What are psychopharmaceuticals?
Medications that are psychoactive, impact mood, thoughts, or behaviour, prescribed for psychiatric reasons
What did psychopharmaceuticals do?
- impact on conceptualizing and categorizing illness
- highly prominent in modern treatment
- work alongside therapies, frontline position in treatment
What are different views on the role of psychopharmaceuticals?
- cured mental illness and address chemical imbalance
- aids recover process, allows progress and breakthroughs in therapy
- placebo effect
What reshaped out thoughts about drugs?
Global consumer culture and psychopharmaceutical industry
What was the Patent Medicine sector of the market and what was on it?
- unregulated, advertised directly to consumers without revealing all ingredients and used new substances, morphine and cocaine
What was Morphine and Cocatin sold and marketed by?
Morphine - relieve pain and nervous irritation, quiet restlessness, promote sleep
Cocaine - brain tonic and stimulant
- advertised as therapeutic
What did the unregulated sales of psychoactive substances associated with?
- epidemic of addiction to opiates and cocaine in late 19th century
- reformers advocated for control and regulations to manage distribution, reduce consumption, and health/social problems
What was the reform movement?
- formalize and narrow what was deemed medicine and therapeutic to protect consumers
- increased medical regulation of substances
- sales of drugs by non physicians = criminalized
What was the US 1906 Food and Drug Act?
Requirement to disclose substances in labelling
What was the US 1914 Harrison Anti-Narcotic Act
physician prescription for sale of cocaine and opiates
What were implications from reform movement?
- access to psychoactive drugs fully managed by physicians
- substances were fully medicalized
What were Barbiturate and Amphetamines?
- drugs used after decline in opiates and cocaine, widely prescribed, anxiety, insomnia, depression (not thought of as psychiatric drugs)
What did the large public appetite of barbiturates and amphetamines reveal?
-substances thought to be relatively safe, despite high rates of barbiturate overdose
- high prevalence of emotional and psychological suffering among people not institutionalized
- appetite for relief using psychopharmaceuticals
- perception of few side effects
- high barbiturates overdose rates = adverse public health effects of unrestricted psychopharmaceutical use
After WW2 what were two major reasons for psychoactive drugs to be understood as psychiatric medications?
- psychiatry expanding as a profession beyond asylums and into consumer realm, treating milder conditions
- new psychoactive meds became available (Thorazine - psychosis. Mood elevators - severely depressed. Miltown - anti anxiety)
What is Miltown?
first “blockbuster” Pharma drug with high consumption and large cultural impact, high demand = anxiety treatment legit, psychiatry was important by helping people, aggressively advertised towards women
What are some lessons from Miltown? (similar to barbiturates)
- benefits overstated
- risks/side effects harms understated (addiction and toxicity)
- sales and profits
- large consumer demand
The field of psychiatry and new psychopharmaceuticals were partially shaped by…
commercial, professional, and cultural forces
How did the political climate in the 1980’s boost biological psychiatry?
- conservative
- market driven policy
- drug patents = profitable, more marketing and sales
- health systems pressure on physicians to treat in shorter time = more prescribing (psychotherapy = time consuming)
What does a drug need to do to be FDA approved?
- needs to be more effective than a placebo (doesn’t need to be more effective than existing/competing meds)
What is disease mongering and how did it impact pharmaceutical companies?
- marketing strat
- sell meds -> sell disease -> grow patient population -> develop markets -> increase prevalence and severity of mental illness and offer drug solutions
-Pharma companies have great role in defining what is an illness, medicalize normal human experience and diversity
What is Valium and how does it relate to feminism?
- more American women overdose and dependence on Valium
- feminists - valium prescribed to women for conditions that were social problems which stemmed from gender roles and relations rather than mental illness
- led to changes in regulation and marketing of Valium
What is the 3rd most common prescription among Americans 18-44
Antidepressants
How much did antidepressant use increase in the US between 1988-2008?
400% (doubtful there was a 400% increase of depression)
What are the three names drugs have?
chemical name, generic name, trade name(developed by Pharma companies, intentionally selected)
- drug naming = often organized by families of diagnostic symptoms they alleviate or chemical structures of neuroreceptors targeted, or neurochemical mechanisms
