Better Than Prozac: Creating the Next Generation of Psychiatric Drugs

Better Than Prozac: Creating the Next Generation of Psychiatric Drugs

Better Than Prozac: Creating the Next Generation of Psychiatric Drugs

Better Than Prozac: Creating the Next Generation of Psychiatric Drugs

Synopsis

Every day millions of people take psychiatric drugs. In Better Than Prozac Samuel Barondes considers the benefits and limitations of Prozac, Ritalin, Valium, Risperdal, and other widely used medications and the ways that superior ones are being created. In tracing the early history of these drugs Barondes describes the accidental observations that led to their discovery and their great impact on our view of mental illness. He goes on to show how their unexpected therapeutic effects were attributed to their influence on neurotransmitters that carry signals in the brain and how this guided their improvement. But Barondes reminds us that, like the originals, current psychiatric drugs don't always work, and often have negative side effects. Furthermore, none were crafted as remedies for known brain abnormalities. In contrast, the design of the drugs of the future will be based on a different approach: an understanding of the molecular mechanisms that give rise to specific patterns of mental symptoms. Using colorful examples of contemporary research, he shows how it is gradually leading to a new generation of psychiatric medications. A lucid evaluation of psychopharmacology, Better Than Prozac offers a deep understanding of psychiatric drugs for people who take them, those who are considering them, and those who are just fascinated by the powerful effects of these simple chemicals on our thoughts and our feelings.

Excerpt

In the early 1960s, when I began my training in psychiatry, the field was in a state of great excitement. In the previous decade several drugs that had been developed for other purposes were unexpectedly found to be useful for the treatment of mental disorders. For the first time a daily dose of pills could eliminate the bizarre ideas of people with schizophrenia and relieve the agonizing self-hatred of people with severe depression.

Adding to the excitement was a flurry of findings about the effects of these drugs on neurotransmitters, the brain chemicals that transmit signals between nerve cells. Once this became clear, a search was undertaken for still more chemicals that influence the actions of neurotransmitters. This led to the development of many new medications, some after long periods of experimentation. The most famous, fluoxetine (Prozac), was identified in the early 1970s as a chemical that augments neurotransmission by serotonin, and marketed as an antidepressant in 1987. Related drugs soon followed, joining many others as tools for changing neurotransmission in the brain.

These new drugs, which have a better balance of properties than those discovered in the 1950s, transformed the practice of psychiatry. Before they came on the scene, most psychiatrists were mainly interested in psychotherapy and rarely prescribed pills. They believed that drug treatment should be restricted to the small fraction of their patients with severe mental disorders and frowned upon the use of drugs for milder forms of mental distress. Now most peo-

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