DavidBransfordMD Blog

This photo was part of an animal photo album in the London Telegraph !
Young Burrowing Owls adapting rather well to a new home !

I find it hard to imagine that up until the early 1960s, prefrontal lobotomies were considered “State of the Art”- often after regressive ECTs and Insulin Shock Treatments had failed to improve the conditions of people with “Mental Breakdowns”. The powerful book by historian Jack El-Hai was recently published, followed by PBS special on Dr Walter Freeman MD. Then came the recent biographical book “My Lobotomy” by Howard Dulley – who was administered a trans-orbital lobotomy by Dr Freeman – when Howard was 12 yrs old – for what I would consider by today’s nomenclature – Oppositional Defiant Disorder…..Unthinkable in 2012, right?

Growing up in the early 1960s at the age of about 10, while my father entered his Psychiatric Residency Training at the University of Minnesota (He had been a GP in a small town for about 14 years before that), I recalled back then the name ‘Thorazine’ as this great break thru anti-psychotic medication. I learned it was first used for hiccups and pre or post op nausea and vomiting, but it soon began to replace lobotomies and ECT. Photosensitivity was cited as a problem, so Mellaril was launched as the antipsychotic of choice and Stelazine was welcomed. The phenothiazines were the miracle drugs for at least for a decade, until Haldol was gifted to the USA from Belgium, I think.
So many new wonder drugs in the family of antipsychotics followed, each marketed as “new and improved” Tardive Dyskinesia was discussed, but not thought to be a major problem – until it was too late and I still see far too many adults with T.D. due to exposure to the Antipsychotics years before – often in the State Hospitals. But many depressed, anxious outpatients received combinations of the antipsychotic along with a TCA antidepressant…So common that they were placed in a single pill, such as Triavil and Etrifon (amitripyline and perphenazine) The MAOIs were not big at that time due to the dreaded “cheese reaction”. As the antipsychotic Loxatane (loxapine) was about to go off patent, its metabolite amoxapine was launched as an antidepressant under the magical name of Asendin—many patients with TD from that drug too.
With the clozapine revolution, it was amazing to see people with such profound disabilities be able to leave decades of State Hospitalization, but at great risk with bone marrow suppression, cardiac diseases, etc. …sent to Group Homes in remote locations with often inadequate supervision and living conditions.
During the clozapine revolution, “less toxic” pines were launched with Zyprexa, Seroquel, and the “dones” Risperidal, Geodon, and far too many others that also can cause TD. But the biggest deception has been the Metabolic Syndromes from these Atypical Antipsychotics…not just obesity, but diabetes, hormonal changes, increased risk of Stroke and heart attacks in elderly and off label disasters in our children. etc.

Ice Pick Lobotomy to a 12 yr old boy from the infamous Dr Walter Freeman MD
early 1960s

I have not addressed the SSRIs, SNRI, nor the many other Toxic meds used in Psychiatry..Those facts have been unraveling thanks to dedicated bloggers on a daily basis. So many issues with deceptive marketing, corrupt researchers, doctors, etc. Looking back to the early 1960s to the present, I fear the Psychiatric Community has made no meaningful advances and do not see them on the horizon.