Mental health policy and practice across Europe: an overview

chapter
seven
Psychopharmaceuticals
in Europe
Nikolas Rose
Introduction
Over the last half of the twentieth century, health care practices in developed,
liberal and democratic societies, notably in the United States and Europe, have
become increasingly dependent on commercially produced pharmaceuticals. 1
This is especially true in relation to psychiatry and mental health. We could term
these ‘psychopharmacological’ societies. While it is difficult to assess the precise
value of the market, estimates based on ex-manufacturers’ prices put the
European market at US$4741 million in 2000 – up from US$2110 million in
1990 – which compares with a total US market of US$11,619 million – up from
US$2502 million in 1990. 2 In many different contexts, in different ways, in
relation to a variety of problems, by doctors, psychiatrists, parents and by ourselves,
human subjective capacities have come to be routinely reshaped by psychiatric
drugs. The aim of this chapter is to describe the kinds of thinking that
underpin such developments, and to examine the impact of these ways of
thinking on the prescribing of psychiatric drugs in Europe, through an analysis
of comparative data on the use of psychiatric drugs in different countries.
The rise of the psychopharmacological paradigm
It is well known that the first widely used psychiatric drug was chlorpromazine
(Largactil, Thorazine), developed from antihistamines in the years after the
Second World War. 3 Two French psychiatrists, Pierre Deniker and Jean Delay,
who administered it to a group of psychotically agitated patients at the Hôpital
Sainte-Anne in Paris in 1952, are credited with the discovery of its psychiatric
effects. Its use spread through the asylums of Europe and North America, and
made Smith, Kline and French, who held the US patent, US$75 million in 1955