Moncrieff Joanna
Department of Mental Health Sciences, University College London, London, UK.
J Hist Neurosci. 2013;22(1):30-46. doi: 10.1080/0964704X.2012.664847.
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.
20世纪50年代,“抗精神病”药物被引入精神病学领域时,人们认为其作用机制是诱导一种神经抑制状态,从而减少行为障碍和精神症状。这种观点反映在“神经阻滞剂”这个名称中。然而,几年内,药物是针对精神分裂症或精神病的疾病特异性治疗方法,且通过改变病情的潜在病理来发挥作用的观点取代了早期观点,这些药物也因此被称为“抗精神病药物”。关于药物作用方式的这种观点转变在精神病学文献中几乎没有经过辩论或实证评估,掩盖了关于这些药物本质的早期证据。《英国精神病学杂志》上的药物广告也反映了同样的变化,尽管非疾病特异性观点持续的时间更长。有人认为,是专业利益而非科学价值推动了药物作用疾病特异性观点的兴起。非典型抗精神病药物越来越受欢迎,这使得审视现代药物治疗所基于的假设的起源变得很重要。