Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, California 90095-1759, USA; email:
Department of History, University of California, Los Angeles, California 90095-1759, USA.
Annu Rev Clin Psychol. 2019 May 7;15:25-50. doi: 10.1146/annurev-clinpsy-050718-095514. Epub 2019 Feb 20.
We live in an age of psychopharmacology. One in six persons currently takes a psychotropic drug. These drugs have profoundly shaped our scientific and cultural understanding of psychiatric disease. By way of a historical review, we try to make sense of psychiatry's dependency on psychiatric drugs in the care of patients. Modern psychopharmacology began in 1950 with the synthesis of chlorpromazine. Over the course of the next 50 years, the psychiatric understanding and treatment of mental illness radically changed. Psychotropic drugs played a major part in these changes as state hospitals closed and psychotherapy gave way to drug prescriptions. Our review suggests that the success of psychopharmacology was not the consequence of increasingly more effective drugs for discrete psychiatric diseases. Instead, a complex mix of political economic realities, pharmaceutical marketing, basic science advances, and changes in the mental health-care system have led to our current infatuation with psychopharmacology.
我们生活在一个精神药理学的时代。目前,每六个人中就有一人服用精神药物。这些药物深刻地塑造了我们对精神疾病的科学和文化理解。通过历史回顾,我们试图理解精神病学在患者护理中对精神药物的依赖。现代精神药理学始于 1950 年氯丙嗪的合成。在接下来的 50 年里,精神疾病的理解和治疗发生了根本性的变化。精神药物在这些变化中发挥了重要作用,随着州立医院的关闭和心理治疗让位于药物处方。我们的回顾表明,精神药理学的成功并非源于针对特定精神疾病的药物越来越有效,而是政治经济现实、制药营销、基础科学进步以及精神卫生保健系统变化的复杂混合,导致了我们目前对精神药理学的迷恋。