ABSTRACT
This chapter examines the fortuitous development of chlorpromazine, the first antipsychotic. Different types of first- and second-generation antipsychotics and their efficacy are described. Adverse effects: sedation, weight gain, unwanted sexual effects, and movement disorders are discussed. The chapter explores whether the impartiality of some psychiatrists and groups to evaluate drug efficacy may be compromised by close association with pharmaceutical companies. It discusses unease created by high financial benefits to drug firms and their aggressive marketing. Also considered are accusations that companies distort their reporting of drug benefits, and whether new codes of industry practice can improve matters. The chapter observes that dissenters may emphasise adverse effects of antipsychotics rather than strategies for managing them, like differentiating risks of different antipsychotics. It examines claims that people with schizophrenia in developing countries do better with less access to antipsychotics, noting that influential research questions this. Dissenting views that antipsychotics do not fix any known brain abnormality, or rebalance brain chemistry, or cure mental disorder are examined and deemed to be tilting at windmills. An example of critics’ use of inflated language about possible dampening effects of antipsychotics is provided.
