Despite its chequered past, NMD remains a modern treatment for the most unwell and most disabled patients with severe and chronic mental disorders. In the present day there are few who would argue against the claim that the early adoption of ‘psychosurgery’ lacked an evidence base, was driven by a frequently misplaced zeal, and performed on individuals with conditions that would not be indications for surgery now.
However, the evolution of NMD has followed a recognisable path that is shared with many treatments in medicine:
“The practice of lobotomy went through stages of animal experimentation, clinical application, social and clinical criticism and modification, indirect scientific contributions, and finally substitution of another treatment.” (Kucharski, 1984).
Of all the treatments in psychiatry, the two which have engendered the most emotive discussions in public and the medical profession namely NMD and electroconvulsive therapy (ECT), these are the only two which have emerged out of the first half of the twentieth century and remain in current use, albeit modified from their original form
Kucharski, A. (1984) History of frontal lobotomy in the United States, 1935-1955. Neurosurgery, 14, 765-772.