ABSTRACT
Physical treatments used in psychiatry at this present day include antipsychotic and other drugs, electroconvulsive therapy, and psychosurgery. It was the 1950s before antipsychotic drugs began to be introduced. Before that Electroconvulsive therapy (ECT), insulin coma and even psychosurgery were used for schizophrenia and severe depression. The new antipsychotics had fewer side-effects and unlike brain surgery – usually on the frontal lobes – antipsychotics were reversible. This chapter examines case histories based on physical treatments. Before the 20th century physical treatments were even more outlandish and basically ineffective. Patients with schizophrenia who had been hospitalised in asylums for many years were sometimes transformed within weeks of the new treatment. Although chlorpromazine works on a variety of receptors in the brain including cholinergic and histaminergic receptors, it is felt to be its effects on dopamine receptors that are responsible for its antipsychotic effects. Chlorpromazine is seen as a typical antipsychotic or first generation antipsychotic.
