The post examines the theory of treating schizophrenia's prodrome stage, exploring how early intervention might prevent full-blown schizophrenia and discussing the biological mechanisms behind the disease's progression. Longer summary

This post discusses the concept of treating the prodrome of schizophrenia, an early stage where symptoms are just beginning to develop. The author explores the theory that early intervention can prevent full-blown schizophrenia, comparing it to early detection in other medical conditions. The post delves into the 'Duration of Untreated Psychosis' (DUP) model, which suggests that psychosis can be toxic to the brain. The author initially expresses skepticism about this model but later becomes more open to it after learning about the biology of schizophrenia. The post then explains a theory of how schizophrenia develops through aberrant prediction errors and how this process might lead to both positive and negative symptoms. It concludes with a first-person account of schizophrenia that illustrates these concepts. Shorter summary

Scott explores the theory that clozapine's unique effectiveness in treating schizophrenia may be due to its combined action on dopamine and glutamate systems, potentially opening avenues for safer treatments. Longer summary

This post explores why clozapine is considered uniquely effective among antipsychotic drugs for treating schizophrenia. Scott discusses recent research suggesting clozapine's superiority may be due to its action on the glutamate system, specifically as an NMDA receptor agonist, in addition to its dopamine-blocking effects. He explains that adding NMDA modulators to other antipsychotics improves their efficacy, but not when added to clozapine, possibly because clozapine already has this effect. The post speculates that if this theory is correct, it could lead to safer treatments combining standard antipsychotics with NMDA agonists, avoiding clozapine's serious side effects. However, Scott notes that more research is needed to confirm this hypothesis and overcome regulatory hurdles. Shorter summary

Scott Alexander explores the complexities and inconsistencies of drug tolerance in psychiatry, highlighting how different drugs can produce varying tolerance effects across individuals. Longer summary

Scott Alexander discusses the complex and often unpredictable nature of drug tolerance in psychiatry. He explores various examples of how different drugs can lead to tolerance, no tolerance, or even reverse tolerance (increased sensitivity) in different individuals. The post highlights the inconsistencies in how tolerance develops across various drugs and patients, and how this impacts psychiatric treatment. Scott expresses frustration with the lack of attention given to tolerance in psychiatric literature and the difficulty in predicting or explaining tolerance patterns. He also touches on how this unpredictability relates to addiction, the potential for missed opportunities in drug development, and the need for better understanding of tolerance mechanisms. Shorter summary

Scott Alexander shares insights and critiques from a psychiatry conference, covering topics from medication prescribing rights to new monitoring technologies and research methodologies. Longer summary

Scott Alexander humorously recounts his experience at a psychiatry conference, highlighting various issues in the field. He discusses the debate over psychologists prescribing medication, new technologies for monitoring schizophrenic patients, problems with certain study designs, the effectiveness of long-acting injectable antipsychotics, and the superiority of clozapine. He also touches on political lobbying in psychiatry and the influence of drug companies. The post is written with a mix of seriousness and sardonic humor, critiquing various aspects of psychiatric practice and research. 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