Happy Birthday Prozac

Prozac is twenty and The Observer celebrates with an article noting 20 things you may not know about the drug that was supposed to make us ‘better than well’.

Prozac is the brand name for the drug fluoxetine and was so successful that it has become a by-word for antidepressants and psychiatric drug treatment.

Its popularity was partly due to it being a safer alternative to the older tricyclic antidepressants, such as amitriptyline, and the addictive benzodiazepine drugs used to treat anxiety, such as Vallium.

Also, it came at a time when depression was becoming destigmatised and more widely recognised. Helped in no small part, of course, by Eli Lilly heavily funding a number ‘public education’ campaigns and depression support groups.

During the 1990s Prozac was truly considered a wonder drug.

Psychiatrist Peter Kramer’s 1994 book Listening to Prozac (ISBN 0140266712) had case studies of people who’s marriages were saved, porn addiction was cured (!) and generally became better, more thoughtful people after taking the drug.

Notably, several of the case studies were not people who were clinically depressed. Kramer wondered whether we would take such drugs to improve on normality rather than to treat pathology, and coined the term ‘cosmetic pharmacology’ for the former.

As the 90s drew to a close, clouds started to form and the sunshine started to fade.

The storm broke in 1998 as court cases focused on the negative effects of Prozac and related drugs and an influential paper was published suggesting the drug wasn’t as effective as it was thought.

Drug company Smithkline was sued by the family of a man who killed himself and his family after taking the related drug paroxetine, also known as Paxil or Seroxat.

The court case involve psychiatrist Dr David Healy who had been investigating the possible role of Prozac in stirring up suicidal thoughts in some depressed patients.

Healy discovered that Eli Lilly had obscured the adverse effects of Prozac from their pre-release drug trials and was subsequently subjected to a dirty tricks campaign by the company.

This became a legal case in itself and he eventually settled for what are thought to be significant out-of-court damages.

Furthermore, an influential paper published by Irving Kirsh and Guy Sapirstein (wittily titled ‘Listening to Prozac but hearing placebo’), analysed a series of antidepressant drug trials and reported that only 25% of the improvement in the patients was due to the drug, the rest, the data suggested, was placebo effect.

Researchers started to challenge the virtually evidence free message that ‘low serotonin causes depression’ on which the marketing campaigns for SSRI drugs relied.

More recently, worries have emerged about Prozac and related drugs increasing suicidal thoughts in some children (again with allegations about drug companies burying negative findings), with antidepressants now carrying a warning on the box to alert doctors and clinicians.

The pendulum has swung back a little since then, with recent studies indicating that while some children will have an increase in suicidal thinking, they are a small minority and, generally, the benefits outweigh the risks in most children.

Current evidence suggests that Prozac is an effective treatment for depression, although it’s not without side-effects and, on balance, is about as effective as most other antidepressants.

Prozac is a useful treatment for depression and anxiety, but is no longer the ‘wonder drug’ it once was – and we’re probably all better off for having a more balanced view.

The Observer article is a guide to the drug and its wide-ranging impact on society, covering everything from its neurochenical effects to its influence on the music scene.

Link to Observer article ‘Eternal sunshine’ (via Furious Seasons).

Staying awake record attempt live on the web

Tony Wright is aiming to beat the world record for staying awake, and you can watch him on a webcam. The record is currently held by Randy Gardner who managed 11 days without sleep.

A previous record was famously claimed by Radio DJ Peter Tripp who stayed awake for 8 days, but used methylphenidate (Ritalin) to help him fight off sleep.

Methylphenidate is a form of amphetamine and it’s known to increase the risk of psychosis in some people. Sleep deprivation is also linked to psychosis.

Needless to say, Tripp was quite psychotic by the end of his ‘wakeathon’ with hallucinations and paranoid delusions.

As it wasn’t widely known that Tripp had taken stimulants, it was assumed that sleep deprivation led to madness.

This is why Gardner suggested at the final press conference that he was perfectly fine, announcing that “I wanted to prove that bad things didn’t happen if you went without sleep”.

Contrary to Gardner’s claims, it was obvious that the lack of sleep was causing cognitive difficulties, as well as temporary delusions and hallucinations, although not to the same extent as Tripp suffered.

We know now that sleep deprivation causes significant mood problems, reality distortion and profound cognitive difficulties.

So, if you’re watching the webcam you might see some rather unusual behaviour, as Tony Wright is likely to be experiencing some very odd things as time goes on.

Link to Tony Wright’s record attempt webpage (via MeFi).
Link to live webcam.

Hume on the perversions of John Locke

18th century Scottish philosopher David Hume makes a dig at John Locke in the footnote to one of his most famous books – A Treatise of Human Nature.

Hume wrote that completing the Treatise, at the age of 26, affected his mental health, causing ‘philosophical melancholy and delirium’.

Footnote 1. I here make use of these terms, impression and idea, in a sense different from what is usual, and I hope this liberty will be allowed me. Perhaps I rather restore the word, idea, to its original sense, from which Mr LOCKE had perverted it, in making it stand for all our perceptions.

Link to Wikipedia page on David Hume.
Link to online copy of A Treatise of Human Nature.

How the Mind Works: The video lectures

The Technology, Entertainment, Design conference has strayed from its original focus and now hosts a wide-ranging set of talks, including a number on ‘How the Mind Works‘, all of which are available online as streamed video.

I’m always a bit suspicious of anything in psychology with grand titles like this.

I remember smiling to myself when I started reading Steven Pinker’s (actually very good) book of the same name, where he wrote in the first few pages that the book won’t actually tell you how the mind works, but will just help explain what we’ve worked out already.

I thought it would be better called ‘What I Think About What We Know About How the Mind Works So Far’, but I suspect the publisher’s would have objected.

The joke goes that Daniel Dennett’s equally as grandly titled book ‘Consciousness Explained’ should really be called ‘Consciousness Explained Away’, as he argues that their is no such thing as qualia and no hard problem to solve, two of the main issues thought to be key in consciousness research.

If you want to know more about Dennett’s views on consciousness, you can have a look at his TED lecture.

The other talks are fascinating and diverse. Helen Fisher talks about the psychology and biology of love, Daniel Gilbert talks about happiness and why we are so bad at understanding it, Ray Kurzweil talk about how we’re shortly all to become super evolved drug-enhanced semi-robots.

There’s plenty of other talks as well, so see what catches your interest. None of them will tell you how the mind works, but they’ll tell you some of what we know so far.

Link to videos of TED mind, brain and society talks.

Minds and computers

ABC Radio National’s The Philosopher’s Zone just had an excellent edition on artificial intelligence and whether a computer could ever simulate the mind.

The guest on the show is philosopher Matt Carter, who’s also just written a book on the subject called Minds and Computers (ISBN 0748620990).

For half an hour, the programme is a remarkably comprehensive guide to some of the key issues in the philosophy of artificial intelligence and computational models of mind.

Alan Saunders: Is it an interesting question because we think that perhaps we could develop computers that are like us in some intellectual respect and to whose rights we will perhaps have to give recognition? Or is it because we think that the computational model will tell us something about our own minds?

Matt Carter: It’s an excellent question, and I think the answer is both. There’s a sense in which we really hope to understand our own minds better through this kind of computational understanding, and certainly the computational theory of mind is currently by far the most dominant theory in the philosophy of mind and the culture of sciences broadly. But there are also a number of people working on strong artificial intelligence projects, and the ultimate goal of those projects is to produce man-made artifacts that have minds in precisely the same sense, or some very similar sense, in which we take ourselves to have minds.

Link to Philosopher’s Zone on ‘Minds and Computers’.

Neuropsychoanalysis: Freud and the brain

Bookslut has an in-depth interview with neuropsychologist Dr Mark Solms, one of the pioneers of neuropsychoanalysis, the field that attempts to test, extend and integrate Freudian ideas with modern neuroscience.

Twenty years ago, Freud’s ideas were considered virtually obsolete by mainstream cognitive scientists, but some recent findings have suggested a neurocognitive basis for some key Freudian ideas.

For example, a 2001 paper by Anderson and Green suggested that people can effectively suppress unwanted memories from consciousness and that the executive system (considered a key control function of the frontal lobes) may be responsible.

More recently, a study of brain injured patients who confabulate (produce false or unlikely memories without intending to deceive) have reported that the false memories are more likely to be positive and emotionally uplifting, suggesting a level of wish fulfilment.

In the interview, Solms discusses the future of neuropsychoanalysis, addresses some of the criticisms, and talks about his new translation of Freud’s complete works.

Link to Mark Solms interview.
Link to Wikipedia page on neuropsychoanalysis.

Face contributes most to overall attractiveness

New Scientist has a short report suggesting that the face contributes more to the overall impression of attractiveness than the body.

The research was led by biologist Marianne Peters who asked participants to rate the attractiveness of a number of people, presented as photographs of either the whole person, the face only or the body only.

They found that faces account for more of the variation among ratings than do bodies; in other words, faces are more important. For women rating men, 52 per cent of the attractiveness score was made up by the face rating, while for bodies it was 24 per cent. The trend was similar when men rated women, with 47 per cent of a woman’s overall attractiveness accounted for by her face, and 32 per cent by her body.

Interestingly, the face and body affected the overall attractiveness independently and there was no interaction.

For example, there was no ‘double whammy’ effect for having a face and body that were both rated either high or low on the attractiveness scale.

Link to NewSci report ‘The face, not the body, attracts a mate’.
Link to abstract of scientific paper.

Bioterrorism and the brain

ABC Radio National’s All in the Mind has a compelling discussion about the development and dangers of weapons designed to target the brain and nervous system.

The guests on the programme are Prof Malcom Dando and Dr Mark Wheelis, who have recently written a paper for the International Red Cross entitled ‘Neurobiology: A Case Study of the Imminent Militarization of Biology’ [pdf].

The programme largely focuses on what we known about the secret development of nerve agents, based on the glimpses we see of them in action – for example, during the Moscow theatre siege of 2002, where Russian special forces used an opiate-based ‘knock out gas’ that resulted in the death of 129 hostages.

Interestingly, one of the guests notes that although these sorts of compounds are banned for use in war under international treaties, these regulations can have specific exemptions that allow them to be used in civilian ‘crowd control’ operations.

So while it would be illegal to use some drugs as weapons against soldiers, governments are, in some cases, allowed to use them on their own population.

It’s fascinating and somewhat troubling coverage of a too-rarely discussed topic.

Link to AITM on ‘Bioterrorism and Your Brain’.
Link to full-text of ‘Neurobiology: A case study of the imminent militarization of biology’.

Weird world of the Psychological Atlas

Archive.org has a copy of a 1948 book entitled the Psychological Atlas that is full of weird and wonderful things from the world of 1940s psychology and beyond.

It’s got some serious psychology in there, mixed in with the paranormal, weird and curious stuff, probably reflecting the public understanding of the field at the time.

The Second World War was a critical time for psychology as many influential psychologists (like Gordon Allport and JJ Gibson) were employed to help select recruits and design better functioning equipment.

This helped significantly with psychology being taken seriously as a science, and this slightly post-war volume probably still has some of the hangovers from the pre-war years.

A fascinating read nonetheless.

Link to Psychological Atlas (via BoingBoing).

Brain scan lie detection still truth or dare

The Scientist has an article on the latest developments in the world of fMRI lie detection, looking at how accurate and reliable the technology really is.

This is a particularly hot topic because a commercial company, No Lie MRI, are marketing a brain scan lie detection service.

This is despite the fact that neuroscientists and the legal system are still unconvinced that it is accurate enough to be useful.

Interestingly, the company was partly funded by the US Government, and you can bet that they’ll be trying the system, even with the low accuracy rates, in case it proves useful for the secret services.

Probably the main advantage for most buyers is that is looks intimidating and high-tech.

Like with the polygraph test, many people put through the system will undoubtedly be more truthful because they believe that they will be caught if they lie.

In terms of its ability to catch genuine lies made by an individual, it’s still fairly limited though.

Not least because most brain imaging research is done as group studies. The results are usually based on average brain activity across all participants, rather than on any one individual.

Also, the studies don’t really resemble real-world conditions:

And in the real world, lying is verbal and carried out in defiance of instruction, and the stakes are incomparably higher. Rather than missing out on a $20 study reward, being caught in a lie could mean life in prison. Lying under these circumstances comes with an emotional component that is poorly elicited by a playing card, she argues.

“Applied fMRI studies of the kinds done so far have similar limitations to those of typical laboratory polygraph research,” according to a 2003 National Academy of Sciences report. “Real deception in real life circumstances is almost impossible to explore experimentally. You can’t randomly assign people to go do crimes. I do think that’s an inherent limit,” says Gabrieli, a professor of cognitive neuroscience. Others worry about the level of nuance that fMRI-posed questions can accommodate.

Still, researchers are hoping further studies will help improve the system, until, maybe, it will be the most accurate lie detection system in existence.

Until then, it’s an interesting field, but I wouldn’t bet your life on it.

Link to Scientist article ‘Watching the Brain Lie’.

2007-05-11 Spike activity

Quick links from the past week in mind and brain news:

One I missed a while ago: Developing Intelligence looks at a paper that actually attempts to define consciousness (rather than relying on the usual “we all know what we’re talking about, don’t we?” definition).

The Toronto Globe and Mail reports on research suggesting that doing good deeds improves our health.

Marriages are slightly more likely to end in divorce when the couple have daughters, according to research covered by Slate.

The Globe and Mail investigates the effect of the higher rates of Alzheimer’s disease in people with Down Syndrome.

Amateur boxers have higher levels of neurofilament light in their cerebrospinal fluid after fights, suggesting they suffer some level of brain damage despite the protective head gear.

Study shows greater amygdala activity in response to fearful faces in people who were closer to the 9/11 disaster.

Another study on the psychological benefits of meditation: it may fine-tune control over attention.

The LA Times reports that some US states still happy to execute people with intellectual disabilities.

InQuisitive Mind, a new online social psychology magazine has been launched.

The art of non-verbal attraction

PsyBlog has just published a couple of short articles on non-verbal communication, one examining a common myth, and the other looking at how it indicates attraction between people who’ve just met.

The first article is on the research that debunks the myth that ‘93% of communication is nonverbal’.

Just the precision of those sorts of statements make me suspicious. To quote the wise words of comedian Vic Reeves “88.2% of statistics are made up on the spot”.

The second article examines a study that looked at the dynamic patterns of non-verbal communication when men and women met for the first time, and looked at how these patterns were related to attraction.

Contrary to many previous findings, attraction was predicted by patterns of synchronisation and not simple mirroring of body language. What emerged were rhythmic structures of movement synchrony – patterns of bodily movement people adopted. In common with previous research, Grammer et al. (1998) found it was women who tended to start and control these patterns. Indeed, the more interested a woman was in a man, the more complicated these patterns became.

There’s more on this impressive study in the PsyBlog article.

Link to article on myth of non-verbal communication.
Link to article ‘The Nonverbal Symphony of Attraction’.

Treating children, pushing drugs

The New York Times has another investigative article on the pharmaceutical industry, this time looking at how promotions aimed at psychiatrists encourage the prescription of antipsychotic drugs to children.

As far as I know, none of the newer ‘atypical’ antipsychotics are licensed for children (actually, I’d be interested to hear otherwise).

This doesn’t mean doctors can’t prescribe them, as they have the freedom to prescribe ‘off-label’ whatever they feel would help the individual, but it does mean that the drug companies can’t advertise them for this purpose.

‘Off-label’ drug promotion is illegal, but it is an open secret that it occurs widely.

Notably, the number of children prescribed atypical antipsychotics has soared in recent years, and in the only US state that keeps records of drug company promotional spending, promotional money seems to be a key factor:

From 2000 to 2005, drug maker payments to Minnesota psychiatrists rose more than sixfold, to $1.6 million. During those same years, prescriptions of antipsychotics for children in Minnesota’s Medicaid program rose more than ninefold.

Those who took the most money from makers of atypicals tended to prescribe the drugs to children the most often, the data suggest. On average, Minnesota psychiatrists who received at least $5,000 from atypical makers from 2000 to 2005 appear to have written three times as many atypical prescriptions for children as psychiatrists who received less or no money.

It seems that these drugs are increasingly being prescribed for a whole range of different disorders in children, despite limited evidence for their effectiveness in some conditions and a shocking lack of studies on the long-term effects.

The fact is, psychiatric drugs have an important and useful part to play in treating mental illness, sometimes even in children.

Unfortunately, this sort of underhand marketing and out-of-control prescribing puts some parents off when their children would genuinely benefit, and unnecessarily gives powerful and potentially dangerous drugs to some children when they could be helped in other ways.

The answer? Stick to the science when prescribing – just say no to drug promotion.

Link to article ‘Psychiatrists, Children and Drug Industry‚Äôs Role’

It’s not a quirk, it’s a feature

Prof Richard Wiseman tackles some of the quirkier findings in the psychological literature in a New Scientist article which has been made freely available online.

The article accompanies the launch of Wiseman’s new book, Quirkology, which apparently looks at these sorts of curious research studies in more detail.

He’s also created a very impressive inattentional blindness demonstration video on YouTube. Simple but very cool.

Presumably the gorilla in the background is a nod to Daniel Simons and Chris Chabris’ classic study of the effect, published, rather brilliantly, under the name ‘Gorillas in Our Midst’ [pdf].

It’s the only psychology experiment I’ve ever come across that used a man in a gorilla suit. Unsurprisingly, it won an IgNobel prize, but is actually a valuable contribution to our understanding of the mind.

Link to NewSci article ‘A quirky look at our quirky species’.
Link to cool inattentional blindness demo.

Five minutes with Petra Boynton

Dr Petra Boynton is a social psychologist, researcher, author, broadcaster, blogger, and award winning sex educator.

She’s an advocate for evidence-based sex education, amid the largely sensationalist media coverage of the subject, and a tireless campaigner for sexual equality, having worked to improve media sex coverage both in the UK and internationally.

As well as conducting extensive research into sexual attitudes and behaviours, she also promotes the public understanding of social and health science research through her teaching, writing and broadcasting.

Petra has kindly agreed to talk to Mind Hacks about her work, motivations and current interests in the world of sex research.

Continue reading “Five minutes with Petra Boynton”