Out of Mind

When I was a medical student in the mid-1990s, many of the newer generation antipsychotics used to treat schizophrenia, such as risperidone and olanzapine, were just coming on the market. My psychiatry rotation was at the famed Bellevue Hospital in New York, and half of the unit to which I was assigned was filled with patients in clinical trials of many of those drugs. In many cases, these were double-blinded, placebo controlled trials, but that was a bit of a feint. As we made rounds, we could nearly always tell which patients were taking the new medications. It wasn't whether or not they were still psychotic. They were the ones who were stiff or drooling.

In a nutshell, that's the frustrating story of schizophrenia treatment, an effort, until recently, largely directed at blocking dopamine 2(D2) receptors. Even the most successful of drugs turn out to have side...

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