2_The Latest Mania - Selling Bipolar Disorder - David Healy

2_The Latest Mania - Selling Bipolar Disorder - David Healy...

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PLoS Medicine | www.plosmedicine.org 0442 for using the anticonvulsant sodium valproate (Depakote) for treating acute mania [4]. After 1995, there was a dramatic growth in the frequency with which the term “mood stabilizer” appeared in the title of scientiF c articles (see ±igure 1). By 2001, more than a hundred article titles a year featured this term. Repeated reviews make it clear that the academic psychiatric community still has not come to a consensus on what the term “mood stabilizer” means [5–7]. But this lack of consensus did not get in the way of the message that patients with bipolar disorders needed to be detected and once detected needed mood stabilizers, and perhaps should only be given these drugs and not any other psychotropic drugs [8,9]. The F rst group of drugs to colonize this new mood stabilizer niche was anticonvulsants. Anticonvulsants are beneF cial in epilepsy and were until recently widely thought to be beneF cial by quenching the increased risk of succeeding epileptic F ts brought about by F ts that have gone before. Robert Post in the 1980s suggested that anticonvulsants might stabilize moods by a comparable quenching of the kindling effect of an episode of mood disorders on the risk of further episodes [10]. It was this idea that provided a pharmacological rationale for treatment of bipolar disorders that was so attractive to pharmaceutical companies, and, in their hands, the growth of awareness of mood stabilization and of bipolar disorders was sensational. Bipolar disorders entered the DSM
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