Not at all sure about this approach. Step forward Stepford, a future vision of controlled mediocrity. This from The Times (UK) http://www.timesonline.co.uk/article/0,,8123-2492393.html :
A balm for your badness
Can taking a pill prevent road rage? Or curb gambling? Roger Dobson looks at chemical ‘cures’ for our behaviour
The game may soon be up for fruit-machine addicts. Men and women who spend hours gambling may be medically unwell rather than simply indulging in bad habits; at least that’s what the Centre for Addiction in Toronto, Canada, is telling us. It has just started recruiting one-armed-bandit addicts for a clinical trial of a new drug to cure gambling.
Gambling is one of scores of behaviours, traits and habits that are being regarded as treatable illnesses. Soon you’ll be able to cure your worst habits with a pill. Road rage, kleptomania, sex addiction, drinking, teenage tantrums and domestic violence are all being treated with drugs. And more could be in the pipeline, with new trials designed to define the symptoms of workaholism and acute boredom.
NI_MPU('middle');With more than 1,000 trials under way worldwide on therapies for behavioural problems, there is growing concern about this process of “medicalisation”. Dr Derek Summerfield, a psychiatrist, writing in the British Medical Journal, has questioned the numbers of people being treated for such traits. Post-traumatic stress disorder, he says, exemplifies a growing obsession with turning emotions into conditions.
“Originally framed as applying only to extreme experiences, it has come to be associated with commonplace events: accidents, muggings, a difficult childbirth, verbal sexual harassment,’’ he says. “Once it becomes advantageous to frame distress as a psychiatric condition people will choose to present themselves as medicalised victims rather than as feisty survivors.’’ There are also concerns that prescribing drugs for unacceptable activities gives disease status to simple bad behaviour. Others argue that if medication works, and can change lives for the better, it should be tried, and that any approaches that stop domestic violence, gambling and road rage are welcome. A number of studies have found that the impulsive aggression may have a link with serotonin levels in the brain and that antidepressants therefore may have some effect.
“Recent studies have shown that fluoxetine — a drug commonly used to treat depression and panic disorder — can decrease acts of aggression,” say the researchers carrying out the domestic violence trial.
As the gambling pill trial gets under way in Canada, results from an earlier pilot study indicate that most of those taking part are going into remission. But the message for problem gamblers is that though it’s possible that the drug will be a cure, please don’t bet on it.
Meanwhile, here are some of your bad habits that may soon have you popping pills.
ROAD RAGE Intermittent explosive disorder, including some cases of road rage, is believed to affect 7.3 per cent of people at some time. Main symptoms are failure to resist aggressive impulses that result in assaults or damage to property.
Treatment Anger-management programmes and counselling were the main strands of treatment, but a new trial, sponsored by the US National Institute of Mental Health, is looking at the use of two antidepressants, fluoxetine and divalproex, in 144 men and women. “It is a vaguely defined condition for which effective treatments have not been identified. Research suggests that serotonin, a chemical that helps regulate mood and emotions, may play a role,” say the researchers.
SHOPPING Between 2 and 8 per cent of us have symptoms of a compulsive shopping disorder, according to researchers. Symptoms include a preoccupation with shopping and buying unnecessary items. “Shopaholics, when they are feeling out of sorts, shop for a pick-me-up. They go out and buy to get a high,” say Indiana University researchers. Although some question its status as an illness, Dr Lorrin Koran, a professor of psychiatry at Stanford University, says it’s a real disorder. One shopper in his study had amassed 2,000 wrenches for no apparent reason.
NI_MPU('middle');Treatment Sixty-three per cent of people who took the drug citalopram for seven weeks in a small trial at Stanford University were much improved and had a 50 per cent or greater reduction in symptoms. The drug is an antidepressant, which works by increasing levels in the brain of the feel-good chemical serotonin.
SEX ADDICTION This is defined as an excessive engagement in conventional sexual activities, including extramarital affairs, prostitution and pornography. Prevalence is unknown since most addicts prefer to keep their affliction, if not their desires, to themselves.
Treatment Researchers at the University Hospital of Geneva have used topiramate, an anticonvulsant used to treat certain types of seizure, successfully on sex addicts. It works by decreasing abnormal excitement in the brain. Not only did the patients’ sex addiction improve, but their weight went down, too. “Topiramate seems to be a promising medication for treatment of sexual addiction, ” say the researchers.
TEENAGE TANTRUMS Conduct disorder is a childhood behaviour disorder characterised by aggressive and destructive activities that cause disruption in the child’s home, school or neighbourhood. In the United States, one boy in ten is said to show signs.
Treatment A trial is under way using divalproex sodium, an anticonvulsant that is thought to increase brain levels of gamma-aminobutyric acid (GABA), lowering anxiety and increasing relaxation. About 70 people have been taking part in the study sponsored by the US National Institute on Drug Abuse. Scientists at the institute say: “Disruptive behaviour disorders among children and adolescents are readily diagnosed; however, few individuals with such disorders receive drug treatment.
SOCIAL ANXIETY Sometimes known as social phobia, the main symptom is an excessive and unreasonable fear of social situations, often as a result of a fear of being watched, judged and criticised. Research in America suggests that anything from 5 to 13 per cent of people suffer from this disorder. The average age of the first symptom is 15 and it can last for as long as 16 years.
Treatment A trial sponsored by the National Institute of Mental Health in America is examining whether the antibiotic d-cycloserine (DCS) can boost the effectiveness of cognitive behaviour therapy in 104 people with social anxiety. Just how is not clear, but the researchers say DCS has been shown to boost learning ability.
DOMESTIC VIOLENCE The British Crime Survey estimates that 21 per cent of women and 10 per cent of men have experienced at least one domestic threat of force or actual force since they were 16.
Treatment Until now, treatment for domestic violence has centred on behavioural therapies, including anger-management but in a trial launched in America, fluoxetine, better known as Prozac, will be given to perpetrators of domestic violence. It is the first trial of a drug treatment for the problem, and 136 male and female abusers aged 18 to 65 will take part. “The study will evaluate whether fluoxetine, used with psychotherapy, can reduce aggression in people who are violent towards their spouses,” says the US National Institute of Alcohol Abuse and Alcoholism, which is supporting the trial.
KLEPTOMANIA More commonly known as stealing, it’s defined as a failure to resist impulses to steal items. Some psychiatrists believe that it is linked to obsessive compulsion, while others say it is a form of depression. Sufferers are mainly women.
NI_MPU('middle');Treatment Researchers at the University of Minnesota are treating patients for eight weeks with the drug naltrexone. “The hypothesis is that naltrexone will be effective in reducing the urge to steal,” say the researchers. Naltrexone works by blocking the effects of narcotics, especially the feeling of being “high”that drives addiction.
DRINKING According to Alcohol Concern, alcohol kills 22,000 people in the UK every year, making it one of the biggest public health problems.
Treatment The drug rimonabant has been on trial looking at its effects on mild to moderate drinkers who consume 20 to 40 units a week. The drug, which has been used in obesity, works by blocking cannabinoid-1 receptors in the brain. The theory is that when they are blocked, less alcohol is drunk. In the trial, those taking the drug and those having placebos will be tested with offers of drink or cash for not drinking. “It is hypothesised that participants receiving the drug will have decreased alcohol consumption,”says the US National Institute of Alcohol Abuse and Alcoholism.