Wednesday, 20 January 2016

Tranquillizing drugs are deceptively non-specific - they reduce complaints of problems, impair thinking, but seldom cure

Tranquillizing drugs are psychiatry's aspirin. They leave patients calm and quiet so they do not feel like complaining.

While taking tranquillizers, the thought processes become simpler, new thoughts become rare, and complex thoughts are diminished.

Patients lose abilities and skills and they are not upset by this loss. Indeed, they are usually not even concerned or aware of the loss.

This should be no surprise because this is what 'tranquillization' means!

Therefore, giving tranquillizing drugs makes psychiatric symptoms of all types decrease...

But let us not believe or pretend that tranquillizers cure...

Edited from page 182 of Psychotic Depression by Conrad M Swartz and Edward Shorter - Cambridge University Press, 2007.

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Tranquillizing drugs include antipsychotics (also known as neuroleptics and major tranquillizers), anxiolytics (also known as minor tranquillizers) and anticonvulsants, also lithium.

Most of the so-called 'mood stabilizers' are tranquillizers including anti-epileptic anticonvulsants, benzodiazepines and antipsychotics - including some of the most big-selling and mega-profitable drugs of recent years. 

These drugs are often given in 'cocktails' (multiple drug combinations) to patients with 'bipolar disorder' (currently diagnosed in about one in twenty people - including young children), ADHD (attention deficit hyperactivity disorder), depression, anxiety, schizophrenia and other psychoses, and hypomania/ mania.

Using many standard rating scales, these drugs will on average alleviate the severity of symptoms all of these disorders, because 'symptoms' are what the patient complains of - and these drugs reduce awareness of problems.

(This is how tranquillizing drugs got FDA approval and were licensed for treating a wide range of disorders.)

But they may make overall functioning and quality of life worse - because tranquillized patients are less aware of their problems or deny them.

For example, a boy with ADHD treated with tranquillizers would become more placid and less troublesome - which might look like effective treatment -- but he would lose mental abilities, self-awareness and motivation - and will almost-certainly function worse at life-in-general (including being academically impaired). 

When the patient has a severe psychotic disorder, such as psychotic melancholic depression, the depression will remain untouched - and so will the problems of severe depression, including high risk of suicide. If the problem is 'schizophrenia' (e.g. long term hallucinations, delusions, thought disorder) the patient may complain less, but function worse and exhibit poor judgment.

If the patient is being given tranquillizers for long periods in hope of prevention (which is happening increasingly); then these drugs are creating definite here-and-now and permanent psychological deficits and reduced functionality in hope of preventing a future disorder which probably would never happen (although drug withdrawal itself makes breakdowns much more likely).

In general, therefore, tranquillizers suppress psychiatric symptoms by suppressing awareness of symptoms - and not by curing them.

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Note: An exception is mania or acute agitated psychosis, where tranquillizers may induce sleep and lead to a rapid improvement and indeed cure of the episode - allowing discharge from hospital in just a few days.

Background - When the early minor tranquillizers were discovered in the 1950s, their effect on animals was striking. Monkeys, and even lions and tigers were made tame. A mouse would become floppy and lie on its back apparently without distress and would not attempt to turn onto its feet. Mice would not attempt to avoid flashing lights or mild electric shocks. These findings vividly demonstrate the pros and cons of tranquillization.
  

2 comments:

Stiltdancer said...

I'm curious about your thoughts on amphetamines - they create the opposite effect on much of the behavior you describe.

Bruce Charlton said...

@S - This is about the general issue of stimulants versus sedatives, and what they say about the Zeitgeist -

http://charltonteaching.blogspot.co.uk/2011/02/why-are-psychiatric-drugs-dysphoric.html