Posted by med_empowered on December 2, 2005, at 13:50:18
In reply to Re: Implants, ECT, posted by Squiggles on December 2, 2005, at 11:54:31
as I understand the implants, it takes a minor procedure to implant them, and another minor procedure to remove them. So..they *are* reversible, more so than depot neuroleptics. But...given the costs involved with removal and the hurdles to getting off antipsychotic treatment in general, my guess would be that, in practice, a schizophrenic patient would have a difficult time getting the implants removed. I'm also concerned b/c developments like this don't really benefit patients (I have yet to meet someone begging to be given a long-acting haloperidol implant.) Really they seem to serve to increase the psychiatrist's power in the doctor-patient relationship.
As for lobotomy...it was pretty rough stuff. The idea of a "dysfunctional brain" is enchanting, but has yet to be proven satisfactorily. As it stands now, psychiatric illness is "understood" to be biological, but there still aren't any scans or other tests that can DX an illness based on any sort of physical abnormality. So..basically, the idea that mental illness is physical in origin is pretty much the statement of *consensus* within the psychiatric community rather than the result of any sort of ground-breaking research or anything of that nature. Conveniently enough, the emphsis on physical origins of mental illness became more pronounced in the 1970s, which was about the time the APA and Big Pharma began a "partnership" that continues to this day.
Additionally, its worth noting that although lobotomy did help *some* patients, on the whole it wasn't that great (one study showed no major difference from placebo). The **big** advantage, one which many psychosurgeons openly pursued in performing lobotomy, was making patients more manageable--they could be cared for at home with minimal fuss, or kept in the insitutions with less supervision and care (which helped keep down costs).
The idea of giving patients anaesthesia during a crisis intrigues me. Its interesting how in the past opiates and heavy sedatives were pretty standard treatment for crises, such as "manic depressive psychosis". After years of looking on such treatment with disdain, given today's "sophisticated" treatments, docs are re-visiting a modified version of old-school treatments (ex: Temgesic for depression, other opiates as adjunctive therapy in severe, refractory schizophrenia). Its also interesting that antipsychotics are often used as part of anaethesia cocktails--like DPT, the demerol, promethazine, Thorazine combo used for pediatric anaesthesia.
poster:med_empowered
thread:584162
URL: http://www.dr-bob.org/babble/20051126/msgs/584592.html