Magic Bullets for Mental Disorders: The Emergence of the Concept of an “Antipsychotic” Drug

When “antipsychotic” drugs were introduced into psychiatry in the 1950s, they were thought to work by inducing a state of neurological suppression, which reduced behavioral disturbance as well as psychotic symptoms. This view was reflected in the name “neuroleptic.” Within a few years, however, the idea that the drugs were a disease-specific treatment for schizophrenia or psychosis, and that they worked by modifying the underlying pathology of the condition, replaced this earlier view, and they became known as “antipsychotics.” This transformation of views about the drugs' mode of action occurred with little debate or empirical evaluation in the psychiatric literature and obscured earlier evidence about the nature of these drugs. Drug advertisements in the British Journal of Psychiatry reflect the same changes, although the nondisease-specific view persisted for longer. It is suggested that professional interests rather than scientific merit facilitated the rise of the disease-specific view of drug action. The increasing popularity of atypical antipsychotics makes it important to examine the origins of the assumptions on which modern drug treatment is based.     

Continuity and Discontinuity in the Historical Development of Modern Psychopharmacology

In the middle of the twentieth century psychiatry underwent a transition that is often referred to as the “psychopharmacology revolution.” Implicit in the term revolution is the idea that a paradigm shift occurred. Specifically, it has been argued that psychiatry abandoned the psychoanalytic paradigm in favor of a qualitatively distinct conceptual system based on brain chemistry. The validity of this view requires that psychoanalysis had the status of a paradigm. This paper presents evidence that psychoanalysis did not constitute a paradigm and that the advent of psychopharmacology was not, technically, a scientific revolution. Instead, the rise of modern psychopharmacology was the culmination of a linear growth of biological knowledge that began to develop in the nineteenth century.     

Aretaeus on Migraine and Headache

Aretaeus of Cappadocia's classification of headache has been referred to for many centuries. Several Latin translations and an English translation (1856) of his books have been published in the past. We translated the pertinent texts on headache from the Greek text as published by Hude in 1958. In this paper, we present an annotated translation preceded by an outline of contemporary knowledge of headache from Celsus’ De Medicina. Although symptomatic headache was most probably involved in the types of headache identified by Aretaeus and the making of retrospective diagnoses is hazardous, the terms heterocrania and cephalea may be compared with what today we would call migraine and tension type headache respectively.