- Classification, mechanism of action, adverse drug reactions, and FDA approved uses. - A brief history of psychiatric diagnosis from the very beginning (i.e., military psychiatry - 1905 to date). - Maudsley debate: Does psychiatric drugs cause more harm than good?. - The serotonin myth. - etc

1. « Antipsicóticos »
"Show me a sane man and I will cure
him for you." - Carl Jung

4. Week9Week7Week5Week3
afterstartoftherapy
Chlorpromazine
Butyrophenone type:
Haloperidol
Sedation
Autonomic disturbance
due to atropine-like
action
Movement disorders
due to dopamine
antagonism
Antiemetic effect
Phenothiazine type:
Neuroleptics

5. 40%
40%
20%
Triflupromazine
30 – 150 mg/d
1
10
50
Clozapine
FlupentixolTrifluoperazine
R=H Fluphenazine
2.5 – 10 mg/d
Haloperidol
2 – 6 mg/d
R=H
Long-acting
or
“depot”
neuroleptics i.m. 50–150 mg every 2 weeks i.m. 50–150 mg every 4 weeks
R =
O
C C9H19 R =
O
C C9H19
25 – 200 mg/d
15 – 20 mg/d
-decanoate -decanoate
R
R
2 – 10 mg/d
Relative potency

9. ?

10. Una breve historia…

12. Desertion and shell shock

16. Medicine Under Hitler. Bull N Y Acad Med - 1949.

17. ?
“DSM-5: un instrumento de poder corporativo sin credibilidad
científica que va contra la ética y el sentido común” —
NoGracias

18. DSM 0

19. ¿El mito del antipsicótico?

20. « Story of antipsychotics is one of myth and
misrepresentation »

21. « Henri Laborit, the French surgeon
proclaimed as a hero for introducing it
to psychiatrist colleagues, was using it
in a highly dangerous procedure he
devised called “artificial hibernation”
or “sedation without narcosis”. But the
procedure killed off most of the dogs it
was demonstrated on during Laborit’s
tour of the US. »

22. « As Richard Bentall, an expert on psychosis and a volunteer into a study of
Droperidol, described it:
For the first hour I didn’t feel too bad. I thought maybe this is okay. I can get away
with this. I felt a bit light-headed … [After being asked to fill in a form] I couldn’t
have filled it in to save my life. It would have been easier to climb Mt Everest … It
was accompanied by a feeling that I couldn’t do anything, which is really
distressing. I felt profoundly depressed. They tried to persuade me to do these
cognitive tests on the computer and I just started crying. »
Antipsychotics gained a reputation as “chemical straight-
jackets”

25. Serotonin and depression
The marketing of a myth
David Healy professor of psychiatry
Hergest Unit, Bangor LL57 2PW, UK
The serotonin reuptake inhibiting (SSRI) group of drugs came
on stream in the late 1980s, nearly two decades after first being
mooted. The delay centred on finding an indication. They did
not have hoped for lucrative antihypertensive or antiobesity
The myth co-opted the complementary health market. Materials
from this source routinely encourage people to eat foods or
engage in activities that will enhance their serotonin levels and
in so doing they confirm the validity of using an antidepressant.9
BMJ 2015;350:h1771 doi: 10.1136/bmj.h1771 (Published 21 April 2015) Page 1 of 2
Editorials
EDITORIALS

26. MAUDSLEY DEBATE
Does long term use of psychiatric drugs cause more
harm than good?
We could stop almost all psychotropic drug use without deleterious effect, says Peter C Gøtzsche,
questioning trial designs that underplay harms and overplay benefits. Allan H Young and John
Crace disagree, arguing that evidence supports long term use
Peter C Gøtzsche professor, Nordic Cochrane Centre, Rigshospitalet, DK-2100 Copenhagen,
Denmark, Allan H Young professor of mood disorders, Institute of Psychiatry, Psychology and
Neurosciences, King’s College London, UK, John Crace psychiatric patient and parliamentary sketch
writer, Guardian, London, UK
The Finnish cohort study of mortality in patients with
BMJ 2015;350:h2435 doi: 10.1136/bmj.h2435 (Published 12 May 2015) Page 1 of 3
Head to Head
HEAD TO HEAD

28. « Now that we have a drug, let’s create a disease. »
« If a marketing campaign is really successful, it goes beyond
hype to insinuate itself into the language and thought of the
population as a whole, essentially remaking the way people
think of themselves. Concepts such as reflux disease, erectile
dysfunction, and irritable bowel syndrome have had
considerable success, but the most remarkable changes
have come in the language of psychiatry with the emergence
of neurobiological concepts such as social anxiety disorder,
attention deficit hyperactivity disorder, and bipolar disorder.
What is striking about this neurobiological language is the
extent to which ordinary people have come to incorporate it
into their identities. You may have erectile dysfunction or
irritable bowel syndrome, but you are bipolar or ADHD. Your
diagnosis is part of who you are. »