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Despite our ambivalence, sales of psychiatric drugs amounted to more than seventy billion dollars in 2010. In the past few years, one pharmaceutical giant after another—Glaxo Smith Kline, Astra Zeneca, Novartis, Pfizer, Merck, Sanofi—has shrunk or shuttered its neuroscience research facilities.They have become yet another commodity that consumers have learned to live with or even enjoy, like S. Clinical trials have been halted, lines of research abandoned, and the new drug pipeline has been allowed to run dry.Aggressive, violent patients are often psychotic and have diagnoses such as polysubstance abuse, schizophrenia, delusional disorder, or acute mania.Other causes include physical disorders that cause acute delirium (see Selected Mental Symptoms Due to Physical Disorders), a chronic organic brain disorder (eg, dementia) and intoxication with alcohol or other substances, particularly Management typically occurs simultaneously with evaluation, particularly evaluation for a possible physical disorder (see Medical Assessment of the Patient With Mental Symptoms); it is a mistake to assume that the cause of abnormal behavior is a mental disorder or intoxication, even in patients who have a known psychiatric diagnosis or an odor of alcohol.As I finished washing the last of the day’s dishes, an angry voice broke the silence, “Stop it, just stop it!” I dried my hands and hurried outside before the situation could escalate.Why would an industry beat a hasty retreat from a market that continues to boom?(Recent surveys indicate that mental illness is the leading cause of impairment and disability worldwide.) The answer lies in the history of psychopharmacology, which is more deeply indebted to serendipity than most branches of medicine—in particular, to a remarkable series of accidental discoveries made in the fifteen or so years following the end of the Second World War.
Numerous reports indicate that individuals with SMI are over-represented in the criminal justice system. prisons and offenders with mental illness, the organization Human Rights Watch indicated that up to 19 percent of adults in State prisons have significant psychiatric or functional disabilities.
Such interventions are done to prevent harm to patients and others and to allow evaluation of the cause of the behavior (eg, by taking vital signs and doing blood tests).