ABSTRACT
Expectations were high that the anticipated progress in neuroscience would reveal the cause and cure of mental and neurological illness. There was to be a massive investment in research and development in public and private sectors. By the end of the first decade of the twentyfirst century, it was clear that much of the promise of George H. W. Bush’s proclamation remained unfulfilled. Indeed, Akil and colleagues have argued,
Large-scale studies of the state of treatment of schizophrenia, most notably the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE),3 indicate that the lot of a person suffering from schizophrenia has changed little since the advent of chlorpromazine in the 1950s. More to the point, the level of untreated medical illness in this group of people is alarmingly high, the product of iatrogenic harm and the gross social disadvantage they face. The management of depression, at the heart of mental healthcare, has equally disappointed in the aftermath of the decade of the brain. Far from merely confirming 1990 s-era assumptions about treatment efficacy of antidepressants, the Sequenced Treatment Alternatives to Relieve Depression (STAR*D)4 findings paint an even bleaker picture of the actual benefit of these drugs.
