Mad in America
 Part One describes early treatments like a spinning chair which could reach 100 revolutions per minute, the Tranquilizer Chair which immobilized patients, and water therapies. Whitaker then describes moral treatment, dating back to 1793 and the French Revolution and established in the U.S. by Quakers in 1817, in which lay superintendents treated the mentally ill in small homes with great kindness and had good outcomes: About 35 to 80 percent of patients were discharged within a year, the majority of them cured. Pennsylvania Hospital reported that about 45 percent of patients were discharged as cured and 25 percent discharged as improved. In Worcester State Hospital, 35 percent were chronically ill or had died while mentally ill. Dr. George Wood, a visitor, reported in 1851: Part Two describes the rise of eugenics which did away with moral treatment in favor of forced sterilization of the mentally ill, and led to newly invigorated fields of psychiatry and neuroscience whose experts practiced insulin coma, metrazol convulsion, forced electroshock, and lobotomy. Part Three describes the invention of the neuroleptic drug chlorpromazine (Thorazine) by Rhône-Poulenc in France, and its purchase by Smith, Kline & French (today known as GlaxoSmithKline). The drug "produced an effect similar to frontal lobotomy", according to early reports by the company's lead investigator. Whitaker says that pharmaceutical advertising, articles published in the scientific literature, and stories in the media of "miracle drugs" transformed Thorazine into a healing drug. Whitaker says that marketing money from pharmaceutical companies began to flow to the American Medical Association in 1951, a year after Thorazine was synthesized, because of the Durham-Humphrey Amendment to the Federal Food, Drug, and Cosmetic Act which "greatly expanded the list of medications that could only be obtained with a doctor's prescription". In Part Three, Whitaker also describes the American (but not for example British) propensity to classify patients as "schizophrenic", as well as the error (confusion of schizophrenia with the yet-to-be-discovered encephalitis lethargica) in the original classification by Emil Kraepelin which psychiatry chose to not revisit and fix. Whitaker then describes three pathways that dopamine may take in the human brain, and quotes first-person accounts of the effects of antipsychotic drugs on individuals. He calls a 1996 New York Times advertisement by a consortium of pharmaceutical companies a "bald-faced lie": the group sought to say that the cause of psychosis and schizophrenia is an abnormal dopamine level and that their drugs worked by altering the level of dopamine. Whitaker then criticizes some American studies, and points out the work of George Crane at the National Institute of Mental Health to get tardive dyskinesia recognized, and he contrasts the dosages that British doctors were comfortable in prescribing (300 milligrams per day of Thorazine) with what American psychiatrists prescribed (1,500 up to perhaps 5,000 milligrams per day). He sees irony in the fact that The New York Times reported on Soviet forced use of neuroleptic drugs (which Florida Senator Edward Gurney called "chemicals which convert human beings into vegetables") in "psychiatric jails" but called the same drugs "widely acknowledged to be effective" when reporting on American schizophrenic patients. Whitaker describes the demise of modern-day moral treatment in a short history of Loren Mosher's Soteria Project, funded by the U.S. while Mosher was chief of schizophrenia at NIMH. He attributes the results in a World Health Organization 1979 study of outcomes for schizophrenia patients (which found better outcomes in undeveloped countries like India, Nigeria and Colombia than in developed countries like the United States, England, Denmark, Ireland, Russia, Czecholslovakia and Japan) to doctors in the developed world who maintained their patients on medications. He then describes fifty years of American scientists doing experiments on schizoprenia patients: to intentionally exacerbate their symptoms and study the results. He compares the doctors' behavior, unfavorably, to 1947 after American trials of Nazi doctors ended in the Nuremberg Code for ethics in human experimentation. Part Four is Whitaker's description of drug trials for the newer atypical antipsychotics. He says that many of these trials were stacked in favor of the drug being proposed by eliminating the placebo, or by comparing multiple doses of the new drug against a single, very high dose of the old one. He says that the pharmaceutical companies and the press used their influence to make claims for these drugs (some claims that the Food and Drug Administration had explicitly asked them not to make). Risperidone and olanzapine, for example, were both claimed to have fewer side effects than the first generation of antipsychotics. Whitaker also tells the stories of patients whose deaths were caused by drug trials but were not mentioned to the public. Whitaker calls it a type of medical fraud that we tell schizophrenics that they suffer from too much dopamine or serotonin activity and that drugs put these brain chemicals back in "balance". He writes, "Little is known about what causes schizophrenia. Antipsychotic drugs do not fix any known brain abnormality, nor do they put brain chemistry back into balance. What they do is alter brain function in a manner that diminishes certain characteristic symptoms....".