Changes in the medication methods
 When
Göran Sedvall, Fritz Axel Wiesel and Henrik Nybäck in
the mid-seventies came to the psychiatric clinic at the Karolinska
Hospital, big substantial changes could be observed. The research
about psychoses that was then initiated was characterized by the
wish to try to understand the contributing factors behind mental
illness. There was also a clinical direction that was focused on
the question how the drugs could be improved,” says Håkan.
“It was a matter of first investigating what the optimal dose
was and when the treatment should be initiated, then the treatment
began, and finally the effects were observed. Prior to this point,
it was rather a matter of starting with the highest possible dose.”
“The
problem was also that people, probably because of the current attitude
in society, not seeed for help before they were practically collapsing
from the disease. And at this acute stage people often did not quite
receive the right kind of treatment.” Håkan says the
praxis at this time was to start with a relatively high dose from
the beginning, which usually caused serious side effects. From there
the dose was successively decreased until a minimal amount of side
effects could be observed.
Today,
the procedure is reversed, that is one starts with a low dose and
then increases it until the symptoms start disappearing. Håkan
here points out that studies later showed that the new way of medicating
for that matter did not lead to longer periods of treatment. Modern
techniques have also shown that the clinical dose in fact does not
have to be as high as it was first thought.
Håkan
further says that the new routines in psychiatric health care aimed
to make the patient fells as involved as possible. It was important
to keep contact with the home, the family, and the patient’s
social network. The nursing staff often went on day trips or arranged
other activities. Basically, the patient was supposed to feel welcomed
and part of the group.
“One
negative thing that was negative though,” means Håkan,
“was that there in many cases was a wrongful opinion that the
patient was ill because of the way he or she had been treated. And
in this way, patients and other people that were close to the patient
were often easily blamed for more that they were guilty of.”
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