Are "Antipsychotics" Antipsychotics?

This is the question asked by Tilman Steinert & Martin Jandl in a letter to the journal Psychopharmacology.

They point out that in the past 20 years, the word "antipsychotic" has exploded in popularity. Less than 100 academic papers were published with that word in the title in 1990, but now it's over 600 per year.

The older term for the same drugs was "neuroleptics". This terminology, however, has slowly but surely fallen into disuse over the same time period.

To illustrate this they have a nice graph of PubMed hits. Neuroskeptic readers will be familiar with these as I have often posted my own and I recently wrote a bash script to harvest this data automatically. Now you too can be a historian of medicine from the comfort of your own home...

Why does it matter what we call them? A name is just a name, right? No, that's the problem. Actually, neuroleptic is just a name, because it doesn't mean anything. The term derives from the Greek "neuron", meaning... neuron, and "lambanō" meaning "to take hold of". However, no-one knows that unless they look it up on Wikipedia because it's just a name.

Antipsychotic, on the other hand, means something: it means they treat psychosis. But whether or not this is an accurate description of what "antipsychotics" actually do, is controversial. For one thing, these drugs are also used to treat many non-psychotic illnesses, like depression, and PTSD.

More fundamentally, it's not universally accepted that they have a direct anti-psychotic effect. All antipsychotics are powerful sedatives. There's a school of thought that says that this is in fact all they are, and rather than treating psychosis, they just sedate people until they stop being obviously psychotic.

Personally, I don't believe that, but that's not really the point: the point is that it's controversial, and calling them antipsychotics makes it hard to think about that controversy in a sensible way. To say that antipsychotics aren't actually antipsychotic is a contradiction in terms. To say they are antipsychotic is a tautology. Names shouldn't dictate the terms of a debate in that way. A name should just be a name.

The same point applies to more than just antipsychotics - I mean neuroleptics - of course. Perhaps the worst example is "antidepressants". Prozac, for example, is called an antidepressant. Implying that it treats depression.

But according to clinical trials, Prozac and other SSRIs are a lot more effective, relative to placebo, in obsessive-compulsive disorders (OCD) than they are in depression (though this is not necessarily true of all "antidepressants", yet more evidence that the word is unhelpful.)

So, as I asked in a previous post: "Are SSRIs actually antiobsessives that happen to be helpful in some cases of depression?" Personally, I think the only name for them which doesn't make any questionable assumptions, is simply 'SSRIs'.

Tilman Steinert and Martin Jandl (2010). Are antipsychotics antipsychotics? Psychopharmacology DOI: 10.1007/s00213-010-1927-3

Are "Antipsychotics" Antipsychotics?

This is the question asked by Tilman Steinert & Martin Jandl in a letter to the journal Psychopharmacology.

They point out that in the past 20 years, the word "antipsychotic" has exploded in popularity. Less than 100 academic papers were published with that word in the title in 1990, but now it's over 600 per year.

The older term for the same drugs was "neuroleptics". This terminology, however, has slowly but surely fallen into disuse over the same time period.

To illustrate this they have a nice graph of PubMed hits. Neuroskeptic readers will be familiar with these as I have often posted my own and I recently wrote a bash script to harvest this data automatically. Now you too can be a historian of medicine from the comfort of your own home...

Why does it matter what we call them? A name is just a name, right? No, that's the problem. Actually, neuroleptic is just a name, because it doesn't mean anything. The term derives from the Greek "neuron", meaning... neuron, and "lambanō" meaning "to take hold of". However, no-one knows that unless they look it up on Wikipedia because it's just a name.

Antipsychotic, on the other hand, means something: it means they treat psychosis. But whether or not this is an accurate description of what "antipsychotics" actually do, is controversial. For one thing, these drugs are also used to treat many non-psychotic illnesses, like depression, and PTSD.

More fundamentally, it's not universally accepted that they have a direct anti-psychotic effect. All antipsychotics are powerful sedatives. There's a school of thought that says that this is in fact all they are, and rather than treating psychosis, they just sedate people until they stop being obviously psychotic.

Personally, I don't believe that, but that's not really the point: the point is that it's controversial, and calling them antipsychotics makes it hard to think about that controversy in a sensible way. To say that antipsychotics aren't actually antipsychotic is a contradiction in terms. To say they are antipsychotic is a tautology. Names shouldn't dictate the terms of a debate in that way. A name should just be a name.

The same point applies to more than just antipsychotics - I mean neuroleptics - of course. Perhaps the worst example is "antidepressants". Prozac, for example, is called an antidepressant. Implying that it treats depression.

But according to clinical trials, Prozac and other SSRIs are a lot more effective, relative to placebo, in obsessive-compulsive disorders (OCD) than they are in depression (though this is not necessarily true of all "antidepressants", yet more evidence that the word is unhelpful.)

So, as I asked in a previous post: "Are SSRIs actually antiobsessives that happen to be helpful in some cases of depression?" Personally, I think the only name for them which doesn't make any questionable assumptions, is simply 'SSRIs'.

Tilman Steinert and Martin Jandl (2010). Are antipsychotics antipsychotics? Psychopharmacology DOI: 10.1007/s00213-010-1927-3

AS COISAS MUDAM DE LUGAR...

AS COISAS MUDAM DE LUGAR... AS MUDANÇAS EXISTEM...E DEVEMOS MUDAR SEMPRE PARA O MELHOR...AMAR O OUTRO E RESPEITAR É UMA GRANDE ATITUDE PARA O AMANHÃ.

É sempre bom ser legal com as pessoas, por que...

as coisas mudam ao longo do tempo!!!


"Nunca desvalorize ninguém...
Guarde cada pessoa perto do seu coração, porque um dia você pode acordar e perceber que perdeu um diamante enquanto estava muito ocupado colecionando pedras."

...OBRIGADA PELO SEU CARINHO.
AMO CADA UM QUE CHEGA NESTA CASA.
VOCÊ FAZ PARTE DESTA MORADA.



GRADEÇO A SUA COMPANHIA!!!

Poetas-Um Voo Livre-

Sinal de Liberdade-uma expressão de sentimento-

Blog Coletivo-Uma Interação de Amigos- NOVOS TEMAS...COMPARTILHE...

MEUS MIMOS . AQUI. OFERECIDOS/RECEBIDOS- TEM UM ABRAÇO PARA VOCÊ!!

NOSSO ADEUS AO HOLD!!!

AMIGO HOLD!

NÃO EXISTE NADA QUE FAÇA ALIVIAR A DOR QUE CADA UM DE NÓS ESTÁ SENTINDO NESTE MOMENTO. EM NOME DE TODOS OS BLOGUEIROS, VENHO TE HOMENAGEAR E DEIXAR O NOSSO ADEUS. VOCÊ FOI UM GRANDE AMIGO QUE ENSINOU, E NOS MOSTROU MUITOS MOMENTOS DE ALEGRIAS E CARINHO. NOS CONQUISTOU, PELA SUA SINCERIDADE E HONESTIDADE. SEMPRE MUITO PERTINHO DE NÓS. NOS CONHECIAMOS A DOIS, TRÊS ANOS. SEMPRE ALI, COMPARTILHANDO SEUS MOMENTOS DE AFETIDADES E TERNURAS. QUANTAS COLETIVAS PARTICIPAMOS JUNTOS...QUANTO MOMENTOS E AMIGOS ESPECIAIS, VOCÊ CONQUISTOU.
VAI DEIXAR GRANDES SAUDADES, AMIGOS.
JAMAIS ME ESQUECEREI DE TI. POIS TE LEMBRAREI TODOS OS ANOS NO DIA 28 DE JULHO. UMA DATA EM COMUM COM O MEU MARIDO: O SEU ANIVERSÁRIO. QUEREMOS LHE DIZER, QUE VOCÊ É UM PÁSSARO E ESTA VOANDO SOBRE NÓS. SABEMOS QUE DO LUGAR QUE VOCÊ ESTÁ, ESTARÁ SEMPRE NOS OLHANDO, COM AMOR E CARINHO. UM PESSOA LINDA E BATALHADORA. FEZ MUITO PELA VIDA. MAS QUE HOJE DESCANSA E ESTÁ JUNTINHO DE DEUS. FIQUE EM PAZ AMIGO. JAMAIS ESQUECEREMOS DE TI. QUE BOM QUE VOCÊ EXISTIU EM NOSSAS VIDAS. UM DOCE AMIGO VIRTUAL, QUE CONQUISTOU MUITOS AMIGOS. SEM FRONTEIRAS. ATRAVESSOU OS LIMITES DA TELINHA, PARA ESTAR JUNTO DE CADA UM DE NÓS. QUERO NUM GESTO CARINHOSO, DIZER QUE TE AMAMOS MUITO HOLD, E QUE ESTARÁ SEMPRE CONOSCO.

NESTE BELA E MARAVILHOSA JANELA A CUIDAR DE CADA UM DE NÓS. OBRIGADA AMIGO PELO SEU CARINHO, AMIZADE E AFETO, QUE VOCÊ DEIXOU.
AGRADECEMOS A SUA COMPANHIA DURANTE TODOS ESSES ANOS.
SEMPRE SEREMOS GRANDE AMIGOS.
ADEUS HOLD!!!ATÉ BREVE AMIGO.. TODOS NÓS BLOGUEIROS TE AMAMOS MUITO...

ESTA OUTRA IMAGEM VEM DO BLOG DA IRENE

AMIGOS..
TEM UM SELINHO NA INTERAÇÃO DE AMIGOS PARA TODOS. BASTA CLICAR NA IMAGEM

TEM UM SELO MUITO ESPECIAL PARA VOCÊ!!!

LUTO!!!!

ESTAMOS TODOS DE LUTO PELO ACONTECIDO COM O NOSSO GRANDE AMIGO. QUE FATALIDADE!!!!!
ADEUS AMIGO HOLD.

HOD DO BLOG O OLHAR DE CARPEDIEM TRANSCENDEU HOJE AS 12:45 EM PORTO ALEGRE

QUANTA SAUDADES VOCÊ VAI DEIXAR!!!!!!

ONTEM VOCÊ PASSOU POR AQUI E DEIXOU ESTE RECADINHO "
Hod disse...

Uma grande data a ser cmemorada. Vai ser um prazer estar presente.

Beijos Sandra.

AMIGOS PARA SEMPRE É O QUE NÓS IREMOS SER NA PRIMAVERA OU EM QUALQUER DAS ESTAÇÕES.

ADEUS MEU QUERIDO AMIGO.
FIQUE EM PAZ. NÓS ESTAREMOS POR AQUI, SEMPRE LEMBRANDO DE TI.
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SANDRA

Marc Hauser's Scapegoat?

The dust is starting to settle after the Hauser-gate scandal which rocked psychology a couple of weeks back.

Harvard Professor Marc Hauser has been investigated by a faculty committee and the verdict was released on the 20th August: Hauser was "found solely responsible... for eight instances of scientific misconduct." He's taking a year's "leave", his future uncertain.

Unfortunately, there has been no official news on what exactly the misconduct was, and how much of Hauser's work is suspect. According to Harvard, only three publications were affected: a 2002 paper in Cognition, which has been retracted; a 2007 paper which has been "corrected" (see below), and another 2007 Science paper, which is still under discussion.

But what happened? Cognition editor Gerry Altmann writes that he was given access to some of the Harvard internal investigation. He concludes that Hauser simply invented some of the crucial data in the retracted 2002 paper.

Essentially, some monkeys were supposed to have been tested on two conditions, X and Y, and their responses were videotaped. The difference in the monkey's behaviour between the two conditions was the scientifically interesting outcome.

In fact, the videos of the experiment showed them being tested only on condition X. There was no video evidence that condition Y was even tested. The "data" from condition Y, and by extension the differences, were, apparently, simply made up.

If this is true, it is, in Altmann's words, "the worst form of academic misconduct." As he says, it's not quite a smoking gun: maybe tapes of Y did exist, but they got lost somehow. However, this seems implausible. If so, Hauser would presumably have told Harvard so in his defence. Yet they found him guilty - and Hauser retracted the paper.

So it seems that either Hauser never tested the monkeys on condition B at all, and just made up the data, or he did test them, saw that they weren't behaving the "right" way, deleted the videos... and just made up the data. Either way it's fraud.

Was this a one-off? The Cognition paper is the only one that's been retracted. But another 2007 paper was "replicated", with Hauser & a colleague recently writing:

In the original [2007] study by Hauser et al., we reported videotaped experiments on action perception with free ranging rhesus macaques living on the island of Cayo Santiago, Puerto Rico. It has been discovered that the video records and field notes collected by the researcher who performed the experiments (D. Glynn) are incomplete for two of the conditions.

Luckily, Hauser said, when he and a colleague went back to Puerto Rico and repeated the experiment, they found "the exact same pattern of results" as originally reported. Phew.

This note, however, was sent to the journal in July, several weeks before the scandal broke - back when Hauser's reputation was intact. Was this an attempt by Hauser to pin the blame on someone else - David Glynn, who worked as a research assistant in Hauser's lab for three years, and has since left academia?

As I wrote in my previous post:

Glynn was not an author on the only paper which has actually been retracted [the Cognition 2002 paper that Altmann refers to]... according to his resume, he didn't arrive in Hauser's lab until 2005.

Glynn cannot possibly have been involved in the retracted 2002 paper. And Harvard's investigation concluded that Hauser was "solely responsible", remember. So we're to believe that Hauser, guilty of misconduct, was himself an innocent victim of some entirely unrelated mischief in 2007 - but that it was all OK in the end, because when Hauser checked the data, it was fine.

Maybe that's what happened. I am not convinced.

Personally, if I were David Glynn, I would want to clear my name. He's left science, but still, a letter to a peer reviewed journal accuses him of having produced "incomplete video records and field notes", which is not a nice thing to say about someone.

Hmm. On August 19th, the Chronicle of Higher Education ran an article about the case, based on a leaked Harvard document. They say that "A copy of the document was provided to The Chronicle by a former research assistant in the lab who has since left psychology."

Hmm. Who could blame them for leaking it? It's worth remembering that it was a research assistant in Hauser's lab who originally blew the whistle on the whole deal, according to the Chronicle.

Apparently, what originally rang alarm bells was that Hauser appeared to be reporting monkey behaviours which had never happened, according to the video evidence. So at least in that case, there were videos, and it was the inconsistency between Hauser's data and the videos that drew attention. This is what makes me suspect that maybe there were videos and field notes in every case, and the "inconvenient" ones were deleted to try to hide the smoking gun. But that's just speculation.

What's clear is that science owes the whistle-blowing research assistant, whoever it is, a huge debt.

Marc Hauser's Scapegoat?

The dust is starting to settle after the Hauser-gate scandal which rocked psychology a couple of weeks back.

Harvard Professor Marc Hauser has been investigated by a faculty committee and the verdict was released on the 20th August: Hauser was "found solely responsible... for eight instances of scientific misconduct." He's taking a year's "leave", his future uncertain.

Unfortunately, there has been no official news on what exactly the misconduct was, and how much of Hauser's work is suspect. According to Harvard, only three publications were affected: a 2002 paper in Cognition, which has been retracted; a 2007 paper which has been "corrected" (see below), and another 2007 Science paper, which is still under discussion.

But what happened? Cognition editor Gerry Altmann writes that he was given access to some of the Harvard internal investigation. He concludes that Hauser simply invented some of the crucial data in the retracted 2002 paper.

Essentially, some monkeys were supposed to have been tested on two conditions, X and Y, and their responses were videotaped. The difference in the monkey's behaviour between the two conditions was the scientifically interesting outcome.

In fact, the videos of the experiment showed them being tested only on condition X. There was no video evidence that condition Y was even tested. The "data" from condition Y, and by extension the differences, were, apparently, simply made up.

If this is true, it is, in Altmann's words, "the worst form of academic misconduct." As he says, it's not quite a smoking gun: maybe tapes of Y did exist, but they got lost somehow. However, this seems implausible. If so, Hauser would presumably have told Harvard so in his defence. Yet they found him guilty - and Hauser retracted the paper.

So it seems that either Hauser never tested the monkeys on condition B at all, and just made up the data, or he did test them, saw that they weren't behaving the "right" way, deleted the videos... and just made up the data. Either way it's fraud.

Was this a one-off? The Cognition paper is the only one that's been retracted. But another 2007 paper was "replicated", with Hauser & a colleague recently writing:

In the original [2007] study by Hauser et al., we reported videotaped experiments on action perception with free ranging rhesus macaques living on the island of Cayo Santiago, Puerto Rico. It has been discovered that the video records and field notes collected by the researcher who performed the experiments (D. Glynn) are incomplete for two of the conditions.

Luckily, Hauser said, when he and a colleague went back to Puerto Rico and repeated the experiment, they found "the exact same pattern of results" as originally reported. Phew.

This note, however, was sent to the journal in July, several weeks before the scandal broke - back when Hauser's reputation was intact. Was this an attempt by Hauser to pin the blame on someone else - David Glynn, who worked as a research assistant in Hauser's lab for three years, and has since left academia?

As I wrote in my previous post:

Glynn was not an author on the only paper which has actually been retracted [the Cognition 2002 paper that Altmann refers to]... according to his resume, he didn't arrive in Hauser's lab until 2005.

Glynn cannot possibly have been involved in the retracted 2002 paper. And Harvard's investigation concluded that Hauser was "solely responsible", remember. So we're to believe that Hauser, guilty of misconduct, was himself an innocent victim of some entirely unrelated mischief in 2007 - but that it was all OK in the end, because when Hauser checked the data, it was fine.

Maybe that's what happened. I am not convinced.

Personally, if I were David Glynn, I would want to clear my name. He's left science, but still, a letter to a peer reviewed journal accuses him of having produced "incomplete video records and field notes", which is not a nice thing to say about someone.

Hmm. On August 19th, the Chronicle of Higher Education ran an article about the case, based on a leaked Harvard document. They say that "A copy of the document was provided to The Chronicle by a former research assistant in the lab who has since left psychology."

Hmm. Who could blame them for leaking it? It's worth remembering that it was a research assistant in Hauser's lab who originally blew the whistle on the whole deal, according to the Chronicle.

Apparently, what originally rang alarm bells was that Hauser appeared to be reporting monkey behaviours which had never happened, according to the video evidence. So at least in that case, there were videos, and it was the inconsistency between Hauser's data and the videos that drew attention. This is what makes me suspect that maybe there were videos and field notes in every case, and the "inconvenient" ones were deleted to try to hide the smoking gun. But that's just speculation.

What's clear is that science owes the whistle-blowing research assistant, whoever it is, a huge debt.