1. Mental Illness and Neurotransmitters: Psychopharmacology and the Prozac Era

2. “The Society of Biological Psychiatry was founded in l945 to encourage the study of the biological causes of and treatments for psychiatric disorders. Its continuing purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms, and treatments of disorders of thought, emotion, or behavior.” Journal founded in 1969

3. Contributing Factors to Rise of Biological Psychiatry Renewed attention to needs of the psychotic in mental hospitals Genetic Studies (Kety, 1968): almost 10% higher incidence of disease in relatives of schizophrenics as compared to controls Rise of controlled clinical trials as the gold standard in medicine; importance of “criteria, control, and variables;” talk therapies didn’t measure up Development of psychopharmaceuticals New journal: Biological Psychiatry (1969)

4. Santiago Ramón y Cajal (1852-1934)

5. Cajal Drawing of Purkinje Cells from Pigeon Cerebellum

6. Cajal’s Anatomical Drawings Axon- conducts impulse Dendrite- receives impulses from other neurons

7. Ramon y Cajal’s drawing of a human motor cortex pyramidal cell as tattoo!

8. Otto Loewi’s (1873-1961) Experiment with Frog Hearts Electrical stimulation of the vagus nerve (attached to heart #1) caused heart #1 to slow down. After a delay, heart #2 also slowed down. Loewi hypothesized that electrical stimulation of the vagus nerve released a chemical into the fluid of chamber #1 that flowed into chamber #2. He called this chemical "Vagusstoff". We know this chemical as the neurotransmitter acetylcholine.

9. Neuroleptic, or Antipsychotic Class of Drugs

10. Pierre Deniker & Jean Delay 1952—Testing of Chlorpromazine St. Anne Hospital Paris, France Side Effects: Tardive Dyskinesia

11. Early Psychotropic Medications Chlorpromazine (Thorazine), 1954 McLean Hospital study—used with schizophrenics Reserpine, used as a tranquilizer Haloperidol was developed in 1958 (better known as Haldol), for psychotics, but non- sedative.

12. Smith, Kline & French Laboratories c. 1956 “…helping to dispel or modify delusions, hallucinations and confusion, while keeping the patient calm and approachable.”

13. 1959

14. “Patients hospitalized for many years have returned to society”

15. “helping patients gain more from psychotherapy… reduce anxiety, agitation and tension in patients…”

16. MEPROBAMATE or Miltown Anti-Anxiety Drug (1959)

17. 1965

18. DTC (Direct to Consumer Advertising) allowed by FDA in 1997 1996 drug companies spent 595 million on advertising 1997 spent 843 million on advertising 2000 2.5 billion spent 2007 around 25 billion, with 3 billion on direct to consumer marketing From Christopher Lane, Shyness, p. 112

19. Anti-Depressant Testing Roland Kuhn Nathan Kline Tested anti-depressant, Imipramine (tri-cyclic) at Münsterlingen asylum in Switzerland, published results 1957 Tested Iproniazid (Monoamine Oxidase inhibitor MAOI) Rockland State Hospital NY

20. IMIPRAMINE tri-cyclic anti- depressant

21. Neurotransmitter Theories of Mental Illness Dopamine (in excess) caused psychotic disturbances Acetylcholine linked to dementia Serotonin linked to depression Popular from 1963-1980; recognition after this period that it was much more complex

22. Newsweek (1990) Time (1992) Class of SSRI: selective serotonin- reuptake-inhibitor

23. “Mental illnesses are biologically based brain disorders. They cannot be overcome through ‘will power’ and are not related to a person's "character" or intelligence.” National Alliance for the Mentally Ill founded 1979