When Did They Stop Doing Lobotomies?

Lobotomies were largely abandoned in the 1950s and early 1960s, as antipsychotic drugs like chlorpromazine became available and as growing ethical and scientific criticism exposed the procedure’s severe harms. The last lobotomy in the United States is generally dated to 1967, though a small number of related psychosurgeries continued in a few countries into the 1970s and, in very limited forms, later.

The story of how a procedure once treated as a medical breakthrough became unthinkable within a single generation is a case study in how medicine changes its mind. It is also a reminder that “widely accepted at the time” is not the same as “proven.”

When Did They Stop Doing Lobotomies?

The decline began in the mid-1950s and the practice was essentially gone in the US by the late 1960s. The last lobotomy performed in the United States is generally dated to 1967, when a patient at a state hospital in West Virginia underwent the procedure.

Three forces drove the change at roughly the same time.

• Antipsychotic medications arrived. Chlorpromazine, introduced in the early 1950s, gave doctors a non-surgical way to reduce severe psychotic symptoms.
• Evidence of harm accumulated. Autopsies and long-term follow-up showed brain damage, seizures, personality change, and death rates that had been underreported.
• Ethical and legal scrutiny grew. Concerns about consent, especially for institutionalized patients who could not refuse, made the procedure increasingly hard to justify.

No single announcement ended lobotomies. They faded as better options appeared and as the harms became impossible to ignore.

What Was a Lobotomy, Exactly?

A lobotomy is brain surgery that cuts or destroys connections between the prefrontal cortex and the rest of the brain. The prefrontal cortex sits behind the forehead and is involved in planning, judgment, impulse control, and aspects of personality and social behavior.

The goal was to interrupt circuits thought to drive severe psychiatric symptoms. In practice, the surgery did not target a specific malfunctioning pathway. It severed or damaged tissue across a broad region.

Two main approaches were used.

The standard prefrontal lobotomy involved opening the skull and cutting nerve fibers. This was major surgery with real risks of bleeding, infection, and death.

The transorbital lobotomy was developed by Walter Freeman. An instrument resembling an ice pick was driven through the thin bone above the eye socket and swept side to side to sever fibers. Freeman promoted it as a quick office procedure. He performed it without a surgeon and, in many cases, without proper consent.

It is worth being precise here: the transorbital version was not a gentler surgery. It was a less controlled one. The damage was simply less visible than an open operation.

Why Did Doctors Think It Worked?

Early reports described patients who seemed calmer, less agitated, and easier to manage. In an era with no effective psychiatric drugs and overcrowded institutions, that counted as success. There was no sham-controlled trial, no blinded assessment, and no long-term follow-up by modern standards.

The problem is that “calmer and easier to manage” is not the same as “treated.” Apathy, blunted emotion, and reduced initiative can look like improvement to staff while representing loss of function to the patient. Some people did report relief from unbearable distress. Others were left permanently changed in ways they could not consent to or describe.

Retrospective reviews of patient records have found that outcomes were far more variable and far more damaging than the early enthusiasm suggested. The published successes were also more likely to be reported than the failures.

What Happened to Patients Who Had One?

Outcomes ranged widely, and that range is part of why the procedure is so difficult to summarize. Some patients died during or shortly after surgery. Others survived with significant, lasting impairment.

Common consequences reported in follow-up accounts included:

• Seizures, sometimes starting years later
• Blunted emotional expression and reduced motivation
• Impaired judgment, planning, and social inhibition
• Memory and attention problems
• Personality changes that families described as the person being “gone”

Many patients were institutionalized for the rest of their lives, which makes it hard to separate the effects of the surgery from the effects of the conditions and settings they were already in. That ambiguity is real. It does not make the surgery safe.

What Replaced Lobotomies?

Medication replaced surgery first. Chlorpromazine and later antipsychotics gave clinicians a tool that could be adjusted, stopped, or changed. That flexibility alone was a fundamental shift.

Other changes followed.

Informed consent became a formal requirement in research and clinical care, driven partly by the broader reckoning with medical abuses of the mid-20th century. Institutionalization declined as community-based care expanded, though the quality and funding of that care has remained uneven.

For a small number of severe, treatment-resistant conditions, surgeons developed far more targeted procedures. These use precise lesions or implanted electrodes rather than broad cutting. They are performed at specialized centers, on carefully selected patients, with ethics review and explicit consent. This is not the same operation as a lobotomy, and the evidence base for each specific procedure varies. Some have more support than others.

Are Lobotomies Still Done Today?

No. The procedure as historically performed is not part of modern medicine anywhere. What exists today is a different category of treatment: deep brain stimulation and a small number of ablative psychosurgical procedures for severe, refractory illness.

Deep brain stimulation involves implanted electrodes that modulate specific brain circuits. It is reversible and adjustable, unlike a lobotomy. It is used in a limited number of conditions and remains an area of active research. Evidence for its effectiveness varies by condition, and it carries surgical risks including infection, bleeding, and device complications.

These procedures are not widely available and are not first-line treatment. They are generally considered only after other options have failed, and only at centers with the expertise to manage them.

Why Does the Lobotomy Story Still Matter?

Because it shows how quickly a treatment can move from celebrated to condemned when better evidence arrives. The doctors who performed lobotomies were not, for the most part, acting in bad faith. They were working with what they had, in systems that rewarded intervention and underweighted harm.

The lesson is not that medicine is untrustworthy. It is that enthusiasm, institutional pressure, and weak evidence can combine to produce harm at scale. The safeguards that exist now, including ethics review, informed consent, and controlled trials, grew partly out of failures like this one.

How Did the Public Learn the Truth?

Public awareness grew slowly, through patient and family accounts, investigative journalism, and later books and films. The 1975 film adaptation of “One Flew Over the Cuckoo’s Nest” brought the procedure into popular culture as a symbol of institutional abuse, though the book it was based on was published in 1962.

Medical historians and journalists also documented the gap between what was reported at the time and what actually happened to patients. That gap is the most important part of the story. It is the reason modern medicine places so much weight on controlled studies and long-term follow-up rather than on early impressions of improvement.