NIMH Director Thomas Insel Acknowledges That Antipsychotics May Worsen Long-Term Outcomes

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Thomas Insel, the director of the National Institute of Mental Health (NIMH), acknowledged yesterday in his “Director’s Blog” that the long-term outcome studies of Lex Wunderink and Martin Harrow indicate that antipsychotics, despite their apparent short-term benefits, “may worsen prospects for recovery” over the long-term.  “It appears that what we currently call “schizophrenia” may comprise disorders with quite different trajectories,” says Insel, “For some people, remaining on medication long-term might impede a full return to wellness. For others, discontinuing medication can be disastrous. For all, we need to realize that reducing the so-called ‘positive symptoms’ (hallucinations and delusions) may be necessary, but is rarely sufficient for a return to normal functioning.”antipsychotic medication, which seemed so important in the early phase of psychosis, appeared to worsen prospects for recovery over the long-term.

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Kermit Cole
Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].

30 COMMENTS

    • markps2;

      BINGO!

      It annoys me to read blogs written by authors who’ve been poisoned with these drugs, have had in some cases Years of this trash distorting their emotional, perceptual, and problem solving functions, . . . . and they’re still calling them medicines.

      Damn Straight they’re not medicines.

      Report comment

    • A simple analgesic like paracetamol is a medicine: what molecule, virus, bacteria does it combat?
      An anticonvulsant/antiepileptic, what molecule/virus/bacteria does it combat?
      A heart medication or hypotensor like Inderalici, what molecule/virus/bacteria does it combat?
      Even an anti-acid medication for your stomach like omeprazol or ranitidine does not “fight” any molecule/virus/bacteria.
      They are all meds. Not understanding how they work offers a limited view and poor information, maybe we should start from there.

      Report comment

    • A simple analgesic like paracetamol is a medicine: what molecule, virus, bacteria does it combat?
      An anticonvulsant/antiepileptic, what molecule/virus/bacteria does it combat?
      A heart medication or hypotensor like Inderalici, what molecule/virus/bacteria does it combat?
      Even an anti-acid medication for your stomach like omeprazol or ranitidine does not “fight” any molecule/virus/bacteria.
      They are all meds. Not understanding how they work offers a limited view and poor information, maybe we should start from there.

      Report comment

  2. markps2,

    Duane recently voiced this/my exact same feeling that toxic poison psych drugs, especially neuroleptics, (the best word per Attorney Jim Gottstein fighting for survivor rights), should always be called “drugs” rather than “medicines” or “medications” by those who know they are toxic, deadly poisons used to disable/damage the brain and body to create a chemical straight jacket effect for the victims forced to take them. That’s the most polite, but I usually feel compelled to add toxic, deadly and other descriptive terms when referring to these killers to counter the lies of those like Dr. Insel claiming they are completely safe and effective for psychosis or schizophrenia even in the early stages, a complete lie!

    Seeing the recent report here and at 1boringoldman that due to the vile practice of a huge increase of toxic neuroleptics for children for behavior issues or just because they are so lucrative for one and all including foster parents no less, the children’s rate of diabetes has tripled, makes my blood boil.

    Anyway, at least this article shows some hope for improvement from the NIMH and I think a great deal of the credit for these “new insights” by Dr. Insel and cohorts are mostly thanks to Bob Whitaker since it is very, very similar to a recent post by Bob at MIA examining these exact same studies. Dr. Steingard also reviewed these studies at MIA recently that Bob included in his article making MIA a tour der force!

    http://www.madinamerica.com/2013/07/harrow-wunkerlink-open-
    dialogue-an-evidence-based-mandate-for-a-new-standard-of-care/

    Perhaps Dr. Insel and others were “wakened from their dogmatic slumber” via Bob Whitaker’s conclusion that if psychiatry did not heed the implications of these studies, it should be seen as a failure without the right to treat such severe emotional distress in people. Of course, I still will see it as a massive failure that should be abolished, but we are all entitled to our opinions. If you check it out, you will see the articles are quite similar citing the same studies.

    Congratulations to Bob Whitaker and his colleagues for their very long term efforts and hard work in trying to make this change happen. Most people citing Dr. Insel’s latest blog on “antipsychotics” have led with words/titles like “Surprised,” “Amazing,” etc.:

    http://1boringoldman.com/

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    • “And Yes Duane, the Times they Are a Changin’ and not for the better”

      I don’t think so. I think Humanity itself is in the process of being born. VERY painful. VERY upsetting. VERY overwhelming. But, that is exactly what I truly think and believe (or maybe, I’m just being desperately hopeful …

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    • dbunker,

      I don’t have a lot of faith in the National Institutes of Mental Health either, however I do remember Loren Mosher, M.D. was in charge of “Schizophrenia” Studies while at NIMH. He did some good in his life. –

      http://www.moshersoteria.com/bio-of-loren-mosher-soteria/

      Soteria’s non-drug approach was quite an accomplishment for Dr. Mosher, who later resigned from the American Psychiatric Association.

      I suppose I’m hopeful Dr. Tom Insel may decide to do something similar.

      Duane

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        • And the former NIMH Chief had some things to say in his resignation letter to the APA:

          “In addition, APA has entered into an unholy alliance with NAMI (I don’t remember the members being asked if they supported such an association) such that the two organizations have adopted similar public belief systems about the nature of madness. While professing itself the “champion of their clients” the APA is supporting non-clients, the parents, in their wishes to be in control, via legally enforced dependency, of their mad/bad offspring: NAMI with tacit APA approval, has set out a pro-neuroleptic drug and easy commitment-institutionalization agenda that violates the civil rights of their offspring.” – Loren Mosher, M.D.

          Full resignation letter December 4, 1998:

          http://www.moshersoteria.com/articles/resignation-from-apa/

          Duane

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      • Duane;

        Don’t mistake my tone as being upset with you. I’ve always found your responses and position to be measured and containing true compassion for your fellow man.

        My Ire is directed Wholly at the Mental Illness Fraudsters, M’Kay?

        Loren Mosher is dead. He’s no longer in the loop.

        http://en.wikipedia.org/wiki/National_Institute_of_Mental_Health

        The NIMH is Directly burning America for $1.5 Billion Dollars a year which we Don’t Have.

        The Secondary Damage they cause with that Borrowed, Defrauded, $1.5 Billion by funding their various SFB pieces of Prohibited By LAW Fraud is impossible for me to calculate.

        I have No use for them, and Less sympathy for their Benevolocratic Horse Shit.

        I do NOT Care What the next person is thinking. If they want to argue with parked cars and plate glass windows it’s Their business.

        If they’re keeping people awake with their tirades, then we already have laws concerning Disturbing the Peace.

        Those offenses are Not punishable by being made the victim of Felony Assault and Aggravated Battery, complete revocation of their Civil Rights, and being made subject to a lifetime of repeat instances of Aggravated Battery and Incarceration sans Habeus Corpus for the offense of Offending someone else.

        I want the NIMH Shut Down, everyone working/Mooching there Laid Off, and the Buildings Sold at Public Auction.

        Each and Every mental illness Diagnosis and Drugging already violate Federal Racketeering, Civil Rights, Mail Fraud and HealthCare Fraud Statutes.

        Each and Every mental illness Diagnosis and Drugging already violate Individual State Statutes prohibiting all Manner of Fraudulent conduct, Battery, and Attempted/Actual Homicide.

        The NIMH exemplifies the nadir of the Low Information/No Information Voter’s shrugging off the actual Issues in Every Election with a “Well SOMEBODY’s got to do Something about this problem. And My Candidate is promising to Do Something/Give Me Something they stole from somebody Else in trade for my vote.”

        The very concept of a National Institute of Mental Control is anathema to everything we as a Nation stand for.

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        • Caution: Then what institutions will be left in NIMH’s place? NAMI? The APA, a guild organization?
          Given time, the Tea Party will totally dismantle every public park, every social service agency, and every public entity that purports to exist for the public good. So you can take solace that NIMH will simply go away in time. defunded. If all we are left with are institutions funded by industry such as NAMI, then what sources of independent research will be available for the few honest researchers that are left in our world?

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  5. I think Insel’s blog post here represents a HUGE shift. Obviously Robert Whittaker is largely to thank, as well as those of us who work in a similar direction. We may not win the battle in the hospitals, but we win EVERY battle on the Internet, and that’s a great start!

    Kudos need to go to Insel. I think his comments were entirely objective, honest and fair. I agree with him that medications were a sign of measurable progress 35 years ago. My wife worked as a therapist in Trieste at that time. People forget that many people who are medicated today, would have been permanently locked up just a few decades ago.

    His admission that psychiatry still has much to learn was remarkable.
    This is a real breakthrough – truly historic.
    Bravo!
    Sean Blackwell

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  6. These are truly remarkable admissions from someone in his position. A cause for a celebration of sorts, to be sure, but for those of us still on these drugs it’s further cause for distress, fear and urgency. I’m aware of all of the research regarding brain shrinkage and other injury to the brain caused by neuroleptics. As I myself taper off of the one I’ve been on for over 8 years (next week I’ll be 1/2 down), what can I do to maximize my brain’s ability to heal and make best use of its natural neuroplasticity? What do we know about the degree to which injury to the brain may be reversed and what cannot be?

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    • “As I myself taper off of the one I’ve been on for over 8 years (next week I’ll be 1/2 down), what can I do to maximize my brain’s ability to heal and make best use of its natural neuroplasticity? What do we know about the degree to which injury to the brain may be reversed and what cannot be?”

      I’ve been mostly off the drugs for nearly 20 years and still have obvious symptoms of brain damage. As for neuroplasticity, that has to do not with the brain healing but rather finding ways to “re-wire” itself to conttinue to function, even if in “haywire” ways. There’s really no reason to think that recovery from neuroleptic drug induced brain damage is possible, if recovery is defined as a return to the normal healthy state of the brain.

      I get a very uncomfortable feeling when I hear people talk about “recoverying” from psych drugs, because too often I’ve heard even just the hope of such possibility be used to justify the drugging of children, including me as a child. E.G. if it doesn’t work out or he get’s tardive dyskenisia, well just take him off and see if he heals or maybe they’ll have a cure by then.

      I rather believe that people like us who have been harmed by psych drugs should seek justice instead of finding ways to assure ourselves that everything can be O.K. again.

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    • I don’t know how much of the shrinkage can be reversed, I don’t know any study that looked at that. From the macaque monkey study we know that the shrinkage is caused by the loss of glia cells.

      http://www.nature.com/npp/journal/v32/n6/pdf/1301233a.pdf

      “Therefore, in the present study, antipsychotic exposure could have impaired the production of oligodendrocytes, astrocytes, or microglia in the face of ongoing elimination, thereby reducing glial
      cell number.”

      It’s quite possible that the shrinkage can be reversed, but we still don’t know if the lower glia cell count is the main damage done to the brain.

      So what can you do to support your brain? I don’t know, but some ideas:

      – Taper off slowly
      – Exercise a little bit (30 minute walks are fine)
      – Don’t sit for an extended period of time, walk around more often
      – Move your body in novel ways (sport, learning an instrument, yoga, feldenkrais, …)
      – Stop eating wheat
      – Check your Vitamin B12 and D levels
      – mindfulness meditation

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  7. Seek justice how? I have a job and a family. Losing my anonymity would destroy my life. The fact that this shouldn’t be so doesn’t mean that it isn’t so.

    I hardly expected a fellow victim on this site to be dismissive of someone who just wants to do what he can to try to mitigate the damage done to his brain by the very same drugs we’re all embittered about.

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    • Well you could try tapering off and maybe you’ll feel fine even if your brain is still damaged, or maybe that’s when the movement disorders will show up, as they often do once the neuroleptics are no longer clamping down on the now-damaged dopaminergic system. In any case, the people who prescribe these drugs have profitted, continue to profit, even while forcing these drugs onto millions of children and adults, and lying and/or with holding information to every patient they talk to about them. That just isn’t right. I don’t want to live in a world where that’s right. But if people don’t acknowledge the damage that they have suffered, and continue to realize it, then even acussing psychiatry of doing such a thing sounds ridiculous. If the majority of people continue mistaking “their illness” for psych drug damage they’ve suffered, or find ways to “forgive” and “move on” , then there’s just no hope that any of us will ever recieve justice. I am bothered every day by the fact that the psychiatrists who messed me up as a child are out there making upper class money and living upper class lives, while I have to live like an invalid even though I’m the only person in my large family to have a “mental illness”…
      so much for blaming genetics.

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  9. My psychiatrist once said to me, “Julie, I INSIST that you take an antipsychotic drug. I am giving you this pill to shut you up.” Those were her words. Literally. I fired her.

    I decided NOT to take her drugs. I will not shut up about the abuse Mass General did to me while I was inpatient on the medical floor there and on the psychiatric floor while being treated for my eating disorder in 2011. They then lied about the abuse to my outpatient psychiatrist, who also practiced at the same hospital until recently. The hospital is attempting to cover it up completely and is insisting that I am lying and am delusional.

    All my friends turned against me. How could this big major hospital possibly be wrong? But they were and they know it. They are dying to shut me up in any way possible, so they told Dr. P to drug me. Hospitalize me. Do anything. One day, she yelled at me nonstop and told me the hospital was denying me admission into their brand-new eating disorders program due to my “big mouth.” Still, I would not take her drugs and I would not shut up. I have fired her. Goodbye, traitor.

    I no longer have any signs of Tardive Dyskinesia. I no longer speak with slurred speech. I no longer appear “out of it” or “drugged” or “slow.” I am very happy about this. I think most of the brain damage I have is from malnutrition from anorexia nervosa more than from the antipsychotics. But certainly not from LACK of antipsychotics as those docs now claim.

    Julie

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  10. I just read this article from Science: Changing brains: why neuroscience is ending the Prozac era. http://www.theguardian.com/science/2013/sep/22/brains-neuroscience-prozac-psychiatric-drugs

    It talks about what will perhaps be the next trend in psychiatry too. It’s about the new circuit based thinking of brain. Instead of causing changes in receptors all over the body and brain, perhaps it’s better to affect specific circuits in brain, or so the thinking goes.

    “Big money has already been committed. The Obama White House has promised $3bn to develop technology to help identify brain circuits, while the National Institute of Mental Health has promised to move its seven-figure funding away from research into conditions such as schizophrenia and depression towards a system that looks at how brain networks contribute to difficulties that are shared across diagnoses. This project, given the unspectacular name Research Domain Criteria or the RDoC Project, is being cited as an eventual replacement for the diagnostic system used by current-day psychiatrists.”

    Insel has clearly been promoting this RDoC program of NIMH. His famous criticism of DSM-5 just before the release promoted explicitly their own RDoC. Now here’s an idea. He has figured out that the criticism of current drugs (our “Whitaker empire”, etc) may actually be used to promote their RDoC program.

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