A review of 'Great and Desperate Cures' by Elliot Valenstein, which examines the history of lobotomy and psychosurgery, explaining how tens of thousands of patients underwent dangerous brain operations from the 1930s-1950s despite poor evidence of effectiveness. Longer summary

The post reviews 'Great and Desperate Cures' (1986) by psychologist Elliot Valenstein, exploring how lobotomy became widespread despite its horrific consequences. The review details the procedure itself (inserting an ice-pick-like instrument through the eye socket into the brain), then examines six factors Valenstein identifies for its acceptance: desperate patients and families, physician ambition (especially Egas Moniz and Walter Freeman), uncritical acceptance by researchers and media, territorial disputes between medical specialties, and cold economics. The post includes extensive details about key figures, particularly Freeman's aggressive promotion of transorbital lobotomy and his traveling surgery roadshows. It discusses patient outcomes, the lack of theoretical justification, media hype, and the procedure's eventual replacement by psychoactive drugs. The review concludes by reflecting on modern parallels and the tragic story of Howard Dully, lobotomized at age twelve, arguing that while Freeman likely had good intentions, the safeguards that might have prevented such harm were inadequate then and remain concerning today. Shorter summary

A review of 'The Family That Couldn't Sleep' by D. T. Max, discussing its exploration of prion diseases and their impact, with updated perspectives on the book's conclusions. Longer summary

This review discusses 'The Family That Couldn't Sleep' by D. T. Max, a book about prion diseases published in 2006. The review covers the book's exploration of various prion diseases, including fatal familial insomnia, kuru, mad cow disease, and chronic wasting disease. It highlights the book's focus on the historical, scientific, and cultural aspects of these diseases, as well as the key figures involved in prion research. The reviewer also provides updated information and critiques some of the book's conclusions in light of more recent research. Shorter summary

Scott Alexander reviews a book critiquing Institutional Review Boards, arguing they now harm medical research more than they help. Longer summary

Scott Alexander reviews Simon Whitney's book 'From Oversight To Overkill', which critiques the current state of Institutional Review Boards (IRBs) in medical research. The book traces the history of IRBs from their noble beginnings to their current state of over-regulation and obstruction. Whitney argues that while IRBs were intended to protect research subjects, they now cause more harm than good by delaying or preventing potentially life-saving research. The review discusses several case studies that illustrate the problems with IRBs, and concludes by considering Whitney's proposed reforms and the broader societal trends that have led to this situation. Shorter summary

Anna Schaffner's 'Exhaustion: A History' traces explanations for chronic fatigue from ancient times to modern Chronic Fatigue Syndrome, showing how they reflect contemporary cultural and scientific ideas. Longer summary

The book 'Exhaustion: A History' by Anna Schaffner explores the concept of chronic, pathological exhaustion throughout Western history. It traces various explanatory models used in science and culture, from ancient humoral theory to modern conceptions of Chronic Fatigue Syndrome (CFS). The author argues that while the symptoms have remained consistent, the explanations for exhaustion have changed over time, reflecting contemporary cultural and scientific ideas. The book covers religious, moral, sexual, and medical explanations, culminating in the current debates surrounding CFS and its controversial status in modern medicine. Shorter summary

Scott Alexander explores the history and mechanism of DNP, a dangerous but effective weight-loss drug, and discusses recent developments in safer mitochondrial uncoupling agents. Longer summary

Scott Alexander discusses 2,4-dinitrophenol (DNP), a controversial and dangerous weight-loss drug that works by uncoupling mitochondria. He traces its history from the 1930s to modern times, explaining its effectiveness and severe side effects. The post then explores recent developments in mitochondrial uncoupling research, including potential safer alternatives and therapeutic applications beyond weight loss. Shorter summary

Scott Alexander examines the history, chemistry, and efficacy of various amphetamine-based ADHD medications, comparing their strengths and weaknesses. Longer summary

Scott Alexander explores the history and differences between various amphetamine-based ADHD medications. He traces the origins of Adderall to a 1950s diet pill, then compares it to other drugs like Dexedrine, Vyvanse, Evekeo, and Desoxyn (methamphetamine). The post discusses the chemical differences, patient preferences, and effectiveness of these medications, noting that pure d-amphetamine (Dexedrine) seems generally superior to the Adderall mixture. Scott also touches on the controversy surrounding methamphetamine use in ADHD treatment, explaining that the main differences between therapeutic use and abuse are dosage and administration method rather than inherent properties of the drug. Shorter summary

Scott Alexander discusses new research suggesting ketamine's antidepressant effects may be linked to the opioid system, exploring the implications and potential future directions for depression treatment. Longer summary

Scott Alexander provides an update on ketamine research, discussing a new study that suggests ketamine's antidepressant effects may be related to the opioid system rather than NMDA receptors as previously thought. He compares this to a study on buprenorphine's effects on suicidal ideation and explores the implications of these findings. The post touches on the medical establishment's response, potential future directions for research and treatment, and the historical context of opiate use in medicine. Scott also raises questions about the relationship between opiates and depression, and the potential risks and benefits of using opioid-related treatments for depression. Shorter summary

Scott Alexander examines conflicting narratives about cancer treatment progress, analyzing data to show that while some improvements are due to social factors, there's evidence of genuine advancements in cancer treatment and outcomes. Longer summary

This post examines the progress made in the 'War on Cancer' by analyzing cancer incidence rates, mortality rates, and five-year survival rates. Scott Alexander explores two competing narratives: one suggesting significant progress and another claiming limited success. He delves into the data, considering factors like age adjustment, smoking trends, and early detection biases. The analysis reveals that while some improvements are due to social factors like reduced smoking, there's evidence of genuine progress in cancer treatment. Stage-specific survival rates have improved, and studies adjusting for various confounders still show advancements. The post concludes that while progress may not meet the grand expectations set in the past, there has been a gradual but real improvement in cancer treatment and outcomes. Shorter summary

Scott Alexander reviews Foucault's 'Madness and Civilization', examining its controversial historical analysis of societal attitudes towards mental illness. Longer summary

Scott Alexander reviews Michel Foucault's 'Madness and Civilization', exploring its historical analysis of societal attitudes towards mental illness from the Renaissance to the 19th century. The review highlights Foucault's controversial interpretations, including the mythical 'Ship of Fools', the confinement of the mad with criminals and the poor, and the author's critical view of mental health reforms. Scott notes the book's fascinating historical insights and beautiful writing, while expressing skepticism about some of Foucault's claims and his postmodern approach to analyzing history. Shorter summary

Scott Alexander analyzes online drug ratings, finding patients prefer older antidepressants while doctors prefer newer ones, and explores potential explanations for this paradox. Longer summary

Scott Alexander analyzes patient ratings of antidepressants from online databases, finding that older drugs like MAOIs are rated higher than newer ones. He then compares this to doctor ratings, discovering a negative correlation between patient and doctor preferences. The post explores possible explanations for these paradoxical results, including confounding factors and the hypothesis that newer antidepressants may actually be less effective. Scott extends the analysis to other drug classes, finding the negative doctor-patient correlation holds broadly, while the preference for older drugs is specific to psychiatric medications. Shorter summary

Scott Alexander presents and humorously critiques a series of strange psychiatric drug advertisements from the 1960s and 1970s, highlighting their peculiar imagery and messaging. Longer summary

Scott Alexander shares a collection of psychiatric drug advertisements from the 1960s and 1970s, highlighting their peculiar and often creepy nature. He comments on various aspects of these ads, including the evolution of psychiatric terminology, the relationship between drug therapy and psychoanalysis, and the bizarre imagery used to market antipsychotics. The post humorously critiques the ads' visual elements, puns, and implied messages, while also noting how they reflect changing attitudes in psychiatry over time. Shorter summary