Astral Codex Ten

antipsychotics

7 min read

antipsychotics

Article

antipsychotics is a recurring concept in the Astral Codex Ten archive, appearing 2 times across 2 issues between August 30, 2023 and July 18, 2024. The archive places it in contexts such as “Inappropriate prescribing of antipsychotics causes 1800 deaths in the UK each year”; “once there were other options (penicillin, antipsychotics, nursing homes)“. It most often appears alongside San Francisco, 2020 election, Access Pass.

Metadata

  • Category: Concepts
  • Mention count: 2
  • Issue count: 2
  • First seen: August 30, 2023
  • Last seen: July 18, 2024

Appears In

Source Context

Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.

Highlights From The Comments On Fetishes
August 30, 2023 · Original source
This is going to sound insensitive, but as far as “bad US medical policies” go, 2,500 children having their lives low-key ruined is nothing. I can think of a dozen US medical policies that are much worse than that! I wrote here about how bad IRB policies probably kill about 50,000 people per year! The failure to allow human challenge trials for COVID vaccines probably killed about 10,000 people; the decision to delay the vaccine an extra few weeks to influence the 2020 election probably killed about 1,000. Inappropriate prescribing of antipsychotics causes 1800 deaths in the UK each year (the US number is probably closer to 10,000). Laws about organ donation incentives are “responsible for millions of needless deaths”. Even if you only care about children, there was the whole FDA fish oil story. Even if you only care about sterilization, Paul Ehrlich is still around! I’ve tried so hard to raise awareness of some of these issues, and although I’m deeply grateful for the five people who take them seriously, it’s a massively uphill battle.
Inline links: wrote here, 1800 deaths, “responsible for millions of needless deaths”, FDA fish oil story, Paul Ehrlich is still around
Highlights From The Comments On Mentally Ill Homeless People
July 18, 2024 · Original source
Actual schizophrenics Around the 1950s, lifespans increased enough that it was worth coming up with separate institutions (eg nursing homes) for demented people. Penicillin cured neurosyphilis. Better prenatal testing decreased Down’s syndrome rates, and better social services let Down’s syndrome patients be treated in the community. It became harder to bribe people to imprison your eccentric relatives. And pharma companies invented antipsychotics to treat schizophrenics. So the effective population for these institutions decreased by an order of magnitude. At the same time, rising health care costs were making them unmaintainably expensive. And yes, civil rights advocates were arguing that they were violations of human rights. So between 1950 and 1980, they were almost all closed down. Recreating this system would be tough, both for practical and political reasons. The practical reason is that the cost of everything has increased by at least an order of magnitude since 1950. Partly this is increasing social and governmental dysfunction. Partly it’s because in 1950, it was considered reasonable to build institutions that looked like this: Cozy! Even at costs likely 10% of ours, the 1950s couldn’t really afford to keep these institutions around; states were spending about 10% of their total budget just to maintain buildings that looked like the picture above. That segues into the political problem - once there were other options (penicillin, antipsychotics, nursing homes), the public willingness to pay to maintain the institutions collapsed. On the other hand, when I calculate this out, it doesn’t seem so bad? The average cost of a psychiatric hospital bed is about $300K per year (sanity check: a California prison bed is $130K per year, and the psych hospital needs more medical personnel, so this seems plausible). There are about 8,000 homeless in San Francisco, but assume that most are ordinary people down on their luck, and we only need to institutionalize 2,000. That suggests a cost of $600 million/year using state-of-California numbers, but everything (eg real estate) is more expensive in SF, so round up to $1 billion/year. I don’t know if this counts the amortized cost of building the institution, but let’s assume it does. San Francisco currently spends about $1 billion/year on homelessness. These institutions would only cover the worst 25% of homeless people, so you’d need maybe another $500 million for the rest, but whatever, same order of magnitude. I think this is more affordable than I expected. The remaining problems are: Where is this? I don’t think there’s anywhere in SF city limits to put it. I suggest putting it in Marin, to piss off George Lucas’ neighbors. But I don’t know about the legalities of a city using an extraterritorial detention institution.
Inline links: https://substackcdn.com/image/fetch/$s_!eZXJ!,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fec410560-b6b1-4f73-91bc-25f377fb8266_800x533.jpeg, about $300K per year
Cozy! Even at costs likely 10% of ours, the 1950s couldn’t really afford to keep these institutions around; states were spending about 10% of their total budget just to maintain buildings that looked like the picture above. That segues into the political problem - once there were other options (penicillin, antipsychotics, nursing homes), the public willingness to pay to maintain the institutions collapsed. On the other hand, when I calculate this out, it doesn’t seem so bad? The average cost of a psychiatric hospital bed is about $300K per year (sanity check: a California prison bed is $130K per year, and the psych hospital needs more medical personnel, so this seems plausible). There are about 8,000 homeless in San Francisco, but assume that most are ordinary people down on their luck, and we only need to institutionalize 2,000. That suggests a cost of $600 million/year using state-of-California numbers, but everything (eg real estate) is more expensive in SF, so round up to $1 billion/year. I don’t know if this counts the amortized cost of building the institution, but let’s assume it does. San Francisco currently spends about $1 billion/year on homelessness. These institutions would only cover the worst 25% of homeless people, so you’d need maybe another $500 million for the rest, but whatever, same order of magnitude. I think this is more affordable than I expected. The remaining problems are: Where is this? I don’t think there’s anywhere in SF city limits to put it. I suggest putting it in Marin, to piss off George Lucas’ neighbors. But I don’t know about the legalities of a city using an extraterritorial detention institution.
Inline links: about $300K per year
Probably many patients will start doing better once they’re on antipsychotics. Do you release them (at which point they will probably get off antipsychotics?) Or do you awkwardly keep sane people around in your mental institution because you don’t trust them?