> I'd love to see the long-term studies that take fMRIs or something similar of people before treatment, 4-6 weeks after treatment begins, then a scan every month or every few months for the years they are on the medication.

Yes, I'd love to see those studies too. What one would ideally also require, however, would be a medication free control group matched for severity of condition. I'm not sure that one could ethically randomly assign people to a 'no neuroleptic treatment' condition. Of course the ethics are begging the question here (assuming that those who aren't treated with medication are being harmed) but I do forsee ethical issues in obtaining a control group.

Without the control group... A finding of degenerative brain damage would probably be taken as evidence for the degenerative nature of schizophrenia rather than being taken as evidence for neuroleptics causing brain damage.

> As I understand it, to date, most of what we have to examine the real long-term effects of some medications are single case studies, which are often dismissed as "oh, that person was unique."

I think there is something to the idea that the Nazi scientists were unable to find a neurological basis to schizophrenia despite their numerous autopsy's. One would also need to know:
- whether the concept 'schizophrenia' (as used by the Nazi's) picked out roughly the same individuals as would be picked out by our present concept. I think it would be fair to assume that they would be picking out the most severe cases, however.
- whether their microscopic investigations were hampered by their lack of more advanced technology. I think it would be fair to assume that they would have been capable of finding enlarged ventricles and shrunken areas, however. how about more dopamine receptors? i'm not sure dopamine receptors had been discovered yet... that could be a potential problem.

I would like to check out the studies that he mentions in order to interpret them for myself. He does seem to offer a fairly sustained argument backed up by solid (and reputable) research, however. Sometimes I find psychology / psychiatry arguments to be lacking (claims are over-enthusiastic and obvious objections aren't considered). I found him to anticipate some of my objections, however, so was fairly impressed by that :-)

> For the record, in the previous books I've read by Breggin, he seems to go a bit to the extreme to make his point. I think he'd be more effective if he didn't go to such extremes, because then his critics simply paint him as someone with an extreme view and his own agenda.

Yes. I haven't read any of his other books, but the initial pages certainly had me thinking that.

To be fair, I think that advocates of all sides (including the biological psychiatrists) do that it is just that it is more apparent to us when we don't agree with (or question) some of their rhetoric.

Szasz is another who is often under-rated and IMHO unfairly dismissed by his critics. I've had psychiatrists say that he simply isn't taken seriously in psychiatric circles but I've certainly seen him getting a fairer hearing very recently with respect to the concept of mental disorder.

Often there are paradigms of research. The dysfunction assumption is thought to ground psychiatry as a science and hence anyone who challenges this assumption is probably going to be ignored. People tend to respond to that by trying to muster some interest (by their hyperbole and attempts to gain publicity) so that the others have to take them seriously enough to respond to their claims.

I think that there is a great deal more to the anti-psychiatry movement than is commonly acknowledged. It is precisely because of the anti-psychiatry movement (and the gay rights movement) that homosexuality was taken out of the DSM and that the DSM taskforce had a work group to look at which disorders should be included and which disorders should be excluded. The anti-psychiatry movement has forced psychiatry to be more accountable than it was previously and that has got to be a good thing.