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A Bíblia da farmacologia e os antidepressivos: análise do livro texto de Goodman e Gilman - as bases farmacológicas da terapêutica de 1941 a 2006

  • Bittencourt, Silvia Cardoso
Publication Date
Oct 25, 2012
Repositório Institucional da UFSC
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If pain and suffering are inherent to the human condition, the manner in which we deal with such conditions has been diverse in different sociocultural and historical contexts. The use of antidepressive medication to cure conditions related to sadness, which can demonstrate symptoms characterized by physical and psychic suffering, is a biomedicinal therapeutic strategy used since the emergence of such drugs. The abuse of such medication has become highly questioned. Inquiries have surfaced in relation to the reduction of suffering to purely biological aspects, thereby excluding a comprehensive approach of health problems that would not be solely restricted to an intervention of endogenous biochemical alterations. The aim of this study is to identify how pharmacology and the antidepressant drugs were introduced to physicians and medical students in the second half of XX century and to analyze which argumentative strategies are utilized in justifying the use of such drugs via scientific discourse. In order to achieve this aim, we have analyzed the different editions of the primary textbook of pharmacology, used in various countries during the XX century as a means of disseminating scientific knowledge: Goodman and Gilman: The Pharmacological Basis of Therapeutics, the commonly recognized #bible of Pharmacology#. Initially examined are the clinical conditions related to depression, a medical category that gave origin to #antidepressants#, by means of melancholia in the early days of biomedicine. Analyzed were texts from doctors such as Pinel, Esquirol, and Dagonet from earlier periods, in which modern medicine was #born#, the second half of the XVIII century, the XIX century, and a brief passage through the beginning of the XX century, when works from such authors as Kraeplin and Freud brought forth questions regarding the imprecision of medical diagnosis in the area of psychological distress. Goodman and Gilman#s textbooks, from the first edition (in 1941) through the eleventh edition (in 2006), have been analyzed from a historical perspective, using discourse analysis as a methodological strategy. We tried to identify issues that influenced both the development of knowledge in the area of pharmacology as well as the development of such medications labeled antidepressants. From the analysis of texts, one can conclude that: difficulties exist when specifying the situations in which the antidepressants are utilized, via the uncertainties of clinical diagnosis; the attempts, from de pharmacological knowledge, to establish a causal relationship between various endogenous substances and clinical symptoms are not supported in any of the textbook editions; the advances in the field of technicalscientific knowledge in order to control the symptoms have obtained a relative amount of success (at least short-term, for example, in the control of side effects and in the ease of administering medication), this being one aspect that has given strength to the expansion of antidepressants being used; these drugs, originally used to treat depressive symptoms (in the sense of little or low body activity), have had their use extended progressively to situations that are not related to the symptoms that initially gave them that name (antidepressants); the development of research in pharmacology is linked to understandings and practices from other areas of knowledge, which in turn determine the development of such drugs as antidepressants; and finally, that the pharmaceutical industry is associated to the development of pharmacology since its inception.

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