The Bitterest Pills: The Troubling Story of Antipsychotic Drugs

293 Pages·2013·1.147 MB·English

by  Joanna Moncrieff

The Bitterest Pills
Also by Joanna Moncrieff
THE MYTH OF THE CHEMICAL CURE
DE-MEDICALISING MISERY (co-editor)
A STRAIGHT TALKING INTRODUCTION TO PSYCHIATRIC DRUGS
Praise for The Myth of the Chemical Cure:
‘A revolutionary book written with the calm assurance of someone who knows
her subject matter – and the people involved – extremely well. Essential reading
for anyone interested in mental health’. Dorothy Rowe, www.dorothyrowe.com.au
‘This is a book that should change psychiatry forever’. Mental Health
‘This book is critically important and should be essential reading for all psy-
chiatrists, politicians, service providers, and user groups. Why? Because Joanna
Moncrieff’s central tenet is right, and the implications for service delivery are
profound. The book is closely argued and well referenced. Even if you disagree
with some of it’s overall premises, it is not legitimate to dismiss it. I urge you to
read it if only as a prompt to a critical evaluation of the status quo, never a bad
thing, and almost always an illuminating exercise’. Sarah Yates, Cambridge, UK
‘This is a sober and thoughtful book. I found it very engaging and worth the
effort to be better informed about a subject that affects many of our clients and
impinges on our professional lives as therapists’. Existential Analysis (Society for
Existential Analysis)
‘...Joanna Moncrieff, a practising psychiatrist and academic, has produced a
devastating critique of the use of psychiatric drugs... This courageous book has
the potential to revolutionise psychiatric practice and the care of people with
many forms of mental distress. Many in the therapy professions will, I am sure,
celebrate its message’. Rachel Freeth, Therapy Today
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The Bitterest Pills
The Troubling Story of
Antipsychotic Drugs
Joanna Moncrieff
University College London, UK
© Joanna Moncrieff 2013
All rights reserved. No reproduction, copy or transmission of this
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permitting limited copying issued by the Copyright Licensing Agency,
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Any person who does any unauthorized act in relation to this publication
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The author has asserted her right to be identified as the author of this work in
accordance with the Copyright, Designs and Patents Act 1988.
First published 2013 by
PALGRAVE MACMILLAN
Palgrave Macmillan in the UK is an imprint of Macmillan Publishers Limited,
registered in England, company number 785998, of Houndmills, Basingstoke,
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ISBN 978–1–137–27742–8 hardback
ISBN 978–1–137–27743–5 paperback
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A catalogue record for this book is available from the British Library.
A catalogue record for this book is available from the Library of Congress.
Typeset by MPS Limited, Chennai, India.
To my life-long companions Sarah, Richard and Madeline
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Contents
List of Tables and Figures x
List of Abbreviations xi
Preface and Acknowledgements xii
1 Cure or Curse: What Are Antipsychotics? 1
2 Chlorpromazine: The First Wonder Drug 20
3 Magic Bullets: The Development of Ideas on Drug Action 39
4 Building a House of Cards: The Dopamine Theory of
Schizophrenia and Drug Action 60
5 The Phoenix Rises: From Tardive Dyskinesia to the
Introduction of the ‘Atypicals’ 76
6 Looking Where the Light is: Randomised Controlled
Trials of Antipsychotics 91
7 The Patient’s Dilemma: Other Evidence on the Effects of
Antipsychotics 113
8 Chemical Cosh: Antipsychotics and Chemical Restraint 132
9 Old and New Drug-Induced Problems 152
10 The First Tentacles: The ‘Early Intervention in Psychosis’
Movement 170
11 The Antipsychotic Epidemic: Prescribing in the
Twenty-First Century 189
12 All is not as it Seems 208
Notes 221
Appendix 1: Common Antipsychotic Drugs 223
Appendix 2: Accounts of Schizophrenia and Psychosis 226
References 229
Index 269
ix