bias. This is what I think a really good experiment might show. The effect is not mainly on delusions and hallucinations.
Like I said there's probably not the same study out there but someone will have done something similar. There just has to be the scientific question answered.
But that's not the important study or trial or question to be answered. A mate of mine - fricking only wise man at the royal college of psychiatry - pointed out my error. It was the assumption that most patients want and expect the cessation of the delusions and hallucinations. The cost of the drug to the individual is very high. The very least it should do is what it is expected to do.
What do patients want and expect? What are their measures? That's the dearth in research.
There's lot of research on psychopathology to empower the psychiatric hegemony. What of the people and what they expect from mental healthcare? Where's the real push to create an evidence base for their measures?
The dearth is because psychiatry is not a democratic system. It falls outside the rules of human rights and democratic principles. As do the victims of the system.
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