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Brain-Disabling Treatments in Psychiatry
Drugs, Electroshock, and the
Psychopharmaceutical Complex
Second Edition, 2008
Peter R. Breggin, MD
Contents
0 Preliminary
1 The Brain-Disabling, Spellbinding Effects of Psychiatric Drugs
2 Deactivation Syndrome (Chemical Lobotomy) Caused by Neuroleptics
3 Neuroleptic-Induced Anguish, Including Agitation, Despair, and Depression
4 Severe and Potentially Irreversible Neurological Syndromes (Tardive Dyskinesia and Neuroleptic Malignant Syndrome) Caused by Neuroleptics
5 Neuroleptic-Induced Neurotoxicity, Brain Damage, Persistent Cognitive Deficits, Dementia, and Psychosis
6 Recent Developments in Antidepressant Label Changes
7 Antidepressant-Induced Mental, Behavioral, and Cerebral Abnormalities
8 Lithium and Other Drugs for Bipolar Disorder
9 Electroconvulsive Therapy (ECT) for Depression
10 From Attention-Deficit / Hyperactivity Disorder (ADHD) to Bipolar Disorder: Diagnosing America's Children
11 Stimulant-Induced Brain Damage, Brain Dysfunction, and Psychiatric Adverse Reactions
12 Antianxiety Drugs, Including Behavioral Abnormalities Caused by Xanax and Halcion
13 The Food and Drug Administration (FDA) and the National Institute of Mental Health (NIMH): Drug Company Advocates
14 Drug Company Deceptions
15 How to More Safely Stop Taking Psychiatric Drugs
16 Failed Promises, Last Resorts, and Psychotherapy
17 Appendix
Detailed Contents
0 Preliminary
0.1 Front Page
0.1.1 Back Page
0.2 Beginning Items
0.2.1 About the Author
0.2.2 Library of Congress Cataloging-in-Publication Data
0.2.3 Warning
0.2.4 For Ginger Breggin
0.2.5 Professional Books by Peter R. Breggin, MD
0.3 Preface: A Word About Words
0.4 Acknowledgments
0.5 Introduction
0.5.1 Confirming the Science Behind the First Edition
0.5.2 A Thorough Update of the Science
0.5.3 Growing Confirmation of the Previous Edition
0.5.4 Confirming the Longer View Starting in 1983
0.5.5 The Situation in Psychiatry Worsens
1 The Brain-Disabling, Spellbinding Effects of Psychiatric Drugs
1.1 The Basic Four Brain-Disabling Principles
1.2 Illustrative Research Confirming the Basic Four Brain-Disabling Principles
1.3 Six Additional Brain-Disabling Principles
1.4 The Biological Basis of Medication Spellbinding
1.5 Psychological Influences on Medication Spellbinding
1.6 Iatrogenic Helplessness and Denial in Authoritarian Psychiatry
1.7 Relationship Between Medication Spellbinding and Iatrogenic Helplessness and Denial
1.8 Mental and Emotional Suffering Routinely Treated with Biopsychiatric Interventions Have No Known Genetic or Biological Causes
1.9 Conclusion
2 Deactivation Syndrome (Chemical Lobotomy) Caused by Neuroleptics
2.1 The Myth that Atypical Antipsychotic Drugs Are Weaker D2 Blockers
2.2 Examples of Differences Among Atypical Neuroleptics
2.2.1 Clozapine (Clozaril)
2.2.2 Risperidone (Risperdal)
2.3 Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE)
2.4 Deactivation Syndrome
2.5 Deactivation and Medication Spellbinding
2.5.1 The Anatomy of Deactivation
2.5.2 Lobotomy-Like Neuroleptic Effects
2.5.3 Atypical Neuroleptics
2.6 Social Control with Antipsychotic Drugs
2.6.1 Suppression of Nursing Home Inmates
2.6.2 Deactivating People and Animals in Varied Settings
2.7 The Unique Function of the Brain
3 Neuroleptic-Induced Anguish, Including Agitation, Despair, and Depression
3.1 Resistance to Treatment
3.2 Acute Dystonic Reactions
3.3 Despair in Neuroleptic-Induced Parkinsonism
3.3.1 Parkinsonism as an Aspect of Brain-Disabling Therapy
3.4 Anguish in Akathisia
3.5 Neuroleptic-Induced Depression and Suicidality
3.6 Risks Associated with Atypical Antipsychotic Drugs
3.7 The Issue of Coercion
4 Severe and Potentially Irreversible Neurological Syndromes (Tardive Dyskinesia and Neuroleptic Malignant Syndrome) Caused by Neuroleptics
4.1 Tardive Dyskinesia (TD)
4.1.1 Clinical Manifestations of TD
4.1.2 TD Rates
4.1.3 Atypical Neuroleptics Cause TD in Adults
4.1.4 Atypical Neuroleptics Cause TD in Children
4.1.5 History of TD
4.1.6 Masking the Symptoms of TD with Continued Neuroleptic Treatment
4.1.7 Extrapyrarnidal Symptoms as Predictors of Future TD
4.1.8 The Elderly and Other Vulnerable Populations
4.1.9 Relapse, Exacerbation, and Delayed Onset After Termination
4.1.10 Reversibility is Rare
4.1.11 Physician and Patient Denial of TD
4.1.12 The Size of the Epidemic
4.2 Tardive Dystonia
4.3 Tardive Akathisia
4.4 Complications of Tardive Disorders
4.4.1 Physical Exhaustion
4.4.2 Psychological Suffering
4.5 Neuroleptic Withdrawal Symptoms
4.5.1 Are Neuroleptics Addictive?
4.6 Other Adverse Reactions
4.7 Neuroleptic Malignant Syndrome
4.8 Biological Basis of Neuroleptic-Induced Neurological Syndromes
4.9 Children and Neuroleptics
4.9.1 Treating Childhood Tourette's with Neuroleptics
4.9.2 The Food and Drug Administration Opens the TD and NMS Floodgates for Children
4.10 Hurrying Death
4.11 Conclusion
5 Neuroleptic-Induced Neurotoxicity, Brain Damage, Persistent Cognitive Deficits, Dementia, and Psychosis
5.1 Demonstrating Neuroleptic-Induced Brain Damage And Cell Death
5.1.1 PET Scans
5.1.2 MRI
5.2 CT Scans and Neuropsychological Correlations
5.2.1 Correlating Tardive Dyskinesias (TD) with Brain Damage and Dementia
5.2.2 Summary of Brain Study Data
5.3 Rates of Tardive Dementia Based on Brain Scans
5.4 Clinical Evidence
5.4.1 Early Correlations Between TD and Cognitive Dysfunction
5.4.2 Tardive Dysmentia and Tardive Dementia
5.4.3 A Serendipitous Finding of Neuroleptic-Induced Generalized Cognitive Dysfunction
5.4.4 Neuroleptic-Induced Mental and Behavioral Deterioration in Children
5.4.5 Denial of Symptoms in TD Patients as a Symptom of Cognitive Dysfunction
5.4.6 Permanent Lobotomy or Deactivation
5.4.7 Tardive Psychosis in Neuroleptic-Treated Patients
5.4.8 Psychiatry Avoids Facing Tardive Psychosis
5.4.9 Tardive Akathisia and Cognitive Deficits
5.5 Human and Animal Autopsy Studies
5.5.1 Animal Autopsy Studies of Brain Damage Induced by Neuroleptic
5.5.2 Human Autopsy Evidence for Neuroleptic-Induced Brain Damage
5.6 Lessons of Lethargic Encephalitis
5.7 Can Schizophrenia Cause Dementia?
5.8 Psychiatric Denial of Neuroleptic-Induced Dementia
5.9 Drugs to Treat Acute Extrapyramidal Side Effects
5.10 Withdrawal Problems and Informed Consent
5.11 Conclusion
6 Recent Developments in Antidepressant Label Changes
6.1 Warning Signs From the Beginning
6.2 The Class of SSRIs
6.3 FDA Finds Increased Suicidality in Children Exposed to Antidepressants
6.4 Easy to Show Serious Adverse Effects; Difficult to Show Efficacy
6.5 Recent FDA Admissions and Warnings
6.5.1 The Final Class Label on Suicidality in Children and Adolescents
6.5.2 The Stimulant Syndrome
6.5.3 The New FDA Medication Guide
6.5.4 The FDA's Final Word on Antidepressant-Induced Suicidality in Children
6.5.5 No Completed Suicides in the Clinical Trials
6.5.6 Canadian and British Regulatory Wamings
6.5.7 Expanding the Suicide Waming to Young Adults
6.5.8 The FDA Helps Out the Drug Companies
6.5.9 Paxil Is the Most Dangerous for Adults
6.5.10 The Real-Life Risk Is Much Greater Than Described
6.6 The Psychopharmaceutical Complex Responds
6.6.1 The American College of Neuropsychopharmacology
6.6.2 The American Psychiatric Association
6.7 Antidepressants Lack Efficacy in Children
6.7.1 So-Called Alternative Treatments
6.8 Conclusion
7 Antidepressant-Induced Mental, Behavioral, and Cerebral Abnormalities
7.1 The Risk of Agitated Depression
7.2 Similarity of Adverse Drug Reaction Patterns Among SSRIs
7.3 Studies Related to SSRI-Induced Depression and Suicidality in Adults
7.3.1 Epidemiological Studies and Clinical Trials of SSRI-Induced Depression and Suicidality in Adults
7.3.2 Coroner Studies of Adult Suicidality
7.3.3 NIMH Confirms that SSRIs Cause Suicidality
7.3.4 Case Reports of Mania, Violence, and Suicide in Adults
7.3.5 Case Reports of SSRI-Induced Akathisia, Suicidality, and Aggression in Adults
7.3.6 Case Reports of SSRI-Induced Obsessive , Suicidality and Aggression in Adults
7.3.7 SSRI-Induced Apathy Syndrome in Adults
7.4 Identifying Antidepressant-Induced
Compulsive Violence and Suicidality in Adults and Children
7.5 Epidemiological Studies and Clinical Trials of SSRI-Induced Mania and Aggression in Adults
7.5.1 Studies of Antidepressant-Induced Aggression in Adults
7.5.2 Antidepressant-Induced Mania in Nonbipolar Adult Patients
7.5.3 Manic Conversion (Switching) In Adult Bipolar Patients
7.6 Comparing Antidepressant-Induced
Mania and Spontaneous Mania
7.7 Antidepressant-Induced Mania Described in Two Standard Sources
7.7.1 The Diagnostic and Statistical Manual of Mental Disorders
7.7.2 Practice Guidelines for Major Depressive Disorder in Adults
7.8 Studies Related to SSRI-Induced Abnormal Behavior in Children
7.8.1 Clinical Case Studies Involving Children
7.8.2 Epidemiological Studies and Clinical Trials Involving Children
7.8.3 Antidepressant-Induced Apathy in Children
7.9 Do Antidepressants Work At All?
7.10 The Elderly
7.11 Professional Reactions
7.12 Underlying Antidepressant-Induced Brain Damage and Dysfunction
7.12.1 Permanent Neurological Adverse Effects
7.12.2 The Brain Resists the Impact of SSRIs
7.12.3 Causing Brain Dysfunction and Shrinkage
7.13 Older Antidepressants
7.13.1 Tricyclic Antidepressants and the Brain-Disabling Principie
7.13.2 Tricyclics: More Cause Than Cure for Suicidality?
7.13.3 Other Antidepressants
7.14 Antidepressant Withdrawal Reactions, Including Mania
7.15 My Clinical and Forensic Experience
7.16 Discussion: "The Drug Made Me Do It"
7.17 What Do the Specialists Know?
7.18 Conclusion
8 Lithium and Other Drugs for Bipolar Disorder
8.1 Claims of Lithium Specificity for Mania
8.2 Brain-Disabling Effects on Animals, Infants, Patients, and Volunteers
8.2.1 Subduing Effects on Animals
8.2.2 Subduing Effects on Normal Infants
8.2.3 Disabling Effects on Normal Volunteers
8.2.4 Turning Down the Dial of Life
8.2.5 Crushing Creativity
8.2.6 Cade Supports the Brain-Disabling Hypothesis
8.3 Spellbinding and Iatrogenic Helplessness and Denial
8.4 Toxicity to the Central Nervous System
8.4.1 The Production of Cognitive Deficits
8.4.2 Acute Organic Brain Syndromes
8.4.3 SILENT: Irreversible Lithium-Induced Neurotoxicity
8.5 Neurotoxic Effects in Low-Dosage
Maintenance Therapy
8.5.1 Abnormal Brain Waves Produced Routine Lithium Therapy
8.5.2 Lithium Disruption of the Compromised
Brain
8.6 Brain Damage As Treatment
8.6.1 General Toxicity to Neurons and Other Cells
8.6.2 The "Protective" and Therapeutic Effects of Poisoning Brain Cells
8.7 The Relative Ineffectiveness of Lithium in Acute Mania
8.8 How Effective Is Lithium in Preventing the Recurrence of Manic Episodes?
8.9 Mania and Depression As Lithium
Withdrawal Reactions
8.10 Other Adverse Reactions to Lithium Withdrawal
8.11 Lithium in Your Drinking Water
8.12 Other So-Called Mood Stabilizers
8.13 Why So Many "Bipolar" Patients?
8.14 Conclusion
9 Electroconvulsive Therapy (ECT) for Depression
9.1 A Life Destroyed By ECT
9.2 Breaking News in ECT Research:
Shock Treatment Causes Irreversible Brain Damage and Dysfunction
9.3 Still Avoiding the Facts
9.4 More Breaking News in ECT Research: Shock Treatment Causes Suicide
9.5 Additional Breaking News: ECT Is Ineffective
9.6 Another Dramatic Event in the World of Shock Treatment
9.7 The Food and Drug Administration and ECT
9.8 The Politics of the 1990 American Psychiatric Association Report
9.9 ECT, Women, and Memory Loss
9.10 ECT and the Elderly
9.11 Brain Injury By Electroshock
9.11.1 The Production of Delirium (Acute Organic Brain Syndrome)
9.11.2 ECT As Closed-Head Electrical Injury
9.11.3 Death, Suicide, and Autopsy Findings
9.11.4 Memory Deficits
9.12 Studies of Brain Damage From ECT
9.12.1 Brain Scans
9.13 Modified ECT
9.13.1 The Brain-Disabling Principle
9.13.2 Iatrogenic Helplessness and Denial, and Spellbinding
9.14 A Long Controversy Surrounding ECT
9.15 The Need to Ban ECT
9.16 Conclusion
10 From Attention-Deficit / Hyperactivity Disorder (ADHD) to Bipolar Disorder: Diagnosing America's Children
10.1 The ADHD/Stimulant Market
10.1.1 Shifting Patterns of Use in the United States
10.1.2 The Worldwide Market
10.2 The ADHD Diagnosis
10.3 Diagnosing Bipolar Disorder in Children
10.3.1 How Doctors Learn to Diagnose and Medicate So-Called Bipolar Children
10.3.2 Developing Guidelines for Medicating Children
10.3.3 Public Backlash
10.3.4 Growing Concerns About Adverse Effects
10.4 Ramifications of the ADHD Diagnosis
10.4.1 Destructive Behavior Disorders
10.4.2 Add Criteria
10.4.3 Russell Barkley: Rationalizing Oppressive Control
10.4.4 A Disease that Goes Away with Attention
10.4.5 ADD and TADD
10.5 Critiques of ADHD
10.5.1 Comorbidity and Misguided Diagnoses
10.5.2 The Supposed Physical Basis for ADHD
10.5.3 ADHD: An American Disease? A Boy's Disease
10.6 CHADD: A Drug Company Advocate
10.6.1 The Power Base of the Parent Groups
10.6.2 On-The-Spot Diagnosis
10.7 Mental Health Screening in Schools: The Latest Threat
10.8 Moral, Psychological, and Social
Harm
10.8.1 Like Shining Stars
11 Stimulant-Induced Brain Damage, Brain Dysfunction, and Psychiatric Adverse Reactions
11.1 An Ineffective Treatment
11.2 A Wide Variety of Adverse Effects
11.3 More Extreme Intoxication Reactions
11.4 Atomoxetine (Strattera)
11.4.1 Strattera-Induced Suicidality
11.5 The Food and Drug Administration Continues to Minimize the Risks of Stimulants
11.6 Once Again, Too Little, Too Late
11.7 A Triumph for the American Psychiatric Association
11.8 Stimulant Dependence
11.9 Concern At the Drug Enforcement Administration
11.10 Nadine Lambert Studies
11.11 The Brain-Disabling, Spellbinding Effects of Stimulants
11.12 Brain Damage and Dysfunction Caused By Stimulants
11.12.1 Brain Atrophy Caused By Methylphenidate
11.12.2 Gross Brain Dysfunction Caused By Methylphenidate and Amphetamine
11.12.3 Abnormalities of Brain Chemistry and Microscopic Pathology Caused By Stimulants
11.12.3.1 Methamphetamine
11.12.3.2 Amphetamine
11.12.3.3 Methylphenidate
11.13 The Latest Ominous News About Ritalin
11.14 Developmental Neurotoxicity
11.15 Growth Suppression Caused By
Stimulants
11.16 Conclusion
12 Antianxiety Drugs, Including Behavioral Abnormalities Caused by Xanax and Halcion
12.1 Frontier Research in Anesthesiology Confirms the Brain-Disabling Principle
12.2 The Drugs
12.3 Brain Disability As the Primary Clinical Effect
12.4 Mechanisms for Producing Behavioral Abnormalities
12.5 Adverse Reactions to Benzodiazepines (BZs)
12.5.1 The Production of Mania and Rage
12.5.2 The Production of Depression and Suicide
12.5.3 Cognitive, Emotional, and Behavioral Abnormalities Caused By Halcion and Xanax
12.5.4 Evidence From the Food and Drug Administration's Spontaneous Reporting System
12.6 American and British Responses Diverge
12.7 Other Risks in Bz Use
12.7.1 BZs As Instruments of Suicide
12.7.2 Effects On Sleep and the Electroencephalogram
12.8 The Diagnostic and Statistical Manual of Mental Disorders Confirms Bz-Induced Persistent Amnesia and Dementia
12.8.1 Research Indicating Persistent Impairment and Dementia From BZs
12.9 Other Medications for Sleep
12.10 Dependence and Withdrawal
12.11 Conclusion
13 The Food and Drug Administration (FDA) and the National Institute of Mental Health (NIMH): Drug Company Advocates
13.1 Gaining Approval to Market the Drug
13.2 Demonstrating Efficacy Before the Drug Is Marketed
13.3 Creating the Label for the Drug
13.4 Monitoring After Drug Approval
13.5 Continuing Drug Company Responsibilities
13.6 Testing Safety Before the Drug Is Marketed
13.7 More Subtle Difficulties in Evaluating Clinical Trial Data
13.8 Other Neglected Areas in the FDA Approval Process
13.9 The Profit Motive
13.10 Monitoring Safety After the Drug Is Marketed
13.10.1 The Impact of Medwatch (The Spontaneous Reporting System)
13.10.2 Drawing Scientific Conclusions From the Medwatch Srs
13.11 Four Approval System Failures
13.11.1 Failure to Recognize Neuroleptic Malignant Syndrome
13.11.2 The FDA Caves in to Industry on Tardive Dyskinesia
13.11.3 Massaged Data: The Prozac Approval Process
13.11.4 Failing Behind European Standards: Zoloft
13.12 NIMH
14 Drug Company Deceptions
14.1 Relying on Junk Science
14.2 Eli Lilly and Prozac
14.2.1 Eli Lilly Knew From the Start that Prozac Acts Like A Stimulant
14.2.2 Eli Lilly Successfully Bamboozles the Legal System
14.2.3 Eli Lilly Acknowledges to the Food and Drug Administration (FDA) That Prozac Frequently Causes Depression
14.2.4 Eli Lilly Hides the Implications of Prozac-Induced Mania
14.2.5 Eli Lilly Confirms and Hides Prozac Overstimulation
14.2.6 Hiding the Risk of Prozac-Induced Mania and Aggression in Children
14.2.7 Eli Lilly and the FDA Ignore Reports of Aggressive Behavior on Prozac
14.2.8 Eli Lilly and the FDA Ignore Reports of Suicidal Behavior on Prozac
14.2.9 Eli Lilly Hides Increased Suicidality on
Prozac in Controlled Clinical Trials
14.2.10 Eli Lilly Employees Express Shame
14.2.11 Adverse Reactions to Prozac in Eli Lilly's Earliest Research
14.2.12 Prozac-Induced Aggression in Eli Lilly's Earliest Animal Studies
14.2.13 British and German Regulatory Authorities Inquire About Prozac-Induced Stimulation, Agitation, and Depression
14.3 Eli Lilly Hides Akathisia
14.4 Lilly Covers Up Prozac Withdrawal Reactions
14.5 Similar Drug Approval Problems with Zoloft and Paxil
14.6 Prozac Interaction with Monoamine Oxidase Inhibitors and Tryptophan
14.7 Prozac in Combination with Tricycuc Antidepressants
14.8 Eli Lilly Mired in Controversies with Life-Threatening Implications
14.9 Lilly Fights to Hide Data on Deadly Adverse Drug Effects
14.10 Glaxosmithkline (GSK) and Paxil
14.10.1 Paxil Overstimulation
14.10.2 The Lacuzong Case
14.11 Paxil and GSK Criticized By Medical Journals and Foreign Drug Regulatory Agencies
14.12 The Attorney General of New York State Takes Action Against GSK and Paxil
14.13 Britain Takes Action
14.14 British Psychiatry Versus American Psychiatry
14.15 Better Than Nothing?
14.16 A Final Word on Spellbinding
15 How to More Safely Stop Taking Psychiatric Drugs
15.1 Basic Principles
15.2 Special Problems
15.3 Avoiding Life-Threatening Risks
15.3.1 Physical Risks During Withdrawal
15.4 Withdrawal Symptoms Associated with Specific Drugs
15.4.1 Withdrawal From SSRIs
15.4.2 Withdrawal From Tricyclics
15.4.3 Withdrawal From Lithium and Other Mood Stabilizers
15.4.4 Withdrawal From Neuroleptics
15.4.5 Withdrawal From Stimulants
15.4.6 Withdrawal From Benzodiazepines
15.5 Psychotherapy During Drug Withdrawal
15.6 Facing the Aftermath of Medication Spellbinding
15.7 Celebrating A New Life
15.8 The Therapist's Healing Presence
16 Failed Promises, Last Resorts, and Psychotherapy
16.1 Actually Talk to Them?
16.2 An Extensive Literature
16.3 Psychiatric Drugs As A Last Resort
16.4 The Surgeon, The Computer Specialist, and The Psychiatrist
16.5 The Moral Foundation of Genuine Psychotherapy
16.5.1 My Clinical Practice of Psychiatry and Psychotherapy
16.6 The Function of Suffering
16.7 Drug-Free Therapy
16.8 20 Guidelines for Treating Deeply Disturbed Persons
16.8.1 Welcome the person as you would a new friend
16.8.2 Dare to be caring
16.8.3 Create and maintain a safe and comfortable relationship
16.8.4 Create an ideal of the highest ethical and personal standards
16.8.5 Do not ignore or enable obnoxious or threatening behavior
16.8.6 Notice odd behavior and ask what it is about
16.8.7 Get to know the person as a fully developed human being
16.8.8 Help your patients learn their own life story
16.8.9 Be optimistic
16.8.10 Be confident
16.8.11 Be willing to improve your own attitudes
16.8.12 Avoid using artificial therapeutic techniques
16.8.13 Refuse to start patients on medication
16.8.14 Refuse to take any kind of threatening, bullying, or coercive actions
16.8.15 Welcome your patients' most painful feelings
16.8.16 Share your most important values with your patients
16.8.17 Make clear your last resort
16.8.18 Address psychological or learned helplessness early in the therapy
16.8.19 Be willing to offer practical advice and guidance
16.8.20 Graciously recognize that you have no
monopoly on helping people
16.9 Conclusion
17 Appendix
17.1 Psychiatric Medications by Category
17.1.1 Antidepressants
17.1.1.1 Selective Serotonin Reuptake Inhibitors (SSRIs)
17.1.1.2 Other Newer Antidepressants
17.1.1.3 Older Antidepressants (Partial List)
17.1.2 Stimulants
17.1.2.1 Classic Stimulants
17.1.2.2 Others
17.1.3 Sedative, Hypnotic, and Anxiolytic Drugs (Tranquilizers and Sleeping Pills)
17.1.3.1 Benzo Tranquilizers
17.1.3.2 Benzo Sleeping Pills
17.1.3.3 Non-Benzo Sleeping Pills
17.1.3.4 Barbiturate Sleeping Pills
17.1.4 Antipsychotic Drugs (Neuroleptics)
17.1.4.1 Newer (Second- or Third-Generation or Atypical) Antipsychotics
17.1.4.2 Older Antipsychotic Drugs
17.1.4.3 Neuroleptics Used for Other Medical Purposes
17.1.5 Lithium and Other Drugs Used as Mood Stabilizers
17.1.5.1 Off-Label or Unapproved Mood Stabilizers
17.2 Author's Note about the Bibliography