Long-Term Antipsychotics: Making Sense of the Evidence in the Light of the Dutch Follow-Up Study
One of my strongest memories from being a medical student was of a young woman who was brought into a hospital in northern England in the 1980s. Confused and frightened, she poured out a profusion of fragmented ideas about having a gadget implanted in her body and feeling that she was being watched and manipulated by vague but malignant forces. She was started on an antipsychotic drug, and as the dose was gradually increased she became increasingly quiet, subdued, emotionless, expressionless and physically sluggish. To me she seemed empty and lifeless compared to what she had been before, although admittedly less distressed. The consensus was she was ‘better’.
Instances like this, combined with the crowds of patients who shuffled about the back wards of the old asylums, soon convinced me that antipsychotic drugs are rightly thought of as a chemical straight jacket, as Thomas Szasz and others have described them. They produce an artificial state of neurological restriction, which affects both the body and the mind. The lower doses that are often used nowadays mean the drug-induced effects are more subtle than they once were, but they occur nonetheless.